CAJ | 학술논문

背景:持续应力刺激已经证明可以促进肩袖损伤的修复,实验尝试在肩袖损伤修复的全过程中进一步量化应力刺激的强度,寻求到达更好的治疗效果.目的:观察不同强度应力刺激在急性肩袖损伤后修复过程中的生物力学表现.方法:取成年雄性新西兰大白兔36只,随机分为大强度实验组、小强度实验组和对照组,每组12只.将冈上肌腱于大结节止点处横断后原位缝合(隧道法),建立兔冈上肌腱损伤模型.术后石膏绷带制动1周后,采用关节持续被动器(CPM)进行功能锻炼,大强度训练组活动范围为-60°～60°,小强度训练组活动范围为-15°～15°,术后第2周,隔天训练,10 min/次;第3周开始每天训练,10 min/次;第4周15 min/次.对照组自由活动.于术后2,3,4,周每组各取4只动物取材,分别比较冈上肌腱-骨界面的刚度和最大抗拉强度的变化.结果与结论:各时间观察,小强度训练组的最大抗拉强度和刚度均明显强对照组和大强度训练组(P＜0.05),大强度训练组最大抗拉强度和刚度最弱,各组断裂点均存肌腱缝合处.结构表明,小强度应力刺激在急性肩袖损伤早期修复中效果较佳,而大强度应力刺激在急性肩袖损伤早期修复中起损伤作用.
배경:지속응력자격이경증명가이촉진견수손상적수복,실험상시재견수손상수복적전과정중진일보양화응력자격적강도,심구도체경호적치료효과.목적:관찰불동강도응력자격재급성견수손상후수복과정중적생물역학표현.방법:취성년웅성신서란대백토36지,수궤분위대강도실험조、소강도실험조화대조조,매조12지.장강상기건우대결절지점처횡단후원위봉합(수도법),건립토강상기건손상모형.술후석고붕대제동1주후,채용관절지속피동기(CPM)진행공능단련,대강도훈련조활동범위위-60°～60°,소강도훈련조활동범위위-15°～15°,술후제2주,격천훈련,10 min/차;제3주개시매천훈련,10 min/차;제4주15 min/차.대조조자유활동.우술후2,3,4,주매조각취4지동물취재,분별비교강상기건-골계면적강도화최대항랍강도적변화.결과여결론:각시간관찰,소강도훈련조적최대항랍강도화강도균명현강대조조화대강도훈련조(P＜0.05),대강도훈련조최대항랍강도화강도최약,각조단렬점균존기건봉합처.결구표명,소강도응력자격재급성견수손상조기수복중효과교가,이대강도응력자격재급성견수손상조기수복중기손상작용.
BACKGROUND:Continuing stress stimulation has been confirmed to promote repair of rotator cuff injury.This experiment attempts to fu rther quantify the intensity of stress stimulation in order to reach a better therapeutic effect in the entire process of rotator cuff injury repair.OBJECTIVE:To explore the biomechanical performance of stress stimulation with different intensities on repair of acute rotator cuffinjuryMETHODS:Sixteen male New Zealand rabbits were randomly divided into high intensity,low intensity and control groups,with 12 animals in each group.Rabbits were received a rotator cuff acute injury and reconstructing insertion of supraspinatus tendon on greater tuberosity of humerus.At 1 week after operation,rabbits were treated by continuous passive motion(CPM)apparatus,which was-60°to 60° flexion-extension for the high intensity group,and-15° to 15° for the low intensity group.At 2 weeks after operation,the CPM was performed every other day,with 10 minutes per time;which was changed to daily training from week 3 with the same frequently,and 15 minutes per time at week 4.Rabbits in the control group were housed freely.Each 4 animals were sacrificed at weeks 2,3 and 4 after operation,and the largest tensile strength and severity at osteotendinous junction were compared.RESULTS AND CONCLUSION:The maximum tensile intensity and stiffness of the supraspinatus tendon in the low intensity group were greater than that of the control and high intensity group(P＜0.05),which was smallest in the high intensity group.All the breakage point existed at the intra-articular portion.The result demonstrated that low intensity stimulation exhibits superior repair effect in acute rotator cuff injury,while high intensity stimulation is harmful to the early repair of acute rotator cuff injury.