腱骨界面力医学及其对腱骨界面损伤的临床诊疗价值

Tendon-bone interface mechanomedicine and its value in the clinical diagnosis and treatment of tendon-bone interface injuries

腱骨界面是肌腱或韧带与骨骼相连接的部位。腱骨界面损伤是一类“软-硬”组织界面损伤,包括肩袖-骨界面损伤、交叉韧带-骨界面损伤,通常是在腱骨界面组织退变的基础上结合急、慢性损伤引起,会对患者的运动能力产生严重影响。近年来,随着生物力学、力生物学与运动医学交叉研究的不断深入,力学因素在腱骨界面损伤修复过程中的作用受到越来越多的关注,成为腱骨界面损伤修复的前沿研究热点。因此,笔者综合国内外相关研究,提出“腱骨界面力医学”这一概念,从生物力学、力生物学、力诊断学和力治疗学4个方面阐释腱骨界面的力学特性和力学刺激对腱骨界面生物学行为的影响,并从力学角度探讨腱骨界面损伤的诊疗方法,为腱骨界面损伤修复提供新的研究视角和思路。

The tendon-bone interface is where the tendons or ligaments are connected with the bones.A spectrum of injuries may happen to the"soft-to-hard"tissue interface,including those to the rotator cuff-bone and cruciate ligament-bone interfaces,which are often precipitated by a combination of degenerative changes on the tendon-bone interface and acute or chronic injuries,thus severely impairing the patients′motor function.In recent years,with the deepening of the interdisciplinary researches in biomechanics,mechanobiology,and sports medicine,the role of mechanical factors in the repair of tendon-bone interface injuries has attracted more and more attention and becomes a focus of the edge-cutting researches on the tendon-bone interface injuries.To this end,the authors proposed the concept of"tendon-bone interface mechanomedicine"based on an overview of the relevant researches at home and abroad.The mechanical properties of the tendon-bone interface and the effects of mechanical stimuli on its biological behavior were elucidated from the four aspects:biomechanics,mechanobiology,mechanodiagnostics,and mechanotherapy,aiming to explore the diagnostic and therapeutic strategies for tendon-bone interface injuries from the angle of mechanics and provide new perspectives and methodologies for the field of tendon-bone interface injury repair.