McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
Orthofix Inc., Lewisville, TX, USA.
J Biomech. 2019 May 9;88:194-200. doi: 10.1016/j.jbiomech.2019.03.029. Epub 2019 Mar 27.
The Achilles tendon, while the strongest and largest tendon in the body, is frequently injured. Inconclusive evidence exists regarding treatment strategies for both complete tears and partial tears. Well-characterized animal models of tendon injury are important for understanding physiological processes of tendon repair and testing potential therapeutics. Utilizing three distinct models of rat Achilles tendon injury, the objective of this study was to define and compare the effects and relative impact on tendon properties and ankle function of both tear severity (complete tear versus partial tear, both with post-operative immobilization) and immobilization after partial tear (partial tear with versus without immobilization). We hypothesized that a complete tear would cause inferior post-injury properties compared to a partial tear, and that immediate loading after partial tear would improve post-injury properties compared to immobilization. All models were reproducible and had distinct effects on measured parameters. Injury severity drastically influenced tendon healing, with complete tear causing decreased ankle mobility and tendon mechanics compared to partial tears. One week of plantarflexion immobilization had a strong effect on animals receiving a partial tear. Tendons with partial tears and immobilization failed early during fatigue cycling three weeks post-injury. Partial tear without immobilization had no effect on ankle range of motion through dorsiflexion at any time point compared to the pre-surgery value, while partial tear with immobilization demonstrated diminished function at all post-injury time points. All three models of Achilles injury could be useful for tendon healing investigations, chosen based on the prospective applications of a potential therapeutic.
跟腱是人体最强壮、最大的肌腱,但经常受伤。对于完全撕裂和部分撕裂的治疗策略,目前还没有确凿的证据。具有良好特征的肌腱损伤动物模型对于理解肌腱修复的生理过程和测试潜在治疗方法非常重要。本研究利用三种不同的大鼠跟腱损伤模型,旨在定义和比较撕裂严重程度(完全撕裂与部分撕裂,均行术后固定)和部分撕裂后固定(部分撕裂伴或不伴固定)对跟腱特性和踝关节功能的影响及其相对影响。我们假设完全撕裂会导致损伤后特性比部分撕裂差,并且部分撕裂后即刻负重会改善损伤后特性比固定好。所有模型都是可重复的,并且对测量参数有明显的影响。损伤严重程度对肌腱愈合有很大影响,完全撕裂导致踝关节活动度和跟腱力学明显低于部分撕裂。部分撕裂后一周的跖屈固定对接受部分撕裂的动物有很大影响。部分撕裂伴固定的肌腱在损伤后 3 周的疲劳循环中很早就失效了。与术前值相比,部分撕裂而不固定在任何时间点都不会影响背屈时的踝关节活动范围,而部分撕裂伴固定在所有损伤后时间点都表现出功能减退。所有三种跟腱损伤模型都可用于肌腱愈合研究,可根据潜在治疗方法的预期应用来选择。