中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (11): 1971-1974.doi: 10.3969/j.issn.1673-8225.2010.11.018

• 组织构建与生物力学 tissue construction and biomechanics • 上一篇    下一篇

急性肩袖损伤早期修复过程中不同强度应力刺激的生物力学反应

王鹏程，靳安民，付国建，李  森，张  飞，许  勇   

  1. 南方医科大学附属珠江医院骨科中心，广东省广州市   510282
  • 出版日期:2010-03-12 发布日期:2010-03-12
  • 通讯作者: 靳安民，主任医师，博士研究生导师，南方医科大学附属珠江医院骨科中心，广东省广州市 510282
  • 作者简介:王鹏程，男， 1983年生，山东省寿光市人，汉族，南方医科大学在读硕士，主要从事骨与肌腱疾病的研究 wpc19832002@yahoo.com.cn

Biomechanical response to stress stimulation with different intensities during early repair period of acute rotator cuff injury

Wang Peng-cheng, Jin An-min, Fu Guo-jian, Li Sen, Zhang Fei, Xu Yong   

  1. Orthopedics Center of Zhujiang Hospital, Southern Medical University, Guangzhou  510280, Guangdong Province, China
  • Online:2010-03-12 Published:2010-03-12
  • Contact: Jian An-min, Chief physician, Doctoral supervisor, Orthopedics Center of Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China
  • About author:Wang Peng-cheng, Studying for master’s degree, Orthopedics Center of Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong Province, China wpc19832002@yahoo.com.cn

PDF

470

被引次数

22

摘要：

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，各组断裂点均在肌腱缝合处。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。

关键词: 应力刺激, 强度, 肩袖损伤, 生物力学分析, 兔, 肌肉肌腱组织工程

Abstract:

BACKGROUND: Continuing stress stimulation has been confirmed to promote repair of rotator cuff injury. This experiment attempts to further 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 cuff injury.
METHODS: 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.

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