Zabrzyński J, Gagat M, Paczesny Ł, Łapaj Ł, Grzanka D
Department of Orthopedic Surgery, Multidisciplinary Hospital, Poznanska street, 97, 88-100 Inowroclaw, Poland.
Folia Morphol (Warsz). 2018;77(2):371-377. doi: 10.5603/FM.a2017.0105. Epub 2017 Nov 13.
The ultrastructural alterations related to tendinopathy have not been well described. Most studies on this subject have been conducted many years ago and focused on material from the Achilles tendon. It was demonstrated that various comorbidities can affect ultrastructural alterations in the advanced tendinopathy; however, there is very little data on ultrastructural morphology in tendinopathies related to mechanical overload as in case of the long head of the biceps brachii tendon (LHBT). The aim was to determine intermediate ultrastructural alterations in middle to severe grade the LHBT tendinopathy and to establish if they are different than those reported in the literature for other anatomical locations.
In this study we examined the ultrastructure of a series of the LHBT fragments arthroscopically removed due to tendinopathy and inve-stigated the morphology of tenocytes and collagen fibres in cases of the LHBT tendinopathy.
In pathological samples tenocytes were randomly scattered, their shape was round and the shape of nuclei was also disrupted. The presence of apoptotic--like features in tenocytes' nuclei was noted. All samples showed replacement of collagen fibrils by non-collagen extracellular matrix and diffuse collagen disorganisation.
It was demonstrated at ultrastructural level that the LHBT tendino-pathy is not simply a wear and tear phenomenon, since chronic degeneration of the extracellular matrix and tenocytes were present, similarly as in tendinopathies, in other anatomical locations. (Folia Morphol 2018; 77, 2: 371-377).
与肌腱病相关的超微结构改变尚未得到充分描述。关于这一主题的大多数研究都是多年前进行的，且主要集中在跟腱材料上。研究表明，多种合并症可影响晚期肌腱病的超微结构改变；然而，对于肱二头肌长头肌腱（LHBT）等与机械性过载相关的肌腱病的超微结构形态，数据非常少。本研究旨在确定中重度LHBT肌腱病的中间超微结构改变，并确定这些改变是否与文献中报道的其他解剖部位的改变不同。
在本研究中，我们检查了一系列因肌腱病而通过关节镜切除的LHBT碎片的超微结构，并研究了LHBT肌腱病病例中肌腱细胞和胶原纤维的形态。
在病理样本中，肌腱细胞随机分布，呈圆形，细胞核形态也被破坏。在肌腱细胞核中发现了类似凋亡的特征。所有样本均显示胶原纤维被非胶原细胞外基质替代，且胶原弥漫性紊乱。
超微结构水平的研究表明，LHBT肌腱病并非简单的磨损现象，因为细胞外基质和肌腱细胞存在慢性退变，这与其他解剖部位的肌腱病类似。（《形态学杂志》2018年；77卷，第2期：371 - 377页）
