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目的比较研究不同肩袖损伤类型以及采用不同方法修复后的肩袖愈合差异,探讨能准确模拟临床肩袖损伤修复术后恢复进程的动物模型。方法取12只成年雄性比格犬,体质量10~15 kg,根据处理方法不同随机分为3组(n=4),分别制备急性肩袖损伤+Mason-Allen缝合修复(A组)、巨大肩袖损伤+Mason-Allen缝合修复(B组)及巨大肩袖损伤+Mason-Allen缝合并自体半腱肌扩张部修复(C组)动物模型;3组修复后均外固定架制动。术后观察各组动物一般情况;于术后6周取材大体观察冈下肌肌腱末端愈合情况,生物力学测试极限负荷,组织学观察肌腱细胞及纤维改变,比较肩袖修复程度。结果术后各组动物均存活至实验完成,切口均愈合良好,无感染发生。大体观察示,A组冈下肌肌腱末端瘢痕组织明显多于正常肌腱组织;B组冈下肌肌腱末端未见明显肌腱组织;C组冈下肌肌腱虽然部分覆盖瘢痕组织,但仍可观察到肌腱及其大致走向。A、B、C组极限负荷分别为(223.75±24.28)、(159.25±34.87)、(233.25±14.24)N,B组显著低于A、C组(P<0.05),A、C组间比较差异无统计学意义(P>0.05)。组织学观察示,A组肌腱纤维排列大致正常;B组肌腱纤维排列较紊乱,并且肌腱细胞明显少于A组;C组肌腱纤维排列整齐,且肌腱细胞多于B组。结论 Mason-Allen缝合联合自体半腱肌扩张部修复犬巨大肩袖损伤能获良好修复效果;制动模型可较好模拟临床肩袖损伤愈合过程,可作为相关研究的理想动物模型。
Objective To compare the different types of rotator cuff injuries and the difference of rotator cuff healing after repair by different methods and to explore the animal model that can accurately simulate the recovery process of rotator cuff repair. Methods A total of 12 adult male Beagle dogs were randomly divided into 3 groups (n = 4) according to different treatment methods. Acute rotator cuff injury and Mason-Allen suture repair (group A) Rotator cuff injury + Mason-Allen suture repair (B group) and huge rotator cuff injury + Mason-Allen suture combined with autologous semitendinosus muscle expansion (C group) animal model; Postoperatively, the general condition of each group of animals was observed. At the 6th week after operation, the tendons of the infraspinatus muscle were harvested and the tendons were harvested. The biomechanical load, histological changes of tendon cells and fibers were observed. The degree of rotator cuff repair was compared. Results All animals in each group survived until the experiment was completed. The incisions healed well and no infection occurred. In general, there was significantly more scar tissue in the tendon of group A than in normal tendon tissue. There was no obvious tendon tissue in the tendon of group B. The tendon of subclavian muscle in group C, although partially covered with scar tissue, was still observed Tendon and its general direction. The ultimate load of group A, B and C were (223.75 ± 24.28), (159.25 ± 34.87) and (233.25 ± 14.24) N, respectively, but significantly lower in group B than those in group A and C (P <0.05) The difference was not statistically significant (P> 0.05). Histological observation showed that the arrangement of tendon fibers in group A was roughly normal; the tendon fibers in group B were more disordered and the number of tendon cells was less than that in group A; and the tendon fibers in group C were arranged neatly with tendon cells more than group B. Conclusions Mason-Allen suture and autologous semitendinosus dorsi can repair the huge rotator cuff injuries in dogs. Brake model can better simulate the process of clinical rotator cuff injury and can be used as an ideal animal model for related studies.