Fabiś Jarosław, Danilewicz Marian, Niedzielski Kryspin R, Waszczykowski Michał, Fabiś-Strobin Anna, Bogucki Andrzej
Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology Medical University of Lodz, Lodz, Poland.
Morphometry Division, Department of Pathology, Medical University of Lodz, Lodz, Poland.
Arch Med Sci. 2021 Mar 5;17(5):1400-1407. doi: 10.5114/aoms/131956. eCollection 2021.
Full-thickness rotator cuff tear is present in almost 50% of patients over age 65 years, and its degree is known to be a good predictor of the severity of muscle-wasting (MW) sarcopaenia, also known as fatty degeneration (FD). A FD CT grade > 2° is recognized as a borderline of its reversibility. A disuse model of supraspinatus FD (grade 2) in rabbits provides clinically relevant data. Therefore, the present study evaluates the correlation between eccentric mechanotransduction, neuromuscular transmission (NT), and reversibility of muscle fatty infiltration (MFI) in rabbit supraspinatus FD > 2°.
The supraspinatus tendon was detached from the greater tubercle, infraspinatus, and subscapularis in 16 rabbits. The tendon was reinserted after 12 weeks, and the animals were euthanized 24 weeks after reconstruction. MFI was measured in the middle part of the supraspinatus. Single-fibre EMG (SFEMG) examination of the supraspinatus NT was performed on 4 animals.
The power of analysis was 99%. Significant differences in MFI volume were found between the operated (4.6 ±1.1%) and the opposite control sides (2.91 ±0.61%) ( < 0.001). SFEMG revealed no significant differences between the disuse and the control supraspinatus muscles ( > 0.05); however, 6.5% of the examined muscle fibres exhibited NT disorders combined with blockade of conduction in 2.5% of muscle fibres.
Critical MFI in a disuse model of rabbit supraspinatus FD, CT grade > 2°, is substantially reversible by eccentric training despite subclinical impairment of neuromuscular transmission. In addition, 0.63% reversal of MFI is correlated with 1% hypertrophy of type I and II muscle fibre diameter.
在65岁以上的患者中,近50%存在全层肩袖撕裂,其程度是肌肉萎缩性(MW)肌少症(也称为脂肪变性(FD))严重程度的良好预测指标。FD CT分级>2°被认为是其可逆性的界限。兔冈上肌FD(2级)的废用模型提供了临床相关数据。因此,本研究评估了兔冈上肌FD>2°时离心机械转导、神经肌肉传递(NT)与肌肉脂肪浸润(MFI)可逆性之间的相关性。
在16只兔中,将冈上肌腱从大结节、冈下肌和肩胛下肌分离。12周后重新插入肌腱,并在重建后24周对动物实施安乐死。在冈上肌中部测量MFI。对4只动物进行冈上肌NT的单纤维肌电图(SFEMG)检查。
分析效能为99%。手术侧(4.6±1.1%)与对侧对照侧(2.91±0.61%)的MFI体积存在显著差异(<0.001)。SFEMG显示,废用的冈上肌与对照冈上肌之间无显著差异(>0.05);然而,6.5%的受检肌纤维表现出NT障碍,2.5%的肌纤维存在传导阻滞。
在兔冈上肌FD的废用模型中,CT分级>2°时,尽管神经肌肉传递存在亚临床损伤,但通过离心训练,严重的MFI基本可逆。此外,MFI 0.63%的逆转与I型和II型肌纤维直径1%的肥大相关。