中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (7): 1187-1190.doi: 10.3969/j.issn.1673-8225.2010.07.011

• 组织构建与中医药 tissue construction and traditional Chinese medicine • 上一篇    下一篇

肩袖损伤模型兔持续被动活动对骨-肌腱界面早期修复的影响：MRI不同时点影像证实

付国建，靳安民，李  森，王鹏程   

  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:2010-02-12 发布日期:2010-02-12
  • 通讯作者: 靳安民，主任医师，教授，博士生导师，南方医科大学珠江医院，广东省广州市 510282
  • 作者简介:付国建★，男，1985年生，安徽省枞阳县人，汉族，南方医科大学在读硕士，医师，主要从事脊柱与脊髓损伤研究。 fuwanyi2008@163.com

Effects of continuous passive motion on early healing of rabbit rotator cuff bone-tendon junction: MRI verification at varied time points

Fu Guo-jian, Jin An-min, Li Sen, Wang Peng-cheng   

  1. Orthopedics Center of Zhujiang Hospital, Southern Medical University, Guangzhou  510282, Guangdong Province, China
  • Online:2010-02-12 Published:2010-02-12
  • Contact: Jin An-min, Chief physician, Professor, Doctoral supervisor, Orthopedics Center of Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China
  • About author:Fu Guo-jian★, Studying for master’s degree, Physician, Orthopedics Center of Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China fuwanyi2008@163.com

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摘要：

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-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-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-肌腱界面的修复，以4 (°)/s的持续被动活动速度最佳。

关键词: 持续被动活动, 肩袖, 腱-骨界面, 修复, 兔, 核磁共振

Abstract:

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 healed 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.

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