同种异体皮质骨锚钉修复肩袖损伤的动物实验

Animal experiment on repair of rotator cuff injury using cortical bone anchors

目的探讨使用同种异体皮质骨锚钉修复肩袖损伤在不同时间段锚钉和骨道壁之间的愈合情况。方法使用深低温冷冻(-80℃)的成年羊胫骨皮质骨制成肩袖缝合锚钉,试验动物选用6只山羊。术中直接取肩关节正中切口,解剖分离出冈上肌腱,于止点处锐性切断,使用锉刀在肌腱止点原附着点进行磨挫直至出现新鲜骨面。将皮质骨锚钉缓慢植入预钻孔内,使用锚钉所带缝线将离断的冈上肌腱组织缝合至新鲜骨面。分别在术后第4、8、12周三个时间点取材,进行放射学、大体形态和组织切片检查,观察冈上肌腱的腱-骨愈合情况及骨锚钉的组织学转归。结果术后第12周固定处冈上肌腱与骨面形成牢固的腱骨愈合,放射学显示骨锚钉在各个时间点逐步与周围骨质融合。HE染色检查显示在第12周时骨锚钉与周围骨质完全融合。结论使用同种异体皮质骨锚钉固定修复肩袖损伤可达到牢固的腱-骨愈合目的,术后皮质骨锚钉与周围骨质融合,没有出现锚钉脱出、骨缺损等并发症。

Objective To observe the healing of rotator cuff injury between the anchor and bone tunnel after repaired with allograft bone anchors in different periods of time. Methods Shoulder bone suture anchors were made using the cortical bone of adult sheep stored at -80 ~C . Six sheep were used as experimental animals. A median incision was made at the shoulder joint to isolate the supraspinatus tendon which was then sharply cut at its end. The end of supraspinatus tendon attached to the cortical bone was finished with a grater until the fresh bone surface was seen. Cortical bone anchors were slowly implanted into the prepared holes and supraspinatus tendon was sutured onto the fresh bone with sutures in anchors. Specimens were taken at weeks 4, 8, and 12, respectively, after operation. Radiology, gross morphology and histology examinations were performed to observe the healing of supraspinatus muscle between the tendon and bone, and the histology turnover of bone anchors. Results The supraspinatus tendon was healed with fresh bones formed 12 weeks after operation. Radiology showed that the cortical bone anchors were fused with bones around them. HE staining of supraspinatus tendon tissue revealed that the cortical bone anchors were completely fused with bones around them 12 weeks after operation. Conclusion Rotator cuff injury between supraspinatus tendon and bone can be repaired with allograft cortical bone anchors, which are then fused with bones around them with no bone defect after operation.