Brinkman Joseph C, Makovicka Justin L, Denard Patrick J, Colbath Gregory P, Mercuri Jeremy, Tokish John M
Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, Arizona, U.S.A.
Oregon Shoulder Institute, Medford, Oregon, U.S.A.
Arthroscopy. 2025 Jun;41(6):1745-1751. doi: 10.1016/j.arthro.2024.09.029. Epub 2024 Sep 26.
To evaluate the effects of this graft preparation technique on histologic evidence of tenocyte mechanical damage.
A consecutive series of patients undergoing biceps tenodesis for shoulder pathology were evaluated. After suprapectoral tenodesis, 27 mm of the long head of the biceps was secured for compression into the patch. The remaining length of the residual tendon was longitudinally split, resulting in 2 equal lengths of remnant tendon from the same zone. One sample was sent to pathology with no preparation, and the other was prepared as a compressed biceps autograft patch according to the manufacturer's recommendations. Both grafts were sent to pathology for evaluation of tenocyte morphology. Records were reviewed to determine if compression resulted in mechanical damage to the tenocytes at the time of biceps augmentation.
Fifty-five shoulder procedures and 110 samples were sent for pathology analysis. Forty-two of the 55 (76%) specimens demonstrated morphologically normal tenocytes in both the compressed and noncompressed groups, and 7 (13%) cases showed evidence of tenocyte necrosis or mechanical damage in both groups. The difference in abnormal tenocyte morphology between the compressed and native groups was not statistically significant (P = .625).
Autograft biceps compression into a point-of-care patch did not result in mechanical damage to tenocyte morphology at the time of insertion for augmentation of rotator cuff pathology.
Free proximal biceps tendon compression can result in a patch that does not mechanically damage the tenocyte. The patch can be used as a biologic autograft to enhance shoulder rotator cuff repair, as well as subscapularis repair in the setting of shoulder arthroplasty.
评估这种移植物制备技术对肌腱细胞机械损伤组织学证据的影响。
对一系列因肩部病变接受肱二头肌肌腱固定术的患者进行评估。在胸大肌上方进行肌腱固定术后，将27毫米的肱二头肌长头固定并压缩到补片中。将残余肌腱的剩余长度纵向劈开，从同一区域得到两段等长的残余肌腱。一个样本未经处理直接送去病理检查，另一个样本则根据制造商的建议制备成压缩自体肱二头肌补片。将两个移植物都送去病理检查以评估肌腱细胞形态。查阅记录以确定在肱二头肌增强手术时压缩是否导致肌腱细胞机械损伤。
55例肩部手术和110个样本送去进行病理分析。55个标本中的42个（76%）在压缩组和未压缩组中均显示肌腱细胞形态正常，7个（13%）病例在两组中均显示有肌腱细胞坏死或机械损伤的证据。压缩组和天然组之间异常肌腱细胞形态的差异无统计学意义（P = 0.625）。
在为增强肩袖病变而植入时，将自体肱二头肌压缩成即时可用的补片不会导致肌腱细胞形态的机械损伤。
游离近端肱二头肌肌腱压缩可形成一种不会对肌腱细胞造成机械损伤的补片。该补片可作为生物自体移植物用于增强肩袖修复，以及在肩关节置换术中用于肩胛下肌修复。
