Basic And Clinical Study On Functional Reconstruction Of Shoulder Joint

The rotator cuff tear and shoulder dislocation are common diseases in sports medicine.With the maturity of domestic arthroscopy in recent years,the diagnosis and treatment of shoulder joint disease has made great progress.However,shoulder arthroscopy is still a challenge for orthopedic surgeons due to the failure rate of the operation itself and the complexity of the operation.How to better promote the tendon-bone healing of patients with rotator cuff tear and improve the stability and exercise capacity of patients with shoulder dislocation is a hot topic at home and abroad.Purpose: 1.The ability of porcine small intestine submucosal tissue(SIS)patch to induce tendon-bone healing when rabbit rotator cuff was bridged was evaluated by gross observation,histomorphometry and biomechanical testing.2.To understand the kinematics of the contralateral and ipsilateral shoulder joints in patients with recurrent shoulder dislocation through a Dual fluoroscopic Imaging System.Materials and methods: 1.Establish a rabbit model of acute huge rotator cuff tear,use SIS patch for scapular sleeve bridging surgery,set autologous fascia bridge as a control,and take 4,8 and 12 weeks postoperatively,respectively,from appearance,histomorphology,biomechanics The ability of the SIS patch to induce tendon-bone healing was assessed.2.Twelve patients with unilateral recurrent shoulder dislocation and no contralateral dislocation history were enrolled.Three-dimensional models of the humerus and scapula were established using the bilateral shoulder CT scan and the Mimics 17.0 software.Dynamic motion images were acquired and correlated with kinematic data were measured and analyzed by the Dual fluoroscopic Imaging System and Rhinoceros 5.0 software.Results: 1.There was no statistically significant difference in histological scores between the SIS patch bridging group and the control group(fascia lata repair)at 4 weeks,8 weeks,and 12 weeks after surgery at 4 weeks,8 weeks,and 12 weeks after surgery(p>0.05);In the biomechanical test,the difference in maximum failure load between the two groups was also not statistically significant(p>0.05).2.During the abduction process,there was no significant difference in the displacement between the affected side and the healthy shoulder joint in the anterior/posterior direction and the up/down direction as the angle increased(p>0.05).During the external rotation of the abduction 90° position,there was a statistical difference(p<0.05)in the anterior/posterior displacement of the affected side and the contralateral shoulder joint as the angle increased,and the displacement in the up/down direction There was still no statistical difference(p>0.05).Conclusion: 1.According to histological and biomechanical results analysis,SIS patch bridging in the rabbit model of acute giant rotator cuff tear can achieve similar effects to autologous fascia lata transplantation.2.Compared with the healthy shoulder joint,the displacement of the shoulder joint on the dislocation side in the anteroposterior direction during the abduction and external rotation was statistically different.