Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich, Munich, Germany.
Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich, Munich, Germany.
J Shoulder Elbow Surg. 2020 Sep;29(9):1892-1900. doi: 10.1016/j.jse.2020.01.078. Epub 2020 Apr 13.
The aim of this study was to investigate the influence of autologous bursal tissue derived from the Achilles bursa on tendon-to-bone healing after rotator cuff tear repair in a rat model.
A total of 136 Sprague-Dawley rats were randomly assigned to either an untreated or a bursal tissue application group or biomechanical testing and histologic testing after rotator cuff repair. After separating the supraspinatus tendon close to the greater tuberosity, the tendon was reattached either unaltered or with a bursal tissue interposition sewn onto the interface. Immunohistologic analysis was performed 1 and 7 weeks after supraspinatus tendon reinsertion. Biomechanical testing of the tendon occurred 6 and 7 weeks after reinsertion.
Immunohistologic results demonstrated a significantly higher percentage of Type II collagen (P = .04) after 1 and 7 weeks in the tendon-to-bone interface using autologous bursal tissue in comparison to control specimens. The bursa group showed a significantly higher collagen I to III quotient (P = .03) at 1 week after surgery in comparison to the 7-week postsurgery bursa groups and controls. Biomechanical assessment showed that overall tendon stiffness (P = .002) and the tendon viscoelasticity in the bursa group (P = .003) was significantly improved after 6 and 7 weeks. There was no significant difference (P = .55) in force to failure between the bursa group and the control group after 6 and 7 weeks.
Autologous bursal tissue derived from the Achilles bursa and implanted to the tendon-to-bone interface after rotator cuff repair facilitates a faster healing response to re-establish the biologic and biomechanical integrity of the rotator cuff in rats.
本研究旨在探讨取自跟腱滑囊的自体滑囊组织对大鼠肩袖撕裂修复后腱骨愈合的影响。
共 136 只 Sprague-Dawley 大鼠随机分为未处理组、滑囊组织应用组或肩袖修复后行生物力学测试和组织学测试组。在分离靠近大结节的冈上肌腱后，将肌腱重新附着于界面上，或者用滑囊组织插入物缝合。在冈上肌腱重新插入后 1 周和 7 周进行免疫组织化学分析。在重新插入后 6 周和 7 周进行肌腱的生物力学测试。
免疫组织化学结果显示，与对照组相比，在冈上肌腱-骨界面使用自体滑囊组织后，1 周和 7 周时 II 型胶原的百分比明显更高（P =.04）。与术后 7 周的滑囊组和对照组相比，滑囊组术后 1 周时胶原 I 与 III 比值明显更高（P =.03）。生物力学评估显示，与对照组相比，滑囊组的肌腱整体刚度（P =.002）和滑囊组的肌腱粘弹性（P =.003）在 6 周和 7 周后均显著提高。在 6 周和 7 周时，滑囊组和对照组之间的失效力无显著差异（P =.55）。
取自跟腱滑囊的自体滑囊组织，在肩袖修复后植入腱骨界面，可促进更快的愈合反应，从而恢复大鼠肩袖的生物学和生物力学完整性。
