CAJ | 학술논문

背景:肩袖损伤中以冈上肌腱损伤最为多见,其修复的难点在于骨一肌腱界面的重建,目前缺乏合适的动物模型以及确切的治疗方法.目的:建立兔肩袖损伤修复的实验动物模型,通过MRI观察持续被动活动对肩袖骨-肌腱界面损伤重建术后骨-肌腱界面早期修复的作用,为肩袖损伤修复术后康复制定一个合适的康复程序.方法:8月龄雄性新西兰大白兔16只,构建双侧冈上肌腱急性损伤模型后重建其在肱骨大结节上的止点,随机分为自由活动组(n=4)和持续被动活动组(n=12).持续被动活动模型与重建组运动术后第2天开始应用自制兔肩关节持续被动活动器,以2,4,10(°)/s不同持续被动活动速度进行屈伸75°～75°运动.分别在术前和术后第1,2,4周观察各组动物一般情况及不同持续被动活动速度时兔肩袖骨-肌腱界面的MRI影像学变化.结果与结论:大体观察可见重建2周后切口愈合良好,拆线后未见切口感染、血肿、裂开等;MRI检查结果显示:术后各组肩袖骨-肌腱界面逐渐愈合,术后第1,2,4周不同时间点与自由活动组相比,持续被动活动组在不同屈伸角度下骨-肌腱界面修复迅速,每屈伸75°～75°运动速度为4(°)/s时,骨一肌腱界面的修复明显好于自由活动组.证实该动物模型能够很好的满足实验的需要,兔冈上肌腱损伤重建术后第2天开始,不同速度持续被动活动屈伸运动,可促进骨一肌腱界面的修复,以4(°)/s的持续被动活动速度最佳.
배경:견수손상중이강상기건손상최위다견,기수복적난점재우골일기건계면적중건,목전결핍합괄적동물모형이급학절적치료방법.목적:건립토견수손상수복적실험동물모형,통과MRI관찰지속피동활동대견수골-기건계면손상중건술후골-기건계면조기수복적작용,위견수손상수복술후강복제정일개합괄적강복정서.방법:8월령웅성신서란대백토16지,구건쌍측강상기건급성손상모형후중건기재굉골대결절상적지점,수궤분위자유활동조(n=4)화지속피동활동조(n=12).지속피동활동모형여중건조운동술후제2천개시응용자제토견관절지속피동활동기,이2,4,10(°)/s불동지속피동활동속도진행굴신75°～75°운동.분별재술전화술후제1,2,4주관찰각조동물일반정황급불동지속피동활동속도시토견수골-기건계면적MRI영상학변화.결과여결론:대체관찰가견중건2주후절구유합량호,탁선후미견절구감염、혈종、렬개등;MRI검사결과현시:술후각조견수골-기건계면축점유합,술후제1,2,4주불동시간점여자유활동조상비,지속피동활동조재불동굴신각도하골-기건계면수복신속,매굴신75°～75°운동속도위4(°)/s시,골일기건계면적수복명현호우자유활동조.증실해동물모형능구흔호적만족실험적수요,토강상기건손상중건술후제2천개시,불동속도지속피동활동굴신운동,가촉진골일기건계면적수복,이4(°)/s적지속피동활동속도최가.
BACKGROUND: Supraspinatus tendon injury is common in rotator cuff injury, the repair difficulty of which is reconstructing the bone-tendon interface. Currently, there are no effective therapeutics and suitable experimental animal models.OBJECTIVE: To establish rabbit rotator cuff injury prosthetic experimental animal model and to observe the effect of continuous passive motion (CPM) on early healing of rabbit rotator cuff bone-tendon interface by MRI, which can provide guidance for preparing an optimal rehabilitation strategy after rotator cuff injury.METHODS: Sixteen male New Zealand rabbits, aged 8 months, were received a rotator cuff acute injury and reconstructing insertion of supraspinatus tendon on greater tuberosity of humerus. The rabbits were randomly divided into cage activity group (n=4) and CPM group (n=12). At 2 days after operation, rabbits were treated by rabbit shoulder joint continuous passive motion apparatus of 75°～75° flexion-extension with various CPM speeds[2 (°)/s, 4 (°)/s, and 10 (°)/s)]. General state and MRI changes of rabbit rotator cuff bone-tendon interface was observed prior to and at weeks 1,2, and 4 after operation.RESULTS AND CONCLUSION: Gross observation showed that the incisions healed very well at 2 weeks after operation. There was no infection, haematoma or disruption after removing the suture. Compared to the cage activity group, the tendon-bone interface of CPM group heeled better at weeks 1, 2 and 4, especially at the speed of 4°/s with 75°-75° flexion-extension. Results demonstrated that this animal model can be satisfied to experimental study. From the following day after operation, various CPM speeds can accelerate the healing of tendon-bone interface, and the optimal speed of CPM was 4 (°)/s.