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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Injuries in Muscle-Tendon-Bone Units: A Systematic Review Considering the Role of Passive Tissue Fatigue
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Injuries in Muscle-Tendon-Bone Units: A Systematic Review Considering the Role of Passive Tissue Fatigue

机译：肌腱骨箱的伤害：考虑到被动组织疲劳的作用的系统审查

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Background: Low-cycle fatigue damage accumulating to the point of structural failure has been recently reported at the origin of the human anterior cruciate ligament under strenuous repetitive loading. If this can occur in a ligament, low-cycle fatigue damage may also occur in the connective tissue of muscle-tendon units. To this end, we reviewed what is known about how, when, and where injuries of muscle-tendon units occur throughout the body. Purpose: To systematically review injuries in the muscle-tendon-bone complex; assess the site of injury (muscle belly, musculotendinous junction [MTJ], tendon/aponeurosis, tendon/aponeurosis–bone junction, and tendon/aponeurosis avulsion), incidence, muscles and tendons involved, mechanism of injury, and main symptoms; and consider the hypothesis that injury may often be consistent with the accumulation of multiscale material fatigue damage during repetitive submaximal loading regimens. Methods: PubMed, Web of Science, Scopus, and ProQuest were searched on July 24, 2019. Quality assessment was undertaken using ARRIVE, STROBE, and CARE (Animal Research: Reporting In Vivo Experiments, Strengthening the Reporting of Observational Studies in Epidemiology, and the Case Report Statement and Checklist, respectively). Results: Overall, 131 studies met the inclusion criteria, including 799 specimens and 2,823 patients who sustained 3,246 injuries. Laboratory studies showed a preponderance of failures at the MTJ, a viscoelastic behavior of muscle-tendon units, and damage accumulation at the MTJ with repetitive loading. Observational studies showed that 35% of injuries occurred in the tendon midsubstance; 28%, at the MTJ; 18%, at the tendon-bone junction; 13%, within the muscle belly and that 6% were tendon avulsions including a bone fragment. The biceps femoris was the most injured muscle (25%), followed by the supraspinatus (12%) and the Achilles tendon (9%). The most common symptoms were hematoma and/or swelling, tenderness, edema and muscle/tendon retraction. The onset of injury was consistent with tissue fatigue at all injury sites except for tendon avulsions, where 63% of the injuries were caused by an evident trauma. Conclusion: Excluding traumatic tendon avulsions, most injuries were consistent with the hypothesis that material fatigue damage accumulated during repetitive submaximal loading regimens. If supported by data from better imaging modalities, this has implications for improving injury detection, prevention, and training regimens.
机译：背景：最近在剧烈重复载荷下，最近报告了对结构失败点积累的低周期疲劳损失。如果这可能发生在韧带中，则肌腱单元的结缔组织也可能发生低循环疲劳损伤。为此，我们审查了肌肉肌腱单位在整个身体上发生的方式，何时何时，何时何地审查了什么。目的：系统地审查肌腱骨骼复合物的伤害;评估损伤部位（肌肉腹部，肌肉肿瘤连接[MTJ]，肌腱/腱膜，肌腱/腱膜骨交界处，发病率，肌肉和肌腱，损伤机制和主要症状;并考虑损伤的假设通常与重复潜水加载方案中的多尺度材料疲劳损伤的积累一致。方法：2019年7月24日搜索了PubMed，Scopus和Proquest网站。使用到达，频闪和护理（动物研究：报告体内实验，加强流行病学观察研究的报告，以及加强流行病学的报告案例报告声明和清单）。结果：总体而言，131项研究符合纳入标准，其中包括799名标本和2,823名患者，持续3,246名伤害。实验室研究表明，MTJ的失效，肌肉肌腱单元的粘弹性行为，以及MTJ的损伤积累，重复载荷。观察性研究表明，35％的伤害发生在肌腱中间阶段; 28％，在MTJ; 18％，在肌腱骨交界处; 13％，在肌肉腹部内，6％的肌腱吹血包括骨片段。二头肌股骨是最受伤的肌肉（25％），其次是冈上肌（12％）和achilles肌腱（9％）。最常见的症状是血肿和/或肿胀，压痛，水肿和肌肉/肌腱缩回。损伤的发作与除肌腱疏水外的所有损伤部位外的组织疲劳一致，其中63％的伤害是由明显的创伤引起的。结论：排除创伤性肌腱疏浚，大多数伤害符合在重复潜水加载方案中累积的材料疲劳损伤的假设一致。如果来自更好的成像方式的数据支持，这对改善伤害检测，预防和培训方案有影响。

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