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Skeletal Muscle Adaptation in a Model of Massive Rotator Cuff Tear.

机译：大型肩袖撕裂模型中的骨骼肌适应。

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摘要

Rotator cuff (RC) tears are a degenerative condition that affects ~30% of people over the age of 60, resulting in pain and loss of function in the shoulder. Chronically torn muscles are prone to atrophy, fatty infiltration, and an increase in tissue stiffness. These changes are insensitive to rehabilitation and are associated with poor patient and surgical outcomes.;Although human clinical studies of RC tears are common, they are limited by a lack of experimental control and logistical difficulties. Thus, animal models have been utilized to study this injury. However, data describing the muscle architecture and mechanics in these models are limited. Therefore, in chapter 2, we characterized muscle architectural adaptations in a rat model of RC injury. We discovered that tenotomy alone leads to mild changes in muscle architecture, while adding a secondary chemical nerve injury causes extensive muscle changes.;Various studies have demonstrated increased passive stiffness of the whole muscle after RC tear, but the mechanisms causing this phenomenon were unknown. Therefore, in Chapter 3, we measured stiffness at the individual fiber and fiber bundle levels. Fiber bundles stiffness increased after a combined tendon and nerve injury, but was unchanged after tenotomy alone. These results suggest that stiffness changes are due to adaptations in the extracellular matrix.;Recent studies have reported functional deficits in tenotomized RC muscles that are not predicted by architectural adaptations. A potential explanation for this could be that muscle strain to sarcomere strain transmission is altered after injury. In chapter 4, we investigated this discrepancy and found that strain transmission was not altered due to tenotomy at low strains. However, sarcomere lengths were significantly shorter in tenotomized muscles at high strains. These results fail to predict the presence of functional deficits in tenomized muscles and do not reconcile the reported deficits.;Overall, these data suggest that this model of RC injury exhibits mild changes that are not representative of the human injury. Future research may need to pursue alternative models (aged animals, alternative species, etc.) of RC tear that result in muscle adaptations that are comparable to what is observed in human patients.
机译：肩袖（RC）眼泪是一种退化性疾病，影响60岁以上的人群约30％，导致肩部疼痛和功能丧失。慢性撕裂的肌肉易于萎缩，脂肪浸润和组织僵硬增加。这些变化对康复不敏感，并且与不良的患者和手术结果有关。尽管人类对RC泪液的临床研究很普遍，但由于缺乏实验控制和后勤方面的困难而受到限制。因此，已经利用动物模型来研究这种损伤。但是，描述这些模型中的肌肉结构和力学的数据是有限的。因此，在第2章中，我们在RC损伤的大鼠模型中描述了肌肉结构的适应性。我们发现，单独的腱切断术会导致肌肉结构的轻度变化，而增加继发性化学神经损伤会导致广泛的肌肉变化。各种研究表明，RC撕裂后整个肌肉的被动僵硬程度增加，但是导致这种现象的机制尚不清楚。因此，在第3章中，我们测量了单个纤维和纤维束水平的刚度。肌腱和神经损伤合并后，纤维束的硬度增加，但单独进行腱切断后，纤维束的硬度没有改变。这些结果表明，刚度的变化是由于细胞外基质的适应所引起的。近期研究已经报道了切角切开的RC肌肉的功能缺陷，这是建筑适应性无法预测的。对此的潜在解释可能是受伤后肌肉向肌小肌的应变传递发生了改变。在第4章中，我们调查了这种差异，并发现在低应变下进行腱切术并不会改变应变传递。然而，在高应变情况下，在腱切开的肌肉中，肌节长度明显较短。这些结果无法预测腱切开的肌肉中功能缺陷的存在，并且不能调和所报道的缺陷。总的来说，这些数据表明这种RC损伤模型表现出轻度的变化，不能代表人的损伤。未来的研究可能需要寻求RC泪液的替代模型（年龄较大的动物，替代物种等），从而导致与人类患者相比可适应的肌肉适应性。

著录项

  • 作者

    Sato, Eugene Julius.;

  • 作者单位

    University of California, San Diego.;

  • 授予单位 University of California, San Diego.;
  • 学科 Biomedical engineering.
  • 学位 Ph.D.
  • 年度 2016
  • 页码 140 p.
  • 总页数 140
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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