Lopiz Y, Arvinius C, García-Fernández C, Rodriguez-Bobada M C, González-López P, Civantos A, Marco F
Unidad de Cirugía de Hombro y Codo, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico San Carlos, Madrid, España.
Unidad de Cirugía de Hombro y Codo, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico San Carlos, Madrid, España.
Rev Esp Cir Ortop Traumatol. 2017 Jan-Feb;61(1):51-62. doi: 10.1016/j.recot.2016.07.002.
Rotator cuff repairs have shown a high level of re-ruptures. It is hypothesised that the use of rhBMP-2 in a carrier could improve the biomechanical and histological properties of the repair.
Controlled experimental study conducted on 40 rats with section and repair of the supraspinatus tendon and randomisation to one of five groups: Group 1 (control) only suture; Group 2 (double control), suture and alginate-chitin carrier; Group 3 (alginate-control), the rhBMP-2 was added to the alginate; Group 4 (chitin-control) application of the rhBMP-2 to the chitin, and Group 5 (double sample): The two components of the carrier (alginate and chitin) have rhBMP-2. A biomechanical and histological analysis was performed at 4 weeks.
A gap was observed in all cases 4 weeks after supraspinatus detachment. The re-rupture rate was 7.5%, with 20% of them in the control-alginate Group. Histologically the best results were obtained in the double sample group: 4.5 (3.3-5.0). Double sample were also able to support higher loads to failure: 62.9N (59.8 to 69.4) with lower rigidity 12.7 (9.7 to 15.9).
The use of alginate-chitin carrier with rhBMP-2 improves the biomechanical and histological properties of the repair site in a chronic rotator cuff tear.
肩袖修复术显示出较高的再破裂率。据推测，在载体中使用重组人骨形态发生蛋白-2（rhBMP-2）可改善修复的生物力学和组织学特性。
对40只大鼠进行了对照实验研究，切断并修复冈上肌腱，随机分为五组之一：第1组（对照组）仅缝合；第2组（双重对照组），缝合并使用藻酸盐-甲壳素载体；第3组（藻酸盐对照组），将rhBMP-2添加到藻酸盐中；第4组（甲壳素对照组），将rhBMP-2应用于甲壳素；第5组（双样本组）：载体的两种成分（藻酸盐和甲壳素）均含有rhBMP-2。在4周时进行生物力学和组织学分析。
冈上肌 detachment 4周后，所有病例均观察到间隙。再破裂率为7.5%，其中20%发生在对照藻酸盐组。组织学上，双样本组取得了最佳结果：4.5（3.3 - 5.0）。双样本组也能够承受更高的破坏载荷：62.9N（59.8至69.4），且刚度较低，为12.7（9.7至15.9）。
使用含有rhBMP-2的藻酸盐-甲壳素载体可改善慢性肩袖撕裂修复部位的生物力学和组织学特性。
