Department of Orthopaedics and Traumatology, Corlu State Hospital, Tekirdağ, Turkey,
Department of Orthopaedics and Traumatology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Med Princ Pract. 2020;29(2):174-180. doi: 10.1159/000503086. Epub 2019 Sep 4.
The objective of this study was to evaluate the efficacy of subacromial injections of collagenase and corticosteroid in rats with experimentally induced adhesive capsulitis.
Thirty adult Wistar albino male rats were distributed into 3 groups of 10 rats each after stabilization of their shoulders for 3 weeks: the first group received a single dose of 0.002 mg (0.25 mL) subacromial collagenase; the second group received a single dose of 1.60 mg (0.25 mL) subacromial steroid, and the third group received a single dose of 0.25 mL subacromial saline solution. One week later, we investigated shoulder range of motions, collagen content of the shoulder, and joint cartilage structure.
There was no statistically significant difference in the cartilage damage between the groups (p > 0.05). Fibrosis measurements were significantly lower in the collagenase group than in the steroid and saline groups. There was no significant difference in fibrosis between the steroid and saline groups (p > 0.05). Abduction measurements were significantly higher in the collagenase group than in the steroid and saline groups (p < 0.001). No significant difference in the abduction measurements was observed between the saline and steroid groups (p > 0.05).
We observed that subacromial injections of collagenase Clostridium histolyticum effectively treated adhesive capsulitis. The results suggest that this treatment could be considered for use in patients with an intact rotator cuff.
本研究旨在评估在实验性粘连性肩关节囊炎大鼠模型中，肩峰下注射胶原酶和皮质类固醇的疗效。
30 只成年 Wistar 白化雄性大鼠在肩部稳定 3 周后，分为 3 组，每组 10 只：第一组接受单次 0.002mg（0.25mL）肩峰下胶原酶注射；第二组接受单次 1.60mg（0.25mL）肩峰下皮质类固醇注射；第三组接受单次 0.25mL 肩峰下生理盐水注射。1 周后，我们评估了肩部活动范围、肩部胶原含量和关节软骨结构。
各组间软骨损伤无统计学差异（p＞0.05）。胶原酶组的纤维化测量值明显低于皮质类固醇组和生理盐水组。皮质类固醇组和生理盐水组之间的纤维化无显著差异（p＞0.05）。胶原酶组的外展测量值明显高于皮质类固醇组和生理盐水组（p＜0.001）。生理盐水组和皮质类固醇组之间的外展测量值无显著差异（p＞0.05）。
我们观察到肩峰下注射胶原酶 Clostridium histolyticum 可有效治疗粘连性肩关节囊炎。结果提示，这种治疗方法可考虑用于肩袖完整的患者。
