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生物增强补片在肩袖撕裂愈合及力学稳定性中的应用

Biologically Enhanced Patch in the Healing and Mechanical Stability of Rotator Cuff Tears.

作者信息

Lp Merlin Rajesh Lal, Agrawal Devendra K

机构信息

Department of Translational Research, College of the Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California 91766, USA.

出版信息

J Biotechnol Biomed. 2024;7(3):379-387. doi: 10.26502/jbb.2642-91280161. Epub 2024 Sep 4.

Abstract

Biological patches have emerged as promising adjuncts in the surgical management of rotator cuff tears, aiming to enhance tissue healing and biomechanical properties of repaired tendons. These patches, derived from human or animal sources such as dermis or small intestinal submucosa, undergo mechanical and pathological changes within the rotator cuff environment post-implantation. These patches provide structural reinforcement to the repair site, distributing forces more evenly across the tendon and promoting a gradual load transfer during the healing process. This redistribution of forces helps alleviate tension on the repaired tendon and surrounding tissues, potentially reducing the risk of re-tears and improving overall repair integrity. Moreover, biological patches serve as scaffolds for cellular infiltration and tissue ingrowth, facilitating the recruitment of cells and promoting collagen synthesis. The integration of these patches into the host tissue involves a cascade of cellular events, including inflammation, angiogenesis, and matrix remodeling. Inflammatory responses triggered by patch implantation contribute to the recruitment of immune cells and the release of cytokines and growth factors, fostering a microenvironment conducive to tissue repair. However, despite their potential benefits, the long-term efficacy and durability of biological patches in rotator cuff repair remain areas of ongoing research and debate. Further studies are needed to elucidate the optimal patch characteristics, surgical techniques, and rehabilitation protocols to maximize clinical outcomes and minimize complications in rotator cuff surgery.

摘要

生物补片已成为肩袖撕裂手术治疗中有前景的辅助材料,旨在促进修复肌腱的组织愈合和生物力学性能。这些补片来源于人或动物,如真皮或小肠黏膜下层,植入肩袖环境后会发生力学和病理学变化。这些补片为修复部位提供结构强化,使力更均匀地分布在肌腱上,并在愈合过程中促进逐渐的负荷转移。这种力的重新分布有助于减轻修复肌腱和周围组织的张力,潜在地降低再次撕裂的风险并提高整体修复的完整性。此外,生物补片作为细胞浸润和组织长入的支架,促进细胞募集并促进胶原蛋白合成。这些补片与宿主组织的整合涉及一系列细胞事件,包括炎症、血管生成和基质重塑。补片植入引发的炎症反应有助于免疫细胞的募集以及细胞因子和生长因子的释放,营造有利于组织修复的微环境。然而,尽管生物补片有潜在益处,但在肩袖修复中的长期疗效和耐久性仍是正在进行研究和辩论的领域。需要进一步研究以阐明最佳补片特性、手术技术和康复方案,以在肩袖手术中最大化临床结果并最小化并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1430/11448454/2ba658d41967/nihms-2022554-f0001.jpg

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