Department of Sports Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China.
Biomed Res Int. 2019 Apr 3;2019:9346567. doi: 10.1155/2019/9346567. eCollection 2019.
Repairs of large to massive rotator cuff tears have a high failure rate. We investigated the efficacy of a novel, reinforced, low immunogenic, porcine small intestine submucosa (SIS) patch to repair a supraspinatus tendon defect in a rabbit model. We hypothesized that the histological and biomechanical results of SIS patch repair would be comparable with those of autologous fascia lata (FL) repair.
The study mainly comprised two parts. First, the characteristics of the SIS patch were evaluated, including its micromorphology, mechanical properties, and immunogenic properties. Second, a supraspinatus tendon defect model was created in 36 rabbits (72 shoulders). The bilateral shoulders were randomly chosen to undergo repair using either a SIS patch (SIS group) or autologous FL (FL group). At 4, 8, and 12 weeks, histological analysis was performed using four shoulders from each group, and biomechanical tests were performed using eight shoulders from each group.
The SIS patch was a three-dimensional construct mainly composed of collagen fibers. The mean single and double suture retention loads of the SIS patch were 48.6 ± 5.8 N and 117.9 ± 2.7 N, respectively. The DNA content in the SIS patch was 53.9 ± 10.9 ng/mg dry weight. Both the histological score and ultimate load to failure increased in a time-dependent manner in both groups, with no significant differences between the SIS and FL groups at 12 weeks.
Repair of a large supraspinatus tendon defect using a reinforced, low immunogenic, SIS patch achieves similar effects as autologous FL in a rabbit model. This novel patch might be useful to be employed as a structural tissue replacement in medical activities.
修复大到巨大肩袖撕裂的成功率很高。我们研究了一种新型的、增强的、低免疫原性的猪小肠黏膜下层（SIS）补片修复兔模型肩袖上回旋肌腱缺损的疗效。我们假设 SIS 补片修复的组织学和生物力学结果将与自体阔筋膜（FL）修复相当。
本研究主要包括两部分。首先，评估 SIS 补片的特性，包括其微观形态、力学性能和免疫原性。其次，在 36 只兔子（72 只肩）中创建肩袖上回旋肌腱缺损模型。双侧肩随机选择使用 SIS 补片（SIS 组）或自体 FL（FL 组）进行修复。在 4、8 和 12 周时，每组各取 4 只肩进行组织学分析，每组各取 8 只肩进行生物力学测试。
SIS 补片是一种主要由胶原纤维组成的三维结构。SIS 补片的单缝线和双缝线保持力平均值分别为 48.6±5.8 N 和 117.9±2.7 N。SIS 补片的 DNA 含量为 53.9±10.9 ng/mg 干重。两组的组织学评分和最终失效负荷均随时间呈依赖性增加，12 周时 SIS 组与 FL 组之间无显著差异。
在兔模型中，使用增强型、低免疫原性的 SIS 补片修复大的肩袖上回旋肌腱缺损可获得与自体 FL 相似的效果。这种新型补片可能在医疗活动中作为结构组织替代物有用。
