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Histologic and biomechanical evaluation of the thoracolumbar fascia graft for massive rotator cuff tears in a rat model.
Li, Huai-Sheng; Zhou, Mei; Huang, Pan; Liu, Juan; Tang, Hong; Zhang, Chen-Ke; Wang, Yun-Jiao; Shi, You-Xing; Liao, Ya-Tao; Jin, Bao-Yong; Tang, Kang-Lai; Zhou, Binghua.
Afiliación
  • Li HS; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Zhou M; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Huang P; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Liu J; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Tang H; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Zhang CK; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Wang YJ; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Shi YX; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Liao YT; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Jin BY; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China.
  • Tang KL; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China. Electronic address: tangkanglai@hotmail.com.
  • Zhou B; Department of Orthopedic Surgery, Southwest Hospital, Army Military Medical University, Chongqing, China. Electronic address: yijian510868@hotmail.com.
J Shoulder Elbow Surg ; 31(4): 699-710, 2022 Apr.
Article en En | MEDLINE | ID: mdl-34775038
BACKGROUND: Fascial autografts, which are easily available grafts, have provided a promising option in patients with massive rotator cuff tears. However, no fascial autografts other than the fascia lata have been reported, and the exact healing process of the fascia-to-bone interface is not well understood. The objective of this study is to histologically and biomechanically evaluate the effect of the thoracolumbar fascia (TLF) on fascia-to-bone healing. METHODS: A total of 88 rats were used in this study. Eight rats were killed at the beginning to form an intact control group, and the other rats were divided randomly into 2 groups (40 rats per group): the TLF augmentation group (TLF group) and the repair group (R group). The right supraspinatus was detached, and a 3 × 5 mm defect of the supraspinatus was created. The TLF was used to augment the torn supraspinatus in the TLF group, whereas in the R group, the torn supraspinatus was repaired in only a transosseous manner. Histology and biomechanics were assessed at 1, 2, 4, 8, and 16 weeks postoperatively. RESULTS: The modified tendon maturation score of the TLF group was higher than that of the R group at 8 weeks (23.00 ± 0.71 vs. 24.40 ± 0.89, P = .025) and 16 weeks (24.60 ± 0.55 vs. 26.40 ± 0.55, P ≤ .001). The TLF group showed a rapid vascular reaction, and the peak value appeared at 1 week. Later, the capillary density decreased, and almost no angiogenesis was observed at 8 weeks postoperatively. Immunohistochemistry results demonstrated a significantly higher percentage of collagen I in the TLF group at 4, 8, and 16 weeks (24.78% ± 2.76% vs. 20.67% ± 2.11% at 4 weeks, P = .046; 25.46% ± 1.77% vs. 21.49% ± 2.33% at 8 weeks, P = .026; 34.77% ± 2.25% vs. 30.01% ± 3.17% at 16 weeks, P = .040) postoperatively. Biomechanical tests revealed that the ultimate failure force in the TLF group was significantly higher than that in the R group at the final evaluation (29.13 ± 2.49 N vs. 23.10 ± 3.47 N, P = .022). CONCLUSIONS: The TLF autograft can promote a faster biological healing process and a better fixation strength. It could be used as an alternative reinforcement or bridging patch when the fascia lata is not appropriate or available for superior capsule reconstruction (SCR).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Lesiones del Manguito de los Rotadores Tipo de estudio: Prognostic_studies Límite: Animals / Humans Idioma: En Revista: J Shoulder Elbow Surg Asunto de la revista: ORTOPEDIA Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Lesiones del Manguito de los Rotadores Tipo de estudio: Prognostic_studies Límite: Animals / Humans Idioma: En Revista: J Shoulder Elbow Surg Asunto de la revista: ORTOPEDIA Año: 2022 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos