Department of Sports Medicine & Research Centre of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China.
Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, China.
Am J Sports Med. 2021 Jul;49(8):2064-2073. doi: 10.1177/03635465211011751. Epub 2021 May 14.
Injuries at the bone-tendon interface (BTI) are common findings in clinical practice. Rehabilitation procedures after BTI surgery are important but are controversial.
To investigate the effects of different exercise intensities on BTI healing by means of an established mouse rotator cuff injury model.
Controlled laboratory study.
A total of 150 specific pathogen free male C57BL/6 mice, with supraspinatus insertion injury, were randomly assigned to 1 of 5 groups according to postoperative rehabilitation of different exercise intensities: (1) control group, (2) low-intensity exercise group, (3) moderate-intensity exercise group, (4) high-intensity exercise group, and (5) increasing-intensity exercise group (IG). The specimens were harvested 4 or 8 weeks postoperatively for microarchitectural, histological, molecular biological, and mechanical evaluations.
Histological test results showed that the degrees of tissue fusion and polysaccharide protein distribution at the healing interface at 4 and 8 weeks after surgery were significantly better in the IG than in the other 4 groups. Synchrotron radiation micro-computed tomography showed that the quantity of subchondral bone at the enthesis (bone volume/total volume fraction, trabecular thickness, trabecular number) was higher and trabecular separation was lower in the IG than in the other 4 groups. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) analysis revealed that the healing interface in the IG expressed more transcription factors, such as , and , than the interfaces in the other groups. Although no significant difference was seen in the cross-sectional area between the groups at postoperative weeks 4 and 8 ( > .05), the tensile load, ultimate strength, and stiffness of the specimens in the IG were significantly better than those in the other 4 groups ( < .05).
The rehabilitation program with increasing-intensity exercise was beneficial for BTI healing.
The results of this study provide evidence supporting the use of a simple and progressive exercise rehabilitation program after rotator cuff surgery.
在临床实践中，骨-肌腱界面（BTI）的损伤是常见的发现。BTI 手术后的康复程序很重要，但存在争议。
通过建立的小鼠肩袖损伤模型，研究不同运动强度对 BTI 愈合的影响。
对照实验室研究。
共 150 只无特定病原体的雄性 C57BL/6 小鼠，采用冈上肌插入损伤模型，根据术后不同运动强度的康复情况随机分为 5 组：（1）对照组，（2）低强度运动组，（3）中强度运动组，（4）高强度运动组和（5）递增强度运动组（IG）。术后 4 周和 8 周分别对标本进行微观结构、组织学、分子生物学和力学评估。
组织学测试结果显示，IG 组在术后 4 周和 8 周时，愈合界面处组织融合程度和多糖蛋白分布程度明显优于其他 4 组。同步辐射微计算机断层扫描显示，IG 组的结合处（骨体积/总体积分数、小梁厚度、小梁数量）的软骨下骨量较高，小梁分离度较低。定量逆转录聚合酶链反应（qRT-PCR）分析显示，IG 组愈合界面表达的转录因子如 、 等比其他组更多。尽管在术后第 4 周和第 8 周时，各组的横截面积没有明显差异（>.05），但 IG 组的标本拉伸载荷、极限强度和刚度明显优于其他 4 组（<.05）。
递增强度的康复方案对 BTI 的愈合有益。
这项研究的结果为肩袖手术后使用简单而渐进的运动康复方案提供了证据。
