McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
J Biomech. 2021 Mar 5;117:110249. doi: 10.1016/j.jbiomech.2021.110249. Epub 2021 Jan 13.
Rotator cuff tendon tears and tendinopathies are common injuries affecting a large portion of the population and can result in pain and joint dysfunction. Incidence of rotator cuff tears significantly increases with advancing age, and up to 90% of these tears involve the supraspinatus. Previous literature has shown that aging can lead to inferior mechanics, altered composition, and changes in structural properties of the supraspinatus. However, there is little known about changes in supraspinatus mechanical properties in context of other rotator cuff tendons. Alterations in tendon mechanical properties may indicate damage and an increased risk of rupture, and thus, the purpose of this study was to use a rat model to define age-related alterations in rotator cuff tendon mechanics to determine why the supraspinatus is more susceptible to tears due to aging than the infraspinatus, subscapularis, and teres minor. Fatigue, viscoelastic, and quasi-static properties were evaluated in juvenile, adult, aged, and geriatric rats. Aging ubiquitously and adversely affected all rotator cuff tendons tested, particularly leading to increased stiffness, decreased stress relaxation, and decreased fatigue secant and tangent moduli in geriatric animals, suggesting a common intrinsic mechanism due to aging in all rotator cuff tendons. This study demonstrates that aging has a significant effect on rotator cuff tendon mechanical properties, though the supraspinatus was not preferentially affected. Thus, we are unable to attribute the aging-associated increase in supraspinatus tears to its mechanical response alone.
肩袖肌腱撕裂和肌腱病是常见的损伤,影响着很大一部分人群,并可能导致疼痛和关节功能障碍。肩袖撕裂的发病率随着年龄的增长显著增加,高达 90%的撕裂涉及冈上肌。先前的文献表明,衰老会导致冈上肌力学性能下降、组成改变和结构特性变化。然而,关于冈上肌机械性能在其他肩袖肌腱中的变化知之甚少。肌腱机械性能的改变可能表明存在损伤和增加破裂的风险,因此,本研究旨在使用大鼠模型来确定与年龄相关的肩袖肌腱力学变化,以解释为什么冈上肌比冈下肌、肩胛下肌和小圆肌更容易因衰老而撕裂。评估了幼年、成年、老年和老年大鼠的肩袖肌腱的疲劳、黏弹和准静态特性。衰老普遍且不利地影响了所有测试的肩袖肌腱,特别是导致老年动物的刚度增加、应力松弛减少以及疲劳割线和切线模量减少,这表明所有肩袖肌腱由于衰老而存在共同的内在机制。本研究表明,衰老对肩袖肌腱的力学性能有显著影响,但冈上肌并未受到优先影响。因此,我们不能仅将与年龄相关的冈上肌撕裂增加归因于其机械反应。