SCOI行技术与双行缝合桥技术修复兔肩袖撕裂的生物力学和组织学研究

Han-Yu Lu, Yi-Xin Yang, Wen-Jun Li, Min Du, Shi-Long Lin, Qi-Jie Sun, Yue-Lin Liu, Mu Gao, Xiao-Fei Zheng, He-Bei He
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摘要

背景:双排缝合桥(SB)是一种有效的肩袖修复技术。然而,由于高张力缝合线和肌腱血管不全,SB修复后肌腱套不愈合或再撕裂是常见的。SCOI Row (SR)技术的低张力缝合和微骨折特征可能有助于解决这些问题。目的:比较SR技术和SB技术治疗兔肩袖撕裂的生物力学和组织学结果。研究设计:实验室对照研究。方法:采用42只新西兰兔肩部急性双侧冈上肌腱撕裂模型。在左肩或右肩随机使用SR或SB技术修复撕裂。12只兔分别于术后2周、4周和8周被安乐死。6只家兔进行组织学评价,6只家兔进行生物力学试验。在最初的42只动物中,有6只在第0周的时间点被专门分配进行初步的生物力学测试。结果:术后8周,所有修复的肌腱均成功附着于大结节足部,无术后并发症。与SB组相比,SR组表现出更好的肌腱-骨组织学愈合,其特征是纤维软骨再生、胶原组成和纤维组织结构增强。在术后0周和8周的评估中,SR组的生物力学结果均优于SB组。结论:两种修复技术在兔肩袖撕裂模型中均显示出有效性。然而,与SB相比,SR在增强生物力学性能和组织肌腱-骨愈合方面表现出更大的优势。临床意义:本研究提出SR技术可以作为人类肩袖撕裂的可行治疗方案,因为它可以改善肌腱-骨愈合并减少愈合失败的发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
SCOI Row Technique Versus Double-Row Suture Bridge Technique for Repairing Rotator Cuff Tears: A Biomechanical and Histological Study in Rabbits
Background: The double-row suture bridge (SB) is an effective technique for rotator cuff repair. However, because of high-tension sutures and tendon vascular insufficiency, nonunion or retearing of the rotator cuff after SB repair is common. The low-tension suture and microfracture features of the SCOI Row (SR) technique may help address these issues. Purpose: To compare the biomechanical and histological outcomes of SR and SB techniques in treating rotator cuff tears in rabbits. Study Design: Controlled laboratory study. Methods: The study utilized a model of acute bilateral supraspinatus tendon tears in the shoulders of 42 New Zealand rabbits. The tear was randomly repaired using either the SR or SB technique on the left or right shoulder. Twelve rabbits were euthanized at 2, 4, and 8 weeks after surgery. Six rabbits were assigned for histological evaluation, while the other 6 were designated for biomechanical testing. Six of the original 42 animals were exclusively allocated for preliminary biomechanical testing at the 0-week time point. Results: At 8 weeks after surgery, all mended tendons were successfully attached to the footprint region of the greater tubercle without any postoperative complications. In comparison with the SB group, the SR group exhibited superior histological tendon-bone healing characterized by enhanced fibrocartilage regeneration, collagen composition, and fibrous tissue structure. The biomechanical results of the SR group exhibited superior performance compared with the SB group at both the 0- and 8-week postoperative assessments. Conclusions: Both repair techniques have demonstrated effectiveness in the rabbit rotator cuff tear model. Nevertheless, when compared with SB, SR demonstrates superior advantages in enhancing biomechanical properties and histological tendon-bone healing. Clinical Relevance: This study proposes that the SR technique could serve as a viable treatment alternative for rotator cuff tears in humans, as it can improve tendon-bone healing and decrease the incidence of failed healing.
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