| BackgroundWith the aging of society and the change of lifestyle,there are the increasing rotator cuff injuries day by day,which seriously affects the quality of life of patients.Rotator cuff injury mainly occurs in the transitional area between supraspinatus tendon and humerus,and the treatment aims to achieve tendon-bone healing.There are many factors affecting tendon-bone healing,including surgical techniques and postoperative rehabilitation.Surgical techniques include arthroscopy and open surgery,and postoperative rehabilitation includes physical and motor rehabilitation.Extracorporeal shock wave is the main physical rehabilitation method,which is mostly used for conservative treatment of rotator cuff injury.Literature retrieval shows that there are few reports on the use of extracorporeal shock wave after operation,and there is a lack of corresponding animal model experimental research to confirm its efficacy after operation.ObjectiveTo establish a rabbit model with tendon-bone healing after supraspinatus tendon injury by applying extracorporeal shock wave to the tendon-bone junction area of the model,and discuss the feasibility,safety and effectiveness of the application of extracorporeal shock wave after the repair of rotator cuff injury by histological,ultrasonic imaging and biomechanical detection methods,so as to provide experimental basis for the application of extracorporeal shock wave after the repair of rotator cuff injury.Methods54 male New Zealand rabbits were randomly divided into experimental group and control group.36 rabbits in experimental group were used to prepare the left supraspinatus muscle injury repair and reconstruction model,and underwent extracorporeal shock wave intervention;18 rabbits in control group were used to prepare the left supraspinatus muscle injury repair and reconstruction model.All rabbits were fed routinely,and stitches were removed at the end of the 2nd week after operation,and the experimental group was treated with extracorporeal shock wave intervention at the beginning of the 3rd week.The shock wave parameters were set:energy density 0.12 m J/mm~2,pressure field 1bar,frequency 4Hz,frequency 500 beats/time,once a week.At the end of the 3W,6W and 9W,the blood supply,edema and anatomical morphology of tendon-bone transition were examined by musculoskeletal ultrasound in vivo.Then,8 rats in the experimental group and 4 rats in the control group were randomly killed by air embolism,and the specimens of tendon-bone transition area were taken for histological examination such as HE staining,Masson staining and CD34 immunohistochemistry.The ultimate tensile strength was measured by biomechanics at the end of 6W and 9W.Similarly,6 rats in the experimental group and 3 rats in the control group were randomly killed by air embolism.The experimental data were statistically analyzed by SPSS 19.0 statistical software,and the comparison of observation indicators between groups at the same time node was carried out by tˊtest,with P<0.05 as the statistical difference.ResultsThe junction position between supraspinatus tendon and humerus in rabbits is superficial,the anatomy is clear,and the preparation process of injury reconstruction model is simple,with high success rate and good consistency.Research objects in the two groups were generally in good condition.There were no significant differences in in musculoskeletal ultrasound and histological examination at the end of the 3rd week between experimental group and control group.At the end of 6W and 9W,the tendon-bone healing was observed in experimental group and control group at the transition site of tendon-bone:Musculoskeletal ultrasound showed that the width and thickness of the tendon in experimental group were(6.73±0.31mm,4.18±0.28mm)and(6.05±0.16mm,3.66±0.31mm),respectively,and in the control group were(5.04±0.30mm,2.50±0.08mm)and(4.08±0.13mm,2.06±0.10mm),respectively.There were statistical differences between the two groups at the same time node.The width and thickness of the experimental group were larger than those of the control group,but they were reduced compared with the end of the third week,indicating that the application of extracorporeal shock wave intervention can cause slight damage to tendon-bone tissue,and delay the regression of edema;HE staining and Masson staining of histological sections showed that the healing trend of tendon-bone in experimental group was better than that in control group.In CD34immunohistochemistry,the number of positive blood vessels per high power field was(7.37±0.38 and 17.40±0.40)in the experimental group and(3.30±0.26 and 8.30±0.26)in the control group.The difference was significant at the same time node;The limit values of biomechanical tension in the experimental group were(15.85±1.01N and 20.87±1.62N),and the limit values of biomechanical tension in the control group were(12.81±0.52N and 17.54±0.75N).There was a significant difference between the two groups at the same time node.ConclusionThe tendon-bone healing model of rabbit with supraspinatus tendon injury is simple to prepare,with high success rate and good consistency.Extracorporeal shock wave can promote the healing process of tendon-bone after repairing rotator cuff injury of supraspinatus muscle in rabbits. |
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