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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Muscle Degeneration Induced by Sequential Release and Denervation of the Rotator Cuff Tendon in Sheep
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Muscle Degeneration Induced by Sequential Release and Denervation of the Rotator Cuff Tendon in Sheep

机译：通过顺序释放和绵羊转子袖带肌腱诱导的肌肉变性

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Background: In a sheep rotator cuff model, tenotomy predominantly induces fatty infiltration, and denervation induces mostly muscle atrophy. In clinical practice, myotendinous retraction after tendon tear or lateralization after tendon repair tear may lead to traction injury of the nerve. Purpose/Hypothesis: To analyze whether an additional nerve lesion during rotator cuff repair leads to further degeneration of the rotator cuff muscle in the clinical setting. We hypothesized that neurectomy after tendon tear would increase atrophy as well as fatty infiltration and that muscle paralysis after neurectomy would prevent myotendinous retraction after secondary tendon release. Study Design: Controlled laboratory study. Methods: Twelve Swiss alpine sheep were used for this study. For the 6 sheep in the tenotomy/neurectomy (T/N) group, the infraspinatus tendon was released; 8 weeks later, the suprascapular nerve was transected. For the 6 sheep in the neurectomy/tenotomy (N/T) group, neurectomy was performed, and the infraspinatus was tenotomized 8 weeks later. All sheep were sacrificed after 16 weeks. Magnetic resonance imaging (MRI) was performed before the first surgery (baseline) and then after 8 and 16 weeks. The MRI data were used to assess muscle volume, fat fraction, musculotendinous retraction, pennation angle, and muscle fiber length of the infraspinatus muscle. Results: Three sheep (2 in the T/N and 1 in the N/T group) had to be excluded because the neurectomy was incomplete. After 8 weeks, muscle volume decreased significantly less in the T/N group (73% ± 2% of initial volume vs 52% ± 7% in the N/T group; P & .001). After 16 weeks, the mean intramuscular fat increase was higher in the T/N group (36% ± 9%) than in the N/T group (23% ± 6%), without reaching significance ( P = .060). After 16 weeks, the muscle volumes of the N/T (52% ± 8%) and T/N (49% ± 3%) groups were the same ( P = .732). Conclusion: Secondary neurectomy after tenotomy of a musculotendinous unit increases muscle atrophy. Tenotomy of a denervated muscle is associated with substantial myotendinous retraction but not with an increase of fatty infiltration to the level of the tenotomy first group. Clinical Relevance: Substantial retraction, which is associated with hitherto irrecoverable fatty infiltration, should be prevented, and additional neurogenic injury during repair should be avoided to limit the development of further atrophy.
机译：背景：在绵羊旋转器袖口模型中，个体术主要诱导脂肪浸润，并且去脱叶诱导大多数肌肉萎缩。在临床实践中，在肌腱修复撕裂后肌腱撕裂或侧向化后的肌肉缩回可能导致神经的牵引损伤。目的/假设：分析旋转器袖带修复期间的额外神经病变是否导致临床环境中的旋转器袖带肌的进一步退化。我们假设肌腱撕裂后神经切除术会增加萎缩以及脂肪切除症，并且神经切除术后的肌肉麻痹将防止次要肌腱释放后肌肉缩回。研究设计：受控实验室研究。方法：使用12种瑞士高山绵羊用于本研究。对于肌肉/神经切除术（T / N）组中的6只羊，侵入血液肌腱; 8周后，初产腺神经被切断。对于神经切除术/个体术（N / T）组中的6只绵羊，进行神经切除术，并且血液肌肌瘤8周后致缩放。 16周后，所有绵羊都被牺牲。在第一次手术（基线）之前进行磁共振成像（MRI），然后在8和16周后进行。 MRI数据用于评估肌肉体积，脂肪分数，肌肉缩回，缠结角和肌纤维长度的抗腹肌。结果：必须排除三只羊（2羊，在N / T组中的T / N和1），因为神经切除术是不完整的。 8周后，T / N组肌肉体积显着降低（初始体积的73％±2％在N / T组中为52％±7％; P＆amp; LT; .001）。 16周后，T / N群（36％±9％）的平均肌肉脂肪增加高于N / T组（23％±6％），而无需达到意义（P = .060）。 16周后，N / T（52％±8％）和T / N（49％±3％）基团的肌肉体积相同（P = .732）。结论：肌肉抑制单位肌肉萎缩术后的继发性神经切除术增加了肌肉萎缩。神经肌肉的赋形术与大量的近距离缩回有关，但没有增加脂肪渗透到腱鞘第一个组的水平。临床相关性：应防止与迄今为止无可挽回的脂肪渗透相关的大量收缩，并且应避免修复过程中的额外神经源性损伤，以限制进一步萎缩的发展。

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