Fabis Jaroslaw, Danilewicz Marian, Zwierzchowski Jacek T, Niedzielski Kryspin
Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Medical University of Łódź, Łódź, Poland; FMC Private Medical Centre, Łódź, Poland.
Morphometry Division, Department of Pathology, Medical University of Łódź, Łódź, Poland.
J Shoulder Elbow Surg. 2016 Mar;25(3):487-92. doi: 10.1016/j.jse.2015.08.034. Epub 2015 Nov 6.
Although clinical investigations indicate that the limit of reversibility of rotator cuff muscles fibers type I and II atrophy is grade 2 of fatty degeneration (FD) according to the Goutallier computed tomography classification, little is known about the morphometric verification of these findings.
The supraspinatus tendon was detached from the greater tubercle and the infraspinatus and subscapularis in 12 rabbits, and a 12-week observation period followed. This proved to be sufficient for development of grade >2 FD of the supraspinatus tendon. The tendon was then reinserted. The animals were euthanized 24 weeks after tendon reconstruction. The sections of middle part of supraspinatus were stained for adenosine triphosphatase reaction, and morphometric measurements were taken of type I and II muscle fiber diameters. The contralateral shoulders served as controls.
The macroscopic inspection of the supraspinatus tendons revealed complete healing in all cases. No statistically significant differences were found between controls and operated-on shoulders for type I (P = .13) and type II (P = .55) muscle fibers.
Atrophy of type I and II muscle fibers in rabbit supraspinatus muscle, characterized by grade >2 fatty degeneration according to the Goutallier computed tomography classification, is reversible after 24 weeks from reattachment of its tendon. A requirement for type I and II muscle fibers hypertrophy is a change in the biomechanical and functional conditions of the muscle after its tendon is reconstructed.
尽管临床研究表明,根据古塔利耶计算机断层扫描分类,肩袖肌I型和II型纤维萎缩的可逆极限为脂肪变性(FD)2级,但对这些发现的形态学验证知之甚少。
在12只兔子身上,将冈上肌腱从大结节、冈下肌和肩胛下肌处切断,随后进行为期12周的观察期。结果证明这足以使冈上肌腱出现>2级的脂肪变性。然后将肌腱重新缝合。肌腱重建24周后对动物实施安乐死。对冈上肌中部切片进行三磷酸腺苷酶反应染色,并对I型和II型肌纤维直径进行形态学测量。对侧肩部作为对照。
对冈上肌腱的宏观检查显示所有病例均完全愈合。I型(P = 0.13)和II型(P = 0.55)肌纤维在对照组和手术侧肩部之间未发现统计学上的显著差异。
根据古塔利耶计算机断层扫描分类,以>2级脂肪变性为特征的兔冈上肌I型和II型肌纤维萎缩,在其肌腱重新附着24周后是可逆的。I型和II型肌纤维肥大的一个必要条件是肌腱重建后肌肉的生物力学和功能状况发生改变。