肩峰下囊保留术可增强肩袖肌腱再生：一项比较大鼠冈上肌腱缺损模型的研究。
Subacromial bursal preservation can enhance rotator cuff tendon regeneration: a comparative rat supraspinatus tendon defect model study.
机构信息
Department of Hand Surgery, Affiliated Hospital of Nantong University, College of Medicine, University of Nantong, Nantong, China; Department of Orthopedic Surgery, ASAN Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
Department of Orthopedic Surgery, ASAN Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea.
出版信息
J Shoulder Elbow Surg. 2021 Feb;30(2):401-407. doi: 10.1016/j.jse.2020.05.025. Epub 2020 Jun 12.
BACKGROUND
The role of subacromial bursa in rotator cuff surgery is unknown. This study aimed to assess the subacromial bursa's role in the healing of supraspinatus tendon injury in a rat model.
METHODS
Twenty-three male Sprague-Dawley rats (9 weeks old; weight, approximately 296 g) were used in this study. Three rats used as biomechanical study controls were killed at 12 weeks of age. A supraspinatus tendon defect was made bilaterally in 20 rats, whereas an additional subacromial bursa sectioning was performed on the left side. Six rats were killed for biomechanical testing and 4 were killed for histologic observation at 3 and 9 weeks, respectively.
RESULTS
The regenerated tendon in the bursal preservation group showed significantly superior biomechanical properties in maximum load to failure at 3 and 9 weeks and stiffness at 9 weeks after surgery compared with the bursal removal group. The modified Bonar scale scores showed better regenerated supraspinatus tendons in the bursal preservation group.
CONCLUSION
The present study found that the subacromial bursa plays an important role in rotator cuff regeneration in this rat supraspinatus injury model. Extensive bursectomy of the subacromial bursa may not be recommended in rotator cuff repair surgery, though future in vivo human studies are needed to confirm these observations.
背景
肩峰下滑囊在肩袖手术中的作用尚不清楚。本研究旨在评估肩峰下滑囊在大鼠模型中对冈上肌腱损伤愈合的作用。
方法
本研究使用了 23 只雄性 Sprague-Dawley 大鼠（9 周龄；体重约 296g）。其中 3 只作为生物力学研究对照在 12 周龄时处死。20 只大鼠双侧冈上肌腱均有缺陷，而左侧同时进行肩峰下滑囊切开术。6 只大鼠用于生物力学测试，4 只大鼠分别在术后 3 周和 9 周时用于组织学观察。
结果
与肩峰下滑囊切除组相比，肩峰下滑囊保留组在术后 3 周和 9 周时的最大失效负荷和刚度，以及术后 9 周时的再生肌腱具有明显更好的生物力学性能。改良的 Bonar 评分显示肩峰下滑囊保留组的再生冈上肌腱更好。
结论
本研究发现，在大鼠冈上肌腱损伤模型中，肩峰下滑囊在肩袖再生中起着重要作用。在肩袖修复手术中，广泛切除肩峰下滑囊可能并不推荐，尽管需要进一步的体内人类研究来证实这些观察结果。
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