髋关节囊修复与凸轮病变切除对关节囊切开愈合的比较效果：一项体内生物力学和组织学分析。
Comparative effects of hip capsule repair and cam lesion excision on capsulotomy healing: An in vivo biomechanical and histological analysis.
作者信息
Aghayev Abbas, Duymaz Burak, Aydemir Selahaddin, Yılmaz Pınar Akokay, Tukel Gurhan, Husemoglu Resit Bugra, Gürsan Onur, Hapa Onur
机构信息
Department of Orthopedics and Traumatology Dokuz Eylul University Faculty of Medicine İzmir Turkey.
Department of Orthopedics and Traumatology Kastamonu Research and Training Hospital Kastamonu Turkey.
出版信息
J Exp Orthop. 2025 May 19;12(2):e70267. doi: 10.1002/jeo2.70267. eCollection 2025 Apr.
PURPOSE
This study evaluates the effects of hip capsule repair and cam lesion excision on capsular healing by assessing biomechanical strength and histological integrity in an in vivo rabbit model.
METHODS
An in vivo rabbit model with 80 rabbits was used, where capsulotomy was performed on the right hip of each subject. The rabbits were assigned into four groups: Group 1 (capsulotomy without repair), Group 2 (capsulotomy with capsule repair), Group 3 (capsulotomy + cam resection without repair), Group 4 (capsulotomy + cam resection + capsule repair). Each group was stratified into 4-week and 8-week follow-up subgroups. Biomechanical testing assessed maximum tensile strength, while histological evaluation included semiquantitative grading of collagen arrangement, inflammatory response, osteogenesis, and angiogenesis.
RESULTS
Histological analysis revealed superior healing in the capsule repair + cam resection group (Group 4) compared to the unrepaired capsulotomy group (Group 1) ( = 0.01). Biomechanical testing demonstrated that capsule repair (Group 2) improved strength over unrepaired capsulotomy (135.2 N vs. 111.9 N, = 0.03). Cam resection alone (Group 3) resulted in significantly higher strength than unrepaired capsulotomy (163.2 N vs. 111.9 N, = 0.01). The combination of cam resection and capsule repair (Group 4) demonstrated superior strength, outperforming capsule repair alone (176 N vs. 135.2 N, = 0.01). At 8 weeks, the capsule repair + cam resection group (Group 4a) showed significantly enhanced biomechanical strength compared to the unrepaired capsulotomy group (Group 1a) (181.6 N vs. 120.9 N, = 0.001) and capsule repair alone (Group 2a) (181.6 N vs. 125.8 N, = 0.01).
CONCLUSION
Our findings indicate that cam resection, particularly when combined with capsule repair, significantly improves biomechanical strength and enhances the healing process of the capsule. These findings offer practical guidance for optimising surgical strategies to enhance patient outcomes and long-term joint function.
LEVEL OF EVIDENCE
Level III, experimental therapeutic study (prospective and controlled).
目的
本研究通过评估体内兔模型的生物力学强度和组织学完整性，来评价髋关节囊修复和凸轮病变切除对关节囊愈合的影响。
方法
采用包含80只兔子的体内兔模型，对每只兔子的右髋关节进行关节囊切开术。将兔子分为四组：第1组（关节囊切开术未修复），第2组（关节囊切开术伴关节囊修复），第3组（关节囊切开术 + 凸轮切除术未修复），第4组（关节囊切开术 + 凸轮切除术 + 关节囊修复）。每组再分为4周和8周随访亚组。生物力学测试评估最大拉伸强度，组织学评估包括胶原蛋白排列、炎症反应、骨生成和血管生成的半定量分级。
结果
组织学分析显示，与未修复的关节囊切开术组（第1组）相比，关节囊修复 + 凸轮切除组（第4组）的愈合情况更好（P = 0.01）。生物力学测试表明，关节囊修复（第2组）比未修复的关节囊切开术强度更高（135.2 N对111.9 N，P = 0.03）。单独进行凸轮切除（第3组）导致的强度显著高于未修复的关节囊切开术（163.2 N对111.9 N，P = 0.01）。凸轮切除和关节囊修复相结合（第4组）显示出更高的强度，优于单独的关节囊修复（176 N对135.2 N，P = 0.01）。在8周时，关节囊修复 + 凸轮切除组（第4a组）与未修复的关节囊切开术组（第1a组）相比，生物力学强度显著增强（181.6 N对120.9 N，P = 0.001），且优于单独的关节囊修复（第2a组）（181.6 N对125.8 N，P = 0.01）。
结论
我们的研究结果表明，凸轮切除，特别是与关节囊修复相结合时，能显著提高生物力学强度并促进关节囊的愈合过程。这些发现为优化手术策略以改善患者预后和长期关节功能提供了实际指导。
证据水平
III级，实验性治疗研究（前瞻性和对照性）。
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