Cheon Sang-Jin, Kim Jung-Han, Gwak Heui-Chul, Kim Chang-Wan, Kim Jeon-Kyo, Park Ji-Hwan
Department of Orthopedic Surgery, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Republic of Korea.
Department of Orthopedic Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
J Shoulder Elbow Surg. 2017 May;26(5):838-845. doi: 10.1016/j.jse.2016.10.005. Epub 2017 Jan 12.
The purpose of this study was to compare histologic healing and biomechanical characteristics between 2 repair techniques (layer by layer, repair of each layer to bone separately; and whole layer, repair of each layer to the bone en masse) for delaminated rotator cuff tear.
Rabbits were used as subjects and classified into 2 groups: group A, right side, the layer-by-layer repair group; and group B, left side, the whole-layer repair group. Histologic evaluations were done at 3 weeks (n = 7) and 6 weeks (n = 4) after operation. Biomechanical tests to evaluate the tensile property were done at time 0 (n = 5) and 3 weeks (n = 5) after operation.
Histologic healing improved in all groups. A smaller cleft was found between layers in group B compared with the cleft in group A at 3 weeks after operation. At time 0, group A showed a higher yield load and ultimate failure load (67 ± 10.5 N and 80 ± 7.8 N, respectively). However, at 3 weeks after operation, group B showed a higher yield load (48 ± 7.6 N).
In the delaminated rotator cuff tear model in the rabbit, the whole-layer repair showed a narrow gap between layers and a higher yield load at 3 weeks after operation. Surgical techniques that unite the cleft in a delaminated tear could improve biomechanical strength after operation.
本研究的目的是比较分层肩袖撕裂的两种修复技术(逐层,每层分别修复至骨;和全层,每层整体修复至骨)之间的组织学愈合和生物力学特性。
以兔为研究对象,分为2组:A组,右侧,逐层修复组;B组,左侧,全层修复组。术后3周(n = 7)和6周(n = 4)进行组织学评估。术后0周(n = 5)和3周(n = 5)进行生物力学测试以评估拉伸性能。
所有组的组织学愈合均有所改善。术后3周,B组各层之间的裂隙比A组小。在0周时,A组的屈服载荷和极限破坏载荷较高(分别为67±10.5 N和80±7.8 N)。然而,术后3周,B组的屈服载荷较高(48±7.6 N)。
在兔分层肩袖撕裂模型中,全层修复在术后3周时各层之间的间隙较窄,屈服载荷较高。将分层撕裂中的裂隙联合起来的手术技术可以提高术后的生物力学强度。