Department of Orthopaedic Surgery, Duke University Medical Center, Duke Sports Sciences Institute, Durham, North Carolina, USA.
Orthopaedic Associates of Lancaster, Lancaster, Pennsylvania, USA.
Am J Sports Med. 2021 Nov;49(13):3680-3686. doi: 10.1177/03635465211049434. Epub 2021 Oct 15.
Biologic augmentation via extracellular matrix (ECM) scaffolds has been utilized to address rotator cuff tears with poor-quality tissue.
To evaluate the cellular changes in graft explants taken from patients treated with porcine dermal grafts for rotator cuff tears.
Case series; Level of evidence, 4.
Four graft biopsy specimens were obtained from patients treated with porcine dermal grafts in an interposition technique for rotator cuff tears and compared with a nonimplanted graft and a normal rotator cuff specimen. Biopsy of the graft site was performed at 18 days, 3 months, 7 months, and 10.5 months after implantation. Hematoxylin and eosin staining was used to evaluate for cellular and vascular changes. Picrosirius red (PSR) stain with 90° polarized light was performed to evaluate collagen fibril size and orientation. All biopsy specimens were analyzed by a pathologist.
There was evidence of progressive remodeling of the porcine dermal grafts. The most mature grafts demonstrated vessel infiltration and extensive remodeling without evidence of inflammation, foreign body reaction, or tissue rejection. PSR demonstrated increased organization of collagen domains, resembling normal tendon by 10.5 months postoperatively.
This series suggests that ECM grafts may serve as an effective scaffold for host cell infiltration, collagen reorganization, and vascularization as a result of histologic changes demonstrated with retrieval of specimens from patients with rotator cuff tears that were augmented with porcine dermal grafts.
生物增强通过细胞外基质（ECM）支架已被用于解决质量差的肩袖撕裂组织。
评估取自接受猪皮移植物治疗肩袖撕裂患者的移植物标本中的细胞变化。
病例系列；证据水平，4 级。
从接受猪皮移植物间隔技术治疗肩袖撕裂的患者中获得了 4 个移植物活检标本，并与未植入的移植物和正常肩袖标本进行了比较。在植入后 18 天、3 个月、7 个月和 10.5 个月时进行了移植物部位的活检。苏木精和伊红染色用于评估细胞和血管变化。用 90°偏振光进行苦味酸天狼星红（PSR）染色，以评估胶原纤维束的大小和取向。所有活检标本均由病理学家进行分析。
猪皮移植物的进行性重塑有证据。最成熟的移植物表现出血管浸润和广泛的重塑，没有炎症、异物反应或组织排斥的证据。PSR 显示胶原域的组织增加，术后 10.5 个月类似于正常肌腱。
本系列研究表明，ECM 移植物可作为宿主细胞浸润、胶原重排和血管化的有效支架，这是通过从接受猪皮移植物增强的肩袖撕裂患者的标本中获得的组织学变化来证明的。
