| Objective:To investigate the biomechanical effects of autologous periosteum transplantation combined with microfracture on the healing of rabbit rotator cuff bone,and to find a certain experimental basis for the clinical success rate of rotator cuff injury repair.Methods:1.Gross observation of the condition of muscle atrophy,sutures,and healing of isolated specimens of experimental animals.2.Biomechanical test:60 rabbits were randomly selected and divided into 4 groups on average.The rabbit rotator cuff tear model was made using the same method and the wounded rabbits were treated according to the group.:experimental group 1:After the local line microfracture,surgical suture rotator cuff to the supraspinatus grandis;Experimental group 2:After the autogenous periosteum was applied to cover the rotator cuff,the rotator cuff was sutured to the supraspinatus muscle of the greater tuberosity.In the experimental group 3,after the local microfracture,the autogenous periosteum was used to cover the rotator cuff.Surgical suture of the rotator cuff was performed on the supraspinatus of the greater tubercle.In the control group,the rotator cuff was simply sutured to the supraspinatus muscle of the greater tubercle without any additional treatment.Then rotator cuff repair was performed on each group,including autogenous periosteal grafting to the repair of rotator cuff,local microfracture of large nodules,and suturing fixed rotator cuff.Finally,biomechanics tests were performed on each group to compare the difference in tensile strength,cross-sectional area,and stiffness between the four groups at the same time point;and the difference in cross-sectional area and stiffness at different time points in the four groups.The experimental data analysis was performed using SPSS25.0 software.All data results were expressed as mean ± standard deviation,and a=0.05 was used as a statistically significant point of differentiation.The same experimental conditions were compared between different groups using one-way analysis of variance.Comparison of specific experimental data within the group between different experimental stages was performed using a single set of repeated measures analysis of variance.There was no significant difference in cross-sectional area between experimental group 3 and experimental group 2,experimental group 1 and control group(P>0.05).Results:1.A few experimental rabbits in each group experienced inflammatory changes in the synovial process of the shoulder at 4,8,and 12 weeks after surgery,and were considered postoperatively.Gross observation of the joint cavity did not see heterotopic ossification and hyperplasia of scar tissue,and the amygdala was not obvious.At 4 weeks postoperatively,incisions of all groups were healed at grade A without obvious exudation,joint adhesion was not obvious,joint tendon was in a good position,suture was firm,morphology was normal,color was gray,texture was soft,and joint fiber structure of joint tendon was visible.There was a small amount of synovial tissue covering outside.The interface of the iliac bone was not seen in all groups.There was no healing in the loose connection;at 8 weeks after operation,the periosteum patch and the surrounding tissue completely healed in the experimental group 2 and the experimental group 3,and the outside was surrounded by similar scar tissue.However,no tissue growth was observed in the tendon defect of each group;at the 12th week after surgery,the hyperplasia of the scar tissue at the junction of the tendon of the supraspinatus muscle was found in the control group.The scar hyperplasia was evident in the control group,and the tendon thickened at the junction of the tibia.A small amount of hyperplasia was observed in the group 1 and 2.In group 3,the scar proliferation was extremely low,and the tibial junction interface was thinner.The scar tissue in experimental group 1 and experimental group 2 was visible to the naked eye and was less than the control group.2.Biomechanical test:There was a statistically significant difference in the tensile strength over time between the four groups(P<0.05).Further two-by-two comparisons showed that the tensile strengths in each group were as follows:12 weeks>8 weeks>4 weeks,with statistically significant differences(P<0.05).The results of one-way ANOVA between the four groups at different time points showed that there was a statistical difference in tensile strength between the four groups(P<0.05).The comparison of the experimental results showed that the tensile strength between the groups at the same time.The order from weak to strong was as follows:experimental group 3>experimental group 2>experimental group 1 or control group,with statistically significant differences(P<0.05);while there was no significant difference in tensile strength between experimental group 1 and the control group(P>0.05).The analysis of the stiffness of the four groups with time showed that the difference was statistically significant(P<0.05).Further comparison results showed that the stiffness of each group had the following relationship,12 weeks>8 weeks>4 weeks,with statistically significant differences(P<0.05).Using the one-way analysis of variance to compare the stiffness of the four groups at different time points shows that the difference is statistically significant(P<0.05).Further comparison results show that the stiffness of each group has the following relationship:The experimental group 1 or the control group had less obvious stiffness compared with experiment group 2 and experiment group 3(P<0.05),while there was no statistically significant difference in stillness between the experimental group 1 and the control group and the experimental group 2 and 3(P>0.05).The cross-sectional areas at different time points in the four groups were also statistically different(P<0.05).The cross-sectional area in each group had the following relationship:12 weeks>4 weeks>8 weeks,and the differences were all statistical Significance(P<0.05).The single-factor analysis of variance between the four groups at each time point showed that there was a statistical difference in the cross-sectional area between the four groups(P<0.05).The comparison between the two groups and the stiffness was more similar than the results,both as follows:Group 3 or experimental group 2>experimental group 1 or control group,and the difference was statistically significant(P<0.05),while there was no statistical difference in cross-sectional area between experimental group 3 and experimental group 2,experimental group 1 and control group(P>0.05).Conclusion:The use of autogenous periosteum as a source of patch combined with microfracture can effectively improve the mechanical strength of rabbit rotator cuff shin bone healing,shorten the healing time of patella,and has good biomechanical properties. |
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