Objective To summarize the evaluation methods of postoperative healing of supraspinatus tendon tear in recent years, in order to provide reference for clinic. Methods CNKI, Wanfang, PubMed, and Foreign Medical Literature Retrieval Service (FMRS) databases were used to search the literatures between 2005 and 2022. The literature related to the diagnosis and postoperative healing of supraspinatus tendon tear was included. Finally, 50 articles were reviewed. ResultsSupraspinatus tendon tear is a common shoulder disease. Physical examination, clinical score, and imaging examination are used to predict and evaluate the postoperative healing. Among them, physical examination and clinical score are non-invasive and the most economical methods, but their accuracy and sensitivity are lower than imaging examination, so they can only be used as auxiliary methods. The acromio-humeral distance (AHD) and upward migration index (UMI) measured by X-ray films can directly reflect the change of supraspinatus tendon thickness, but they are impossible to distinguish whether there is tear or not. Ultrasound and MRI are the main methods for the clinical diagnosis of supraspinatus tendon tear, but the commonly used MRI sequence can not accurately judge the internal healing of the tendon. Shear wave elastrography (SWE) and ultrashort-echo-time (UTE) techniques are the latest research directions in recent years, but different studies have shown opposite conclusions on the application of SWE technique. This conclusion shows that the principle of SWE technique and its relationship with tendons need to be further studied. UTE technique has good clinical effect, and the T2* value obtained by UTE technique is more accurate than that of traditional Sugaya typing, but there are still few research samples. Conclusion AHD and UMI measured by X-ray film and T2* value measured by UTE technique can be used as effective methods for evaluating the healing of supraspinatus tendon tear after repairing, and can be used as a follow-up evaluation method combined with physical examination and clinical score for patients with supraspinatus tendon tear.
Objective Platelet-rich plasma (PRP) can promote wound heal ing. To observe the effect of PRP injection on the early heal ing of rat’s Achilles tendon rupture so as to provide the experimental basis for cl inical practice. Methods Forty-six Sprague Dawley rats were included in this experiment, female or male and weighing 190-240 g. PRP and platelet-poor plasma (PPP) were prepared from the heart arterial blood of 10 rats; other 36 rats were made the models of Achilles tendon rupture, and were randomly divided into 3 groups (control group, PPP group, and PRP group), 12 rats for each group. In PPP and PRP groups, PPP and PRP of 100 μL were injected around the tendons once a week, respectively; in the control group, nothing was injected. The tendon tissue sample was harvested at 1, 2, 3, and 4 weeks after operation for morphology, histology, and immunohistochemistry observations. The content of collagen type I fibers also was measured. Specimens of each group were obtained for biomechanical test at 4 weeks. Results All the animals survived till the end of the experiment. Tendon edema gradually decreased and sliding improved with time. The tendon adhesion increased steadily from 1 week to 3 weeks postoperatively, and it was relieved at 4 weeks in 3 groups. There was no significant ifference in the grading of tendon adhesion among 3 groups at 1 week and at 4 weeks (P gt; 0.05), respectively. The inflammatory cell infiltration, angiogenesis, and collagen fibers were more in PRP group than in PPP group and control group at 1 week; with time, inflammatory cell infiltration and angiogenesis gradually decreased. Positive staining of collagen type I fibers was observed at 1-4 weeks postoperatively in 3 groups. The positive density of collagen type I fibers in group PRP was significantly higher than that in control group and PPP group at 1, 2, and 3 weeks (P lt; 0.05), but no significant difference was found among 3 groups at 4 weeks (P gt; 0.05). The biomechanical tests showed that there was no significant difference in the maximal gl iding excursion among 3 groups at 4 weeks postoperatively (P gt; 0.05); the elasticity modulus and the ultimate tensile strength of PRP group were significantly higher than those of control group and PPP group at 4 weeks (P lt; 0.05). Conclusion PRP injection can improve the healing of Achilles tendon in early repair of rat’s Achilles tendon rupture.
Objective To evaluate the effectiveness of using a bioinductive patch on tendon healing, functional recovery, and safety in arthroscopic rotator cuff repair. Methods A non-concurrent controlled study with prospective enrollment of the intervention group and retrospective collection of the control group was conducted. Patients with rotator cuff injuries admitted between June 2024 and March 2025 were enrolled. The sample size was calculated using G*Power software. A total of 60 patients meeting the selection criteria were enrolled, including 30 patients in the patch group (receiving arthroscopic rotator cuff repair combined with bioinductive patch implantation) and 30 patients in the control group (receiving arthroscopic rotator cuff repair only). There was no significant difference between groups (P>0.05) in baseline data, including age, gender, affected side, disease duration, DeOrio-Cofield classification, degree of fatty infiltration, proportion involving the subscapularis, proportion of revision surgeries, and preoperative visual analogue scale (VAS) score, Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, and University of California, Los Angeles (UCLA) score. The following indicators were compared between groups: the tendon healing rate at 6 months postoperatively and postoperative pain VAS score, functional scores (Constant-Murley, ASES, UCLA), imaging indicators (tendon thickness, footprint coverage, effusion), and patient-reported outcomes [12-Item Short-Form Health Survey (SF-12) physical/mental component score, SF-36 overall score, simple shoulder test (SST), satisfaction]. Additionally, subgroup analyses were performed based on whether the tear involved the subscapularis preoperatively, the degree of fatty infiltration (Goutallier grades Ⅰ, Ⅱ/Ⅲ, Ⅳ), and primary/revision surgery to compare tendon healing outcomes. A multiple linear regression model was used to analyze independent influencing factors of Constant-Murley score improvement at 6 months postoperatively. ResultsIncisions in both groups healed by first intention. All patients were followed up, with follow-up time of (13.0±1.8) months in the patch group and (12.8±1.9) months in the control group, showing no significant difference (t=0.415, P=0.680). The pain and shoulder joint function of the two groups gradually improved over time, and the corresponding scores showed significant differences between different time points (P<0.05). The pain relief and functional recovery improvement in the patch group was better than that in the control group, and there were significant differences in all scores between groups at 1 and 6 months (P<0.05). At 6 months postoperatively, the patch group had significantly better SF-12 physical component scores, SF-36 overall scores, and SST scores than the control group (P<0.05), while the SF-12 mental component score and patient’s satisfaction showed no significant difference between groups (P>0.05). At 12 months postoperatively, the surgical success rate was significantly higher in the patch group than in the control group (P<0.05). Imaging review showed no significant difference between groups in tendon healing rate, retear rate, complete footprint coverage rate, or effusion degree at 6 months postoperatively (P>0.05), but the increase in tendon thickness was significantly greater in the patch group than in the control group (P<0.05). Subgroup analysis showed that for revision surgery patients, there was no significant difference in retear rate based on patch use (P>0.05); however, primary surgery patients had a significantly higher tendon healing rate with patch use (P<0.05). For patients with Goutallier grade Ⅰ, Ⅱ fatty infiltration, patch use resulted in a significantly higher tendon healing rate (P<0.05), while for those with grade Ⅲ, Ⅳ fatty infiltration, the difference was not significant (P>0.05). For patients with or without involvement of the subscapularis, there was no significant difference in tendon healing rate based on patch use (P>0.05). Multiple linear regression analysis showed that independent influencing factors of Constant-Murley score improvement at 6 months postoperatively included the use of bioinductive patch, age, and fatty infiltration degree (P<0.05). ConclusionThe bioinductive patch can effectively promote joint functional recovery and structural improvement after rotator cuff repair with good safety.