脫細胞肌腱片促進兔肩袖損傷腱-骨愈合的實驗研究_《中國修復重建外科雜志》

作者：

潘娟 ^1,2 , 劉國明 ³ , 寧良菊 ⁴ , 羅靜聰 ^4,5 , 黃富國 ³ , 秦廷武 ^4,5

四川大學華西醫院（成都，610041）1 康復醫學科，2康復醫學四川省重點實驗室，3骨科，4生物治療國家重點實驗室·干細胞與組織工程研究室，5 再生醫學研究中心;

關鍵詞：

脫細胞肌腱片肩袖損傷腱-骨愈合犬兔

DOI：

10.7507/1002-1892.20130234

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目的評價犬脫細胞肌腱片（decellularized tendon slices，DTSs）對兔肩袖損傷腱-骨愈合的作用。方法取成年比格犬跟腱經反復凍融5次結合核酸酶處理12 h制備DTSs，體外對DTSs行組織學觀察和細胞相容性評價。取成年雄性新西蘭大白兔24只，體重2.5～3.0 kg，隨機選取一側肩關節自岡下肌腱止點處縱向作寬大于正常肌腱50%、長為8 mm的U形缺損，用犬DTSs修復岡下肌腱缺損并重建腱-骨止點（實驗組）；對側肩關節不作任何處理（對照組）。術后4、8、12周取兩組標本行組織學觀察和生物力學測試。結果體外組織學觀察示犬DTSs膠原結構保留完整，無細胞殘留；細胞相容性實驗示成纖維細胞與DTSs良好黏附。生物力學測試示，隨時間延長，實驗組最大載荷和剛度均呈增加趨勢，12周時顯著高于4周及8周（P lt; 0.05）；除12周實驗組最大載荷與對照組比較差異無統計學意義（t=0.969，P=0.361）外，其余各時間點實驗組最大載荷及剛度均顯著小于對照組（P lt; 0.05）。組織學觀察示，對照組可見腱-骨止點的4層結構。實驗組術后4周腱-骨界面由肉芽組織填充，少量類似Sharpey纖維連接于腱-骨間；隨時間延長肉芽組織界面消失，成纖維細胞、Sharpey纖維、新生軟骨和軟骨細胞數量增多，腱-骨界面逐漸成熟，但未見位于礦化纖維軟骨與非礦化纖維軟骨間的潮線。結論經反復凍融5次結合核酸酶處理12 h制備的犬DTSs 可促進兔肩袖損傷腱-骨愈合，提高肩袖損傷修復的生物力學性能。

引用本文： 潘娟,劉國明,寧良菊,羅靜聰,黃富國,秦廷武. 脫細胞肌腱片促進兔肩袖損傷腱-骨愈合的實驗研究. 中國修復重建外科雜志, 2013, 27(9): 1070-1075. doi: 10.7507/1002-1892.20130234 復制

1.	Ricchetti ET, Aurora A, Iannotti JP, et al. Scaffold devices for rotator cuff repair. J Shoulder Elbow Surg, 2012, 21(2): 251-265.
2.	Goradia VK, Mullen DJ, Boucher HR, et al. Cyclic loading of rotator cuff repairs: A comparison of bioabsorbable tacks with metal suture anchors and transosseous sutures. Arthroscopy, 2001, 17(4): 360-364.
3.	Dines DM, Moynihan DP, Dines JS, et al. Irreparable rotator cuff tears: what to do and when to do it; the surgeon’s dilemma. Instr Course Lect, 2007, 56: 13-22.
4.	Kimura A, Aoki M, Fukushima S, et al. Reconstruction of a defect of the rotator cuff with polytetrafluoroethylene felt graft. Recovery of tensile strength and histocompatibility in an animal model. J Bone Joint Surg (Br), 2003, 85(2): 282-287.
5.	Cole BJ, Gomoll AH, Yanke A, et al. Biocompatibility of a polymer patch for rotator cuff repair. Knee Surg Sports Traumatol Arthrosc, 2007, 15(5): 632-637.
6.	Derwin KA, Badylak SF, Steinmann SP, et al. Extracellular matrix scaffold devices for rotator cuff reapir. J Shoulder Elbow Surg, 2010, 19(3): 467-476.
7.	Nicholson GP, Breur GJ, Van Sickle D, et al. Evaluation of a cross-linked acellular porcine dermal patch for rotator cuff repair augmentation in an ovine model. J Shoulder Elbow Surg, 2007, 16(5 Suppl): S184-190.
8.	Ning LJ, Zhang Y, Chen XH, et al. Preparation and characterization of decellularized tendon slices for tendon tissue engineering. J Biomed Mater Res A, 2012, 100(6): 1448-1456.
9.	Omae H, Zhao C, Sun YL, et al. Multilayer tendon slices seeded with bone marrow stromal cells: a novel composite for tendon engineering. J Orthop Res, 2009, 27(7): 937-942.
10.	Carpenter JE, Thomopoulos S, Flanagan CL, et al. Rotator cuff defect healing: a biomechanical and histologic analysis in an animal model. J Shoulder Elbow Surg, 1998, 7(6): 599-605.
11.	Chen JM, Willers C, Xu J, et al. Autologous tenocyte therapy using porcine-derived bioscaffolds for massive rotator cuff defect in rabbits. Tissue Eng, 2007, 13(7): 1479-1491.
12.	Klepps S, Bishop J, Lin J, et al. Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am J Sports Med, 2004, 32(7): 1716-1722.
13.	Galatz LM, Ball CM, Teefey SA, et al. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg (Am), 2004, 86-A(2): 219-224.
14.	Burkhart SS, Barth JR, Richards DP, et al. Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthroscopy, 2007, 23(4): 347-354.
15.	Phipatanakul WP, Petersen SA. Porcine small intestine submucosa xenograft augmentation in repair of massive rotator cuff tears. Am J Orthop (Belle Mead NJ), 2009, 38(11): 572-575.
16.	Barber FA, Burns JP, Deutsch A, et al. A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthroscopy, 2012, 28(1): 8-15.
17.	Whitlock PW, Smith TL, Poehling GG, et al. A naturally derived, cytocompatible, and architecturally optimized scaffold for tendon and ligament regeneration. Biomaterials, 2007, 29 (29): 4321-4329.
18.	Qin TW, Chen QS, Sun YL, et al. Mechanical characteristics of native tendon slices for tissue engineering scaffold. J Biomed Mater Res B Appl Biomater, 2012, 100(3): 752-758.
19.	Chen CH, Cao Y, Wu YF, et al. Tendon healing in vivo: gene expression and production of multiple growth factors in early tendon healing period. J Hand Surg (Am), 2008, 33(10): 1834-1842.
20.	Kovacevic D, Fox AJ, Bedi A, et al. Calcium-phosphate matrix with or without TGF-β3 improves tendon-bone healing after rotator cuff repair. Am J Sports Med, 2011, 39(4): 811-819.
21.	Kondo E, Yasuda K, Katsura T, et al. Biomechanical and histological evaluations of the doubled semitendinosus tendon autograft after anterior cruciate ligament reconstruction in sheep. Am J Sports Med, 2012, 40(2): 315-324.
22.	Yu Y, Bliss JP, Bruce WJ, et al. Bone morphogenetic proteins and Smad expression in ovine tendon-bone healing. Arthroscopy, 2007, 23(2): 205-210.
23.	Xu H, Wan H, Zuo W, et al. A porcine-derived acellular dermal scaffold that supports soft tissue regeneration: removal of terminal galactose-alpha-(1, 3)-galactose and retention of matrix structure. Tissue Eng Part A, 2009, 15(7): 1807-1819.
24.	Xu Y, Murrell GA. The basic science of tendinopathy. Clin Orthop Relat Res, 2008, 466(7): 1528-1538.
25.	Trudel G, Ramachandran N, Ryan SE, et al. Supraspinatus tendon repair into a bony trough in the rabbit: mechanical restoration and correlative imaging. J Orthop Res, 2010, 28(6): 710-715.
26.	張春禮, 范宏斌, 呂榮, 等. 自體和異體肌腱移植重建前十字韌帶后止點轉歸的組織學研究. 中華骨科雜志, 2004, 24(3): 146-149.
27.	王永健, 敖英芳. 自體半腱肌腱重建兔前交叉韌帶腱骨愈合和止點形成實驗研究. 中國運動醫學雜志, 2007, 26(1): 5-9.

1. Ricchetti ET, Aurora A, Iannotti JP, et al. Scaffold devices for rotator cuff repair. J Shoulder Elbow Surg, 2012, 21(2): 251-265.
2. Goradia VK, Mullen DJ, Boucher HR, et al. Cyclic loading of rotator cuff repairs: A comparison of bioabsorbable tacks with metal suture anchors and transosseous sutures. Arthroscopy, 2001, 17(4): 360-364.
3. Dines DM, Moynihan DP, Dines JS, et al. Irreparable rotator cuff tears: what to do and when to do it; the surgeon’s dilemma. Instr Course Lect, 2007, 56: 13-22.
4. Kimura A, Aoki M, Fukushima S, et al. Reconstruction of a defect of the rotator cuff with polytetrafluoroethylene felt graft. Recovery of tensile strength and histocompatibility in an animal model. J Bone Joint Surg (Br), 2003, 85(2): 282-287.
5. Cole BJ, Gomoll AH, Yanke A, et al. Biocompatibility of a polymer patch for rotator cuff repair. Knee Surg Sports Traumatol Arthrosc, 2007, 15(5): 632-637.
6. Derwin KA, Badylak SF, Steinmann SP, et al. Extracellular matrix scaffold devices for rotator cuff reapir. J Shoulder Elbow Surg, 2010, 19(3): 467-476.
7. Nicholson GP, Breur GJ, Van Sickle D, et al. Evaluation of a cross-linked acellular porcine dermal patch for rotator cuff repair augmentation in an ovine model. J Shoulder Elbow Surg, 2007, 16(5 Suppl): S184-190.
8. Ning LJ, Zhang Y, Chen XH, et al. Preparation and characterization of decellularized tendon slices for tendon tissue engineering. J Biomed Mater Res A, 2012, 100(6): 1448-1456.
9. Omae H, Zhao C, Sun YL, et al. Multilayer tendon slices seeded with bone marrow stromal cells: a novel composite for tendon engineering. J Orthop Res, 2009, 27(7): 937-942.
10. Carpenter JE, Thomopoulos S, Flanagan CL, et al. Rotator cuff defect healing: a biomechanical and histologic analysis in an animal model. J Shoulder Elbow Surg, 1998, 7(6): 599-605.
11. Chen JM, Willers C, Xu J, et al. Autologous tenocyte therapy using porcine-derived bioscaffolds for massive rotator cuff defect in rabbits. Tissue Eng, 2007, 13(7): 1479-1491.
12. Klepps S, Bishop J, Lin J, et al. Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am J Sports Med, 2004, 32(7): 1716-1722.
13. Galatz LM, Ball CM, Teefey SA, et al. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg (Am), 2004, 86-A(2): 219-224.
14. Burkhart SS, Barth JR, Richards DP, et al. Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthroscopy, 2007, 23(4): 347-354.
15. Phipatanakul WP, Petersen SA. Porcine small intestine submucosa xenograft augmentation in repair of massive rotator cuff tears. Am J Orthop (Belle Mead NJ), 2009, 38(11): 572-575.
16. Barber FA, Burns JP, Deutsch A, et al. A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthroscopy, 2012, 28(1): 8-15.
17. Whitlock PW, Smith TL, Poehling GG, et al. A naturally derived, cytocompatible, and architecturally optimized scaffold for tendon and ligament regeneration. Biomaterials, 2007, 29 (29): 4321-4329.
18. Qin TW, Chen QS, Sun YL, et al. Mechanical characteristics of native tendon slices for tissue engineering scaffold. J Biomed Mater Res B Appl Biomater, 2012, 100(3): 752-758.
19. Chen CH, Cao Y, Wu YF, et al. Tendon healing in vivo: gene expression and production of multiple growth factors in early tendon healing period. J Hand Surg (Am), 2008, 33(10): 1834-1842.
20. Kovacevic D, Fox AJ, Bedi A, et al. Calcium-phosphate matrix with or without TGF-β3 improves tendon-bone healing after rotator cuff repair. Am J Sports Med, 2011, 39(4): 811-819.
21. Kondo E, Yasuda K, Katsura T, et al. Biomechanical and histological evaluations of the doubled semitendinosus tendon autograft after anterior cruciate ligament reconstruction in sheep. Am J Sports Med, 2012, 40(2): 315-324.
22. Yu Y, Bliss JP, Bruce WJ, et al. Bone morphogenetic proteins and Smad expression in ovine tendon-bone healing. Arthroscopy, 2007, 23(2): 205-210.
23. Xu H, Wan H, Zuo W, et al. A porcine-derived acellular dermal scaffold that supports soft tissue regeneration: removal of terminal galactose-alpha-(1, 3)-galactose and retention of matrix structure. Tissue Eng Part A, 2009, 15(7): 1807-1819.
24. Xu Y, Murrell GA. The basic science of tendinopathy. Clin Orthop Relat Res, 2008, 466(7): 1528-1538.
25. Trudel G, Ramachandran N, Ryan SE, et al. Supraspinatus tendon repair into a bony trough in the rabbit: mechanical restoration and correlative imaging. J Orthop Res, 2010, 28(6): 710-715.
26. 張春禮, 范宏斌, 呂榮, 等. 自體和異體肌腱移植重建前十字韌帶后止點轉歸的組織學研究. 中華骨科雜志, 2004, 24(3): 146-149.
27. 王永健, 敖英芳. 自體半腱肌腱重建兔前交叉韌帶腱骨愈合和止點形成實驗研究. 中國運動醫學雜志, 2007, 26(1): 5-9.

《中國修復重建外科雜志》

脫細胞肌腱片促進兔肩袖損傷腱-骨愈合的實驗研究

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《中國修復重建外科雜志》

脫細胞肌腱片促進兔肩袖損傷腱-骨愈合的實驗研究

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