Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, and Veterans Affairs Palo Alto Health Care System, Palo Alto, CA.
Department of Orthopedic Surgery, Stanford University School of Medicine, Redwood City, CA.
J Hand Surg Am. 2024 Jun;49(6):612.e1-612.e9. doi: 10.1016/j.jhsa.2022.08.027. Epub 2022 Oct 22.
Partial rotator cuff tears can cause shoulder pain and dysfunction and are more common than complete tears. However, few studies examine partial injuries in small animals and, therefore a robust, clinically relevant model may be lacking. This study aimed to fully characterize the established rat model of partial rotator cuff injury over time and determine if it models human partial rotator cuff tears.
We created a full-thickness, partial-width injury at the supraspinatus tendon-bone interface bilaterally in 31 Sprague-Dawley rats. Rats were euthanized immediately, and at 2-, 3-, 4-, and 8-weeks after surgery. Fourteen intact shoulders were used as controls. Samples were assessed biomechanically, histologically, and morphologically.
Biomechanically, load to failure in controls and 8 weeks after injury was significantly greater than immediately and 3 weeks after injury. Load to failure at 8 weeks was comparable to control. However, the locations of failure were different between intact shoulders and partially injured samples. Bone mineral density at 8 weeks was significantly greater than that at 2 and 3 weeks. Although no animals demonstrated propagation to complete tear and the injury site remodeled histologically, the appearance at 8 weeks was not identical to that in the controls.
The biomechanical properties and bone quality decreased after the injury and was restored gradually over time with full restoration by 8 weeks after injury. However, the findings were not equivalent to the intact shoulder. This study demonstrated the limitations of the current model in its application to long-term outcome studies, and the need for better models that can be used to assess chronic partial rotator cuff injuries.
There is no small animal model that mimics human chronic partial rotator cuff tears, which limits our ability to improve care for this common condition.
部分肩袖撕裂可引起肩部疼痛和功能障碍,比完全撕裂更为常见。然而,很少有研究探讨小动物的部分损伤,因此可能缺乏稳健、与临床相关的模型。本研究旨在随着时间的推移全面描述已建立的大鼠部分肩袖损伤模型,并确定其是否模拟人类部分肩袖撕裂。
我们在 31 只 Sprague-Dawley 大鼠双侧的冈上肌腱-骨界面处创建了全层、部分宽度的损伤。大鼠立即处死,并在手术后 2、3、4 和 8 周时进行尸检。14 个完整的肩部用作对照。对标本进行生物力学、组织学和形态学评估。
生物力学方面,对照组和损伤后 8 周的失效负荷明显大于损伤后即刻和 3 周时。8 周时的失效负荷与对照组相当。然而,完整肩部和部分损伤样本的失效位置不同。8 周时的骨密度明显大于 2 周和 3 周时。尽管没有动物出现完全撕裂的扩展,且损伤部位在组织学上进行了改建,但 8 周时的表现与对照组不同。
损伤后生物力学特性和骨质量下降,随着时间的推移逐渐恢复,8 周后完全恢复。然而,结果与完整肩部并不完全相同。本研究表明,目前的模型在其应用于长期结果研究方面存在局限性,需要更好的模型来评估慢性部分肩袖损伤。
目前尚无模拟人类慢性部分肩袖撕裂的小动物模型,这限制了我们改善这种常见疾病治疗的能力。