CAJ | 학술논문

背景:肩袖损伤治疗的方法很多,但是对其损伤修复机制仍不是非常清楚,尤其是对腱-骨特殊结构的损伤修复机制研究更少.目的:通过建立兔网上肌腱急性断裂术后被动应力刺激(CPM)训练实验动物模型,观察被动应力刺激对其腱-骨界面组织学变化的影响,探讨被动应力刺激在肩袖损伤术后康复中的作用.方法:选取20只成年雄性新西兰白兔,随机选取2只处死作正常对照,余18只白兔建立双侧肩关节行冈上肌腱急性断裂重建模型.1周后拆除石膏,随机选取2只处死作模型对照.余16只白兔随机分为被动应力刺激组8只与非被动应力刺激组8只.被动应力刺激组建模后第2周开始训练;非被动应力刺激组正常笼养.分别于术后第2,4,6,8周训练结束每组分别各处死2只,取材行腱一骨界面大体及组织学观察.结果与结论:建模后2周,与非被动应力刺激组比较,被动应力刺激组炎症反应较重,术后4周,被动应力刺激组炎症较前明显减轻,术后第6周,被动应力刺激组组织结构学显示成纤维细胞数量较非被动应力刺激组增多,且逐渐有序,术后8周,显示被动应力刺激组成纤维细胞较非被动应力刺激组明显增多,且形状及排列较后者更加有序.结果证实采用被动应力刺激(CPM)对兔冈上肌腱急性断裂重建后进行训练,能够促进其腱-骨修复,从而促进肩袖损伤功能恢复.
배경:견수손상치료적방법흔다,단시대기손상수복궤제잉불시비상청초,우기시대건-골특수결구적손상수복궤제연구경소.목적:통과건립토망상기건급성단렬술후피동응력자격(CPM)훈련실험동물모형,관찰피동응력자격대기건-골계면조직학변화적영향,탐토피동응력자격재견수손상술후강복중적작용.방법:선취20지성년웅성신서란백토,수궤선취2지처사작정상대조,여18지백토건립쌍측견관절행강상기건급성단렬중건모형.1주후탁제석고,수궤선취2지처사작모형대조.여16지백토수궤분위피동응력자격조8지여비피동응력자격조8지.피동응력자격조건모후제2주개시훈련;비피동응력자격조정상롱양.분별우술후제2,4,6,8주훈련결속매조분별각처사2지,취재행건일골계면대체급조직학관찰.결과여결론:건모후2주,여비피동응력자격조비교,피동응력자격조염증반응교중,술후4주,피동응력자격조염증교전명현감경,술후제6주,피동응력자격조조직결구학현시성섬유세포수량교비피동응력자격조증다,차축점유서,술후8주,현시피동응력자격조성섬유세포교비피동응력자격조명현증다,차형상급배렬교후자경가유서.결과증실채용피동응력자격(CPM)대토강상기건급성단렬중건후진행훈련,능구촉진기건-골수복,종이촉진견수손상공능회복.
BACKGROUND:Rotator cuff injudes can be treated by many methods,but their mechanisms of repairing are still unclear,especially for tendon-bone injury.OBJECTIVE:To establish continuous passive motion (CPM) models following repairing acute rupture of supraspinatus tendon,to observe the effect of CPM on histological changes of tendon-bone.and to explore the role of CPM in the postoperative rehabilitation following acute rotator cuff injury.METHODS:Twenty adult male New Zealand white rabbits were selected,2 of them were randomly sacrificed as controls.and the remained animals were established rabbit rotator cuff injury prosthetic experimental models.Two rabbits were sacrificed as model controls,and others were divided into the CPM(n=8)and non-CPM (n=8) groups.CPM was performed on rabbits in the CPM group at 2 weeks after model preparation.Rabbits in the non-CPM were housed regularly.Two rabbits were sacrificed at weeks 2,4,6 and 8 after training,and the gross and histological observation of tendon-bone interface was performed.RESULTS AND CONCLUSION:Compared with the non-CPM group,the CPM group presented serious inflammatory response at 2 weeks,which was obviously decreased at 4 weeks.After 6 weeks,the number of fibroblasts of the CPM group was jncreased compared with the non-CPM group.After 8 weeks.the organizational structure study showed that fibroblasts in the CPM were greater than that of the non-CPM group,with ordedy shape and arrangements.The results demonstrated that CPM can contribute to rabbit supraspinatus tendon-bone repair,so as to promote functional recovery.