Salford Royal NHS Foundation Trust, Salford, UK.
Royal London Hospital, Whitechapel Road, London, E1 1BB, UK.
Bone Joint J. 2016 Oct;98-B(10):1389-1394. doi: 10.1302/0301-620X.98B10.37231.
The aim of this study was to analyse human muscle tissue before and after rotator cuff repair to look for evidence of regeneration, and to characterise the changes seen in the type of muscle fibre.
Patients were assessed pre-operatively and one year post-operatively using the Oxford Shoulder Score (OSS) and MRI. The cross-sectional area and distribution of the type of muscle fibre were assessed on biopsies, which were taken at surgery and one year post-operatively. Paired samples from eight patients were analysed. There were three men and five women with a mean age of 63 years (50 to 73).
All but one patient showed improvement in OSS (p = 0.004). The mean increase in the cross-sectional area of the muscle was 1220 μm (-801 to 3712; p = 0.03). There was a reduction of type 2a fibres (p = 0.02). A clear relationship could not be seen between the MRI findings and the histological appearances.
This is the first study to provide evidence that atrophy of the supraspinatus muscle is reversible. Changes in the types of fibre are discussed. MRI assessment of muscle atrophy may not be fully representative of myofibre atrophy. Cite this article: Bone Joint J 2016;98-B:1389-94.
本研究旨在分析肩袖修复前后的人体肌肉组织,寻找再生的证据,并对肌纤维类型的变化进行特征描述。
患者在术前和术后 1 年使用牛津肩肘评分(OSS)和 MRI 进行评估。在手术和术后 1 年时,通过活检评估横截面积和肌纤维类型的分布。对 8 名患者的 8 对样本进行了分析。其中男性 3 名,女性 5 名,平均年龄 63 岁(50-73 岁)。
除 1 例患者外,所有患者的 OSS 均有改善(p=0.004)。肌肉横截面积的平均增加量为 1220μm(-801 至 3712;p=0.03)。2a 型纤维减少(p=0.02)。MRI 结果与组织学表现之间没有明显的关系。
这是第一项提供证据表明肩袖上肌萎缩是可逆的研究。讨论了纤维类型的变化。MRI 评估肌肉萎缩可能不能完全代表肌纤维萎缩。