Holz U
Fortschr Med. 1980 Oct 16;98(39):1517-20.
Ruptures of the Achilles tendon mainly occur in males aged 30 to 40 years; in an analysis of 561 specimens taken from ruptured tendons only 25% were classified as degenerative tendopathy. Ultrastructural studies of areas in and near the tendon rupture and of specimens of tendonitis show more collagen fibres with small diameter in comparison to normal samples. These morphological changes correspond to structures of tendon tissue after reversible damage of rabbit tendons. Test models were throttling of the Arteria poplitea or Arteria femoralis, sheathing of the Achilles tendon and deflecting the tendon in order to increase the tension. The electrophoretic determination of collagen showed increasing type III collagen with formation of repair tissue. First of all the experimental findings as well as the clinical fact of rare secondary ruptures after operatively treated ruptures of Achilles tendons prove good conditions for tendon repair. But probably an increasing number of small diameter collagen fibres and changings in the pattern of collagen types weaken the mechanical properties of the tendon.
跟腱断裂主要发生在30至40岁的男性中;在对561个取自断裂肌腱的标本进行的分析中,只有25%被归类为退行性肌腱病。对肌腱断裂处及其附近区域以及肌腱炎标本的超微结构研究表明,与正常样本相比,胶原纤维直径更小。这些形态学变化与兔肌腱可逆性损伤后肌腱组织的结构相对应。测试模型包括腘动脉或股动脉结扎、跟腱鞘形成以及使肌腱偏转而增加张力。胶原的电泳测定显示,随着修复组织的形成,III型胶原增加。首先,实验结果以及跟腱手术治疗后罕见二次断裂的临床事实证明了肌腱修复的良好条件。但可能越来越多的小直径胶原纤维以及胶原类型模式的改变会削弱肌腱的力学性能。