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首页> 外文期刊>Journal of orthopaedic research >Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss.
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Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss.

机译：肌腱对骨损伤的延迟修复导致生物力学性能下降和骨丢失。

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INTRODUCTION: Repair of the torn rotator cuff tendon is a common procedure performed in the shoulder. In the clinical setting, a significant delay between rotator cuff tear and subsequent repair often exists. The purpose of this study was to investigate the biomechanical properties and bone density of the tendon to bone repair site after acute and delayed repair. METHODS: The supraspinatus tendons in bilateral shoulders of 60 rats were transected from the bone. In the acute group, the tendons were immediately repaired with suture. In the delayed group, the tendons were allowed to retract and repaired in a second procedure after a 3-week delay. Cross sectional area and biomechanical properties were evaluated. Bone density of the humeral head was assessed using peripheral quantitative computed tomography. Histologic sections were obtained and examined. RESULTS: At 10 days the repair tissue displayed vascular and fibroblast proliferation accompanied by predominantly mononuclear infiltrate. At 28 days the inflammatory process gradually decreased. No significant histologic differences were noted between the acute and delayed repair specimens. Cross-sectional area was higher in the delayed group at the early time points (44% at 10 days and 31% at 28 days). Viscoelastic properties were greater in the acute group at the early time points and significantly less at the latest time point, compared to the delayed group. Bone density was markedly decreased (8% and 12%, 28 and 56 days respectively) in the delay group. DISCUSSION: Inferior rotator cuff healing was demonstrated when there was a delay between injury and repair. Viscoelastic properties of the acute repairs were increased compared to the delayed group at 10 days, indicating tendon stiffening during the 3-week delay before repair. Viscoelastic properties of the acute repairs were decreased compared to the delayed group at 56 days indicating deterioration of properties over time in the delayed group. The deterioration in properties in the delayed group coincide with bone density decreases in the greater tuberosity. These results indicate that bone loss may a significant factor in poor healing.
机译：简介：修复肩袖撕裂肌腱是在肩部进行的常见手术。在临床环境中，肩袖撕裂和随后的修复之间通常存在明显的延迟。本研究的目的是研究急性和延迟修复后腱到骨修复部位的肌腱的生物力学特性和骨密度。方法：将60只大鼠双侧肩上棘上肌腱从骨头横切。在急性组，肌腱立即缝合缝合。在延迟组中，延迟3周后，肌腱可在第二次手术中缩回并修复。评估横截面积和生物力学性能。肱骨头的骨密度使用外围定量计算机断层扫描技术评估。获得组织切片并检查。结果：在第10天，修复组织显示出血管和成纤维细胞增生，并伴有单核浸润。在28天时，炎症过程逐渐减少。急性和延迟修复标本之间未发现明显的组织学差异。延迟组的横截面积在早期时间点较高（10天为44％，28天为31％）。与延迟组相比，急性组在早期时间点的粘弹性特性更高，而在最近时间点则明显更低。延迟组的骨密度显着降低（分别为8％和12％，28和56天）。讨论：当损伤和修复之间存在延迟时，证明肩袖愈合欠佳。与延迟组相比，急性修复的粘弹特性在10天时有所增加，表明在修复前3周延迟期间肌腱僵硬。与延迟组相比，急性修复的粘弹性性能在56天时降低了，这表明延迟组的性能随时间而下降。延迟组的性能下降与大结节中骨密度的下降相吻合。这些结果表明，骨质流失可能是导致不良愈合的重要因素。

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