Freislederer Florian, Dittrich Michael, Scheibel Markus
Department of Shoulder and Elbow Surgery, Schulthess Klinik, Zurich, Switzerland.
Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
Arthrosc Tech. 2019 Jul 4;8(7):e741-e747. doi: 10.1016/j.eats.2019.03.010. eCollection 2019 Jul.
Rotator cuff tears can be associated with significant shoulder dysfunction and pain. Despite improved surgical techniques and new materials for rotator cuff reconstruction, there is no significant reduction in the re-rupture rate. Innovative approaches for enhanced tendon healing are required. The potential of biologically optimized tendon integration has probably been insufficiently explored so far. The existing practice of debridement might eliminate repair tissue and a major source of cells and blood vessels necessary for tendon healing. Biological augmentation may be an option to improve the healing process. The subacromial bursa is a highly proliferative tissue with mesenchymal stem cells capable of differentiating into various cell lines and is easily accessible during rotator cuff repair. We describe the technique of bursal augmentation in arthroscopic double-row SutureBridge repair of a posterosuperior rotator cuff tear with the aim of improving tendon-to-bone healing.
肩袖撕裂可伴有严重的肩部功能障碍和疼痛。尽管肩袖重建的手术技术有所改进,且出现了新材料,但再破裂率并未显著降低。需要创新方法来促进肌腱愈合。迄今为止,生物优化肌腱整合的潜力可能尚未得到充分探索。现有的清创做法可能会清除修复组织以及肌腱愈合所需的主要细胞和血管来源。生物增强可能是改善愈合过程的一种选择。肩峰下滑囊是一种高度增殖性组织,含有能够分化为各种细胞系的间充质干细胞,并且在肩袖修复过程中易于触及。我们描述了在关节镜下双排缝线桥修复后上肩袖撕裂时进行滑囊增强的技术,目的是改善肌腱与骨的愈合。