骨膜补片加强修复促进肩袖腱骨愈合

发布时间：2018-03-26 16:29

本文选题：移植　切入点：自体　出处：《中国组织工程研究》2017年30期

【摘要】：背景:最新研究表明,肩袖补片可降低肌腱和骨之间的张力,可为生长因子和细胞生长提供制成的附着点,促进肩袖止点的生物学重建,然而何种材料作为肩袖补片是最安全有效的尚无明确共识。目的:探讨自体骨膜补片加强修复对肩袖腱骨愈合的影响。方法:取48只新西兰白兔,建立单侧肩袖急性肩袖损伤模型,随机分2组修复,对照组进行单纯缝合固定修复,实验组在对照组基础上进行自体骨膜补片加强修复,修复后4,8,12周取肱骨近端标本,进行组织学观察与生物力学测试。结果与结论:①组织学观察:实验组修复后4周可见大量胶原纤维连接和炎性细胞浸润,间充质细胞增生明显,有少量软骨细胞;修复后8周可见膜内化骨,大量新生软骨细胞;修复后12周可见肌腱与骨结合紧密,无间隙,软骨细胞排列规整,类似正常的腱骨界面结构。对照组修复后4周可见疏松结缔组织填充;修复后8周止点处可见大量成纤维细胞,少量胶原纤维连接,少量软骨细胞形成;修复后12周可见胶原纤维连接,软骨细胞排列紊乱;②生物力学测试:两组最大负荷随时间增加逐渐增大,实验组修复后不同时间点的最大负荷高于对照组(P0.05);③结果表明:自体骨膜补片可有效促进肩袖腱骨愈合。
[Abstract]:Background: new research has shown that rotator cuff patch can reduce tension between tendon and bone, provide attachment point for growth factor and cell growth, and promote biological reconstruction of cuff insertion point. However, there is no clear consensus as to which material is the safest and most effective material for rotator cuff patch. Objective: to investigate the effect of autologous periosteal patch on the healing of rotator cuff tendon. Methods: 48 New Zealand white rabbits were selected. An acute rotator cuff injury model was established and was randomly divided into two groups: the control group was repaired with simple suture and fixation, the experimental group was repaired with autogenous periosteum patch on the basis of the control group, and the proximal humerus specimens were collected at 812 weeks after repair. Results and conclusion: a large number of collagen fiber junctions and inflammatory cell infiltration were observed in the experimental group 4 weeks after repair, the proliferation of mesenchymal cells was obvious, and a small number of chondrocytes were observed. At 8 weeks after repair, the membrane internalized bone was seen, and a large number of new chondrocytes were found. At 12 weeks after repair, the tendon and bone were closely bound with the bone, and the chondrocytes were arranged regularly. In the control group, loose connective tissue filling was observed 4 weeks after repair, a large number of fibroblasts, a small number of collagen fibers and a few chondrocytes were observed at the end of 8 weeks after repair. 12 weeks after repair, collagen fiber junctions were observed. Biomechanical test showed that the maximum load of the two groups increased gradually with the increase of time. The maximum load at different time points after repair in the experimental group was higher than that in the control group (P 0.05). The results showed that the autogenous periosteum patch could effectively promote the healing of rotator cuff tendon.
【作者单位】：承德医学院附属医院关节外科;承德医学院附属医院病理科;
【分类号】：R318.08;R68

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