肩袖和拉索界面的机械强度：一项完整的组织学和生物力学研究。

IF 1.4 4区医学 Q2 Medicine

Surgical and Radiologic Anatomy Pub Date : 2024-12-01 Epub Date: 2024-10-23 DOI:10.1007/s00276-024-03499-3

Maxime Fondin, Mathieu Miroir, Raphaël Guillin, Julien Landreau, Gevorg Ghukasyan, Alain Fautrel, Mickael Ropars, Xavier Morandi, Krystel Nyangoh Timoh, Jean-Benoît Le Cam

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引用次数: 0

摘要

目的：本研究旨在利用组织学和生物力学技术评估肩袖与半圆肱骨韧带或肩袖索缆（RCa）之间界面的生物力学特性：在 13 具合格的尸体标本中，5 具尸体肩部的肩袖完好无损，8 具标本因肩袖受伤而被排除在外。组织学研究使我们能够描述冈下肌腱（IST）或冈上肌腱（SST）与 RCa 之间的囊-肌腱界面，并检测疏松结缔组织层，以确定其精确位置并沿界面测量其长度。生物力学研究旨在描述和比较 IST-RCa 与 SST-RCa 界面的机械强度：结果：RCa 的平均厚度为 1.44 ± 0.20 毫米。组织学研究显示，IST-RCA 界面有一层疏松的结缔组织层，而 SST-RCa 界面则没有发现这一现象。生物力学研究表明，SST-RCA 界面的刚度（72.10-2 N/mm）是 IST-RCa 界面（16.10-2 N/mm）的 4.5 倍，SST-RCA 和 IST-RCa 界面达到的平均最大力分别为 19.0 N 和 10.6 N：结论：与 SST-RCa 界面相反，IST-RCa 界面由疏松的结缔组织层组成。同时，还发现了两组不同的机械反应：与 SST-RCa 接口相比，IST-RCA 接口组的刚度更低，断裂更快，因此成为最脆弱的接口，并解释了肩袖撕裂的潜在延伸。

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Mechanical strength of the rotator cuff and cable interface: a complete histological and biomechanical study.

Purpose: This study sought to evaluate the biomechanical properties of the interface between the rotator cuff and the semicircular humeral ligament or rotator cable (RCa) using histological and biomechanical techniques.

Methods: Out of 13 eligible cadaver specimens, 5 cadaver shoulders with an intact rotator cuff were included, 8 were excluded due to an injured rotator cuff. The histological study enables us to describe the capsule-tendon interface between the infraspinatus tendon (IST) or supraspinatus tendon (SST) and RCa, and to detect loose connective tissue layers to determine their precise location and measure their length along the interface. The biomechanical study sought to characterize and compare the mechanical strength of the IST-RCa versus SST-RCa interfaces.

Results: The average thickness of the RCa was 1.44 ± 0.20 mm. The histological study revealed a loose connective tissue layer at the IST-RCa interface, a finding not observed at the SST-RCa interface. The biomechanical study showed that the rigidity of the SST-RCa interface (72.10^-2 N/mm) was 4.5 times higher than for the IST-RCa interface (16.10^-2 N/mm) and the average maximum forces reached were 19.0 N and 10.6 N for the SST-RCa and IST- RCa interfaces, respectively.

Conclusion: The IST-RCa interface consists of a loose connective tissue layer contrary to the SST-RCa interface. In parallel, two different groups in terms of the mechanical response were identified: the IST-RCa interface group had less rigidity and ruptured more quickly than the SST-RCa interface, therefore emerging as the most vulnerable interface and explaining a potential extension of rotator cuff tears.

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来源期刊

Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine

CiteScore

2.40

自引率

14.30%

发文量

期刊介绍： Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.