Beach Zakary M, Tucker Jennica J, Thomas Stephen J, Reuther Katherine E, Gray Chancellor F, Lee Chang-Soo, Glaser David L, Soslowsky Louis J
McKay Orthopaedic Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
McKay Orthopaedic Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
J Biomech. 2017 Oct 3;63:151-157. doi: 10.1016/j.jbiomech.2017.08.021. Epub 2017 Aug 26.
A rotator cuff tear is a common injury in athletes and workers who repeatedly perform overhead movements, and it is not uncommon for this demographic to return to activity shortly after treatment. A biceps tenotomy is often performed in the presence of a rotator cuff tear to help reduce pain and improve joint function. However, the effect of this procedure on the surrounding tissues in the glenohumeral joint is unknown. Therefore, the purpose of this study was to investigate the effect of a biceps tenotomy in the presence of a supraspinatus rotator cuff tear followed by overuse activity on ambulatory function and mechanical and histologic properties of the remaining rotator cuff tendons and glenoid cartilage. 46 rats underwent 4weeks of overuse activity to create a tendinopathic condition, then were randomized into two groups: unilateral detachment of the supraspinatus tendon or detachment of the supraspinatus and long head of the biceps tendons. Ambulatory measurements were performed throughout the 8weeks prior to euthanasia, followed by analysis of the properties of the remaining intact tendons and glenoid cartilage. Results demonstrate that shoulder function was not effected in the biceps tenotomy group. However, the intact tendons and glenoid cartilage showed altered mechanical and histologic properties. This study provides evidence from an animal model that does not support the use of tenotomy in the presence of a supraspinatus tendon rotator cuff tear, and provides a framework for physicians to better prescribe long-term treatment strategies for patients.
肩袖撕裂是反复进行过顶动作的运动员和工人常见的损伤,这类人群在治疗后不久恢复活动并不罕见。在存在肩袖撕裂的情况下,常进行肱二头肌切断术以帮助减轻疼痛并改善关节功能。然而,该手术对盂肱关节周围组织的影响尚不清楚。因此,本研究的目的是调查在存在冈上肌肩袖撕裂并伴有过度使用活动的情况下,肱二头肌切断术对动态功能以及剩余肩袖肌腱和盂肱软骨的力学和组织学特性的影响。46只大鼠进行了4周的过度使用活动以造成肌腱病状态,然后被随机分为两组:冈上肌腱单侧离断或冈上肌腱和肱二头肌长头离断。在安乐死之前的整个8周内进行动态测量,随后分析剩余完整肌腱和盂肱软骨的特性。结果表明,肱二头肌切断术组的肩部功能未受影响。然而,完整的肌腱和盂肱软骨显示出力学和组织学特性的改变。本研究从动物模型提供了证据,不支持在存在冈上肌腱肩袖撕裂时使用切断术,并为医生更好地为患者制定长期治疗策略提供了框架。