肩袖修复后促进腱骨界面软骨再生的研究进展

Recent progress in augmentation of tendon-to-bone healing after rotator cuff repair

肩袖损伤是造成肩关节功能障碍最常见的原因,尽管手术技术不断进步,但肩袖修复术后再撕裂发生率依然高达20%~94%。从组织病理学角度看,传统肩袖重建术后正常腱骨界面组织结构无法重演,主要问题是肌腱插入骨部位的软骨过渡层不能再生,腱骨之间仅为瘢痕愈合,有研究证实修复后肩袖止点的抗拉强度大幅减弱,推测这可能是已修复肩袖容易发生再撕裂的原因之一。近年来,越来越多的国内外研究致力于利用生物学技术促进肩袖修复后腱骨界面软骨再生,尝试恢复正常腱骨连接部的组织形态,已成为目前研究的热点。本文就这方面的基础研究进展作一综述。

Rotator cuff injury is the most common cause of shoulder disability. The rotator cuff retear rate after repair remains as high as 20% - 94% despite the constant development of surgical techniques. The histological structure at the tendon - to - bone interface can not be reconstructed after traditional rotator cuff repair mainly because the cartilage - bone transition zone cannot be regenerated at the tendon - to - bone insertion site after rotator cuff repair and the it is impaired scar healing. It wasalso reported that the tendon - to - bone interface after repair has weaker mechanical strength compared with the normal interface and this is one of the causes of rotator cuff retear after repair. In recent years, more and more researchers around the world have focused on the augmentation of cartilage regen-eration at the tendon - to - bone interface after rotator cuff repair using biological technology to restore the histological structure at the interface, which has become a research hotspot. This article reviews the progress in basic research in this area.