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。
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.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2010年第7期1187-1190,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
