中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2015年
4期
331-336
,共6页
肩关节%修复外科手术%兔%肩袖损伤
肩關節%脩複外科手術%兔%肩袖損傷
견관절%수복외과수술%토%견수손상
Shoulder joint%Reconstructive surgical procedures%Rabbit%Rotator cuff tears
目的 比较单排技术与线桥技术修复兔全层肩袖损伤的治疗效果. 方法 取骨骼成熟的雄性新西兰大白兔76只,体质量为2.5～3.0 kg,平均2.8 kg,均为12个月龄.将兔冈上肌肌腱在足印区处切断制作兔全层肩袖模型,并随机分成2组(n=38):采用单排技术修复肩袖损伤(单排组)和线桥技术修复肩袖损伤(线桥组),手术肩均为右侧肩关节,左肩关节作对照组不予任何处理.术后第2、4、8周取材,显微镜下观察、修补肩袖的愈合情况,并在术后第8周进行生物力学实验,分析2种方法的优、缺点. 结果 线桥组在术后第2、4、8周时,修复肩袖的前1/3区域与中1/3区域腱-骨联合部比较,在软骨生长、胶原纤维形态方面均无明显差异;而单排组修复肩袖的中1/3区域腱-骨联合部软骨生长、胶原纤维形态均较前1/3区域成熟,差异明显.在术后第8周,修复冈上肌的腱-骨界面最大失效负荷线桥组[(134.59±17.69) N]明显大于单排组[(72.23±12.08) N],差异有统计学意义(P＜0.05),但线桥组仍小于正常对照组[(192.61±9.42) N],差异有统计学意义(P＜0.05).术后第8周时单排组2只兔出现肩袖再撕裂,而线桥组无一只兔出现失败. 结论 线桥技术修复肩袖是一种可行、可靠的修复方法,较单排修复技术具有更优的愈合效果.
目的 比較單排技術與線橋技術脩複兔全層肩袖損傷的治療效果. 方法 取骨骼成熟的雄性新西蘭大白兔76隻,體質量為2.5～3.0 kg,平均2.8 kg,均為12箇月齡.將兔岡上肌肌腱在足印區處切斷製作兔全層肩袖模型,併隨機分成2組(n=38):採用單排技術脩複肩袖損傷(單排組)和線橋技術脩複肩袖損傷(線橋組),手術肩均為右側肩關節,左肩關節作對照組不予任何處理.術後第2、4、8週取材,顯微鏡下觀察、脩補肩袖的愈閤情況,併在術後第8週進行生物力學實驗,分析2種方法的優、缺點. 結果 線橋組在術後第2、4、8週時,脩複肩袖的前1/3區域與中1/3區域腱-骨聯閤部比較,在軟骨生長、膠原纖維形態方麵均無明顯差異;而單排組脩複肩袖的中1/3區域腱-骨聯閤部軟骨生長、膠原纖維形態均較前1/3區域成熟,差異明顯.在術後第8週,脩複岡上肌的腱-骨界麵最大失效負荷線橋組[(134.59±17.69) N]明顯大于單排組[(72.23±12.08) N],差異有統計學意義(P＜0.05),但線橋組仍小于正常對照組[(192.61±9.42) N],差異有統計學意義(P＜0.05).術後第8週時單排組2隻兔齣現肩袖再撕裂,而線橋組無一隻兔齣現失敗. 結論 線橋技術脩複肩袖是一種可行、可靠的脩複方法,較單排脩複技術具有更優的愈閤效果.
목적 비교단배기술여선교기술수복토전층견수손상적치료효과. 방법 취골격성숙적웅성신서란대백토76지,체질량위2.5～3.0 kg,평균2.8 kg,균위12개월령.장토강상기기건재족인구처절단제작토전층견수모형,병수궤분성2조(n=38):채용단배기술수복견수손상(단배조)화선교기술수복견수손상(선교조),수술견균위우측견관절,좌견관절작대조조불여임하처리.술후제2、4、8주취재,현미경하관찰、수보견수적유합정황,병재술후제8주진행생물역학실험,분석2충방법적우、결점. 결과 선교조재술후제2、4、8주시,수복견수적전1/3구역여중1/3구역건-골연합부비교,재연골생장、효원섬유형태방면균무명현차이;이단배조수복견수적중1/3구역건-골연합부연골생장、효원섬유형태균교전1/3구역성숙,차이명현.재술후제8주,수복강상기적건-골계면최대실효부하선교조[(134.59±17.69) N]명현대우단배조[(72.23±12.08) N],차이유통계학의의(P＜0.05),단선교조잉소우정상대조조[(192.61±9.42) N],차이유통계학의의(P＜0.05).술후제8주시단배조2지토출현견수재시렬,이선교조무일지토출현실패. 결론 선교기술수복견수시일충가행、가고적수복방법,교단배수복기술구유경우적유합효과.
Objective To compare suture bridge and single row techniques in repair of rotator cuff tears in a rabbit model.Methods Seventy-six mature male New Zealand white rabbits were used in this study.The 12-month old rabbits,weighing from 2.5 to 3.0 kg (average,2.8 kg),were made models of full-thickness rotator cuff tear by cutting off at the foot print the supraspinatus tendon.The models were randomly divided into 2 even groups (n =38 each).Their right shoulders were repaired by suture bridge and single row techniques respectively in the 2 groups,with their left shoulders untreated as controls.The rabbits were then sacrificed at the 2nd,4th and 8th weeks after surgery for histological comparisons of healing under microscopy.Biomechanical comparisons were made at the 8th week to analyze advantages and disadvantages of the two methods.Results At 2,4 and 8 weeks postoperatively,there were no significant differences between the anterior and middle 1/3 zones of bone-tendon junction regarding cartilage growth or collagen fiber morphology in the suture bridge group,while the cartilage growth and collagen fiber morphology in the middle 1/3 zone of bone-tendon junction were significantly more mature than in the anterior 1/3 zone in the single row group.At the 8th postoperative week,the load to failure in the suture bridge group (134.59 ± 17.69 N) was significantly higher than that in the single row group (72.23 ± 12.08 N) (P ＜ 0.05),but remained significantly lower than that in the control group (192.61 ± 9.42 N) (P ＜ 0.05).Conclusion The suture bridge technique is a feasible and reliable method for repair of rotator cuff tear and has a better healing effect than the single row technique.
