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회전근 개 봉합술 후 운동 방법이 건 치유에 미치는 영향에 관한 실험적 연구 원문보기
(An) Experimental Study about the Influence of the Different Types of Joint Motion affecting Tendon Healing after Rotator Cuff Repair

  • 저자

    김성연

  • 학위수여기관

    고려대학교 대학원

  • 학위구분

    국내박사

  • 학과

    의학과

  • 지도교수

  • 발행년도

    2004

  • 총페이지

    29p.

  • 키워드

    회전근 봉합술 운동방법;

  • 언어

    kor

  • 원문 URL

    http://www.riss.kr/link?id=T10068070&outLink=K  

  • 초록

    In recent decades, there have been many studies that have examined the process of tendon healing. Despite the many investigations and the large volume of data concerning tendon healing after a tendon-to- tendon or tendon-to-bone repair, there little information on tendon healing after tendon-to-tendon repair combined with tendon-to-bone repair which is commonly performed in rotator cuff tears. There may be a different healing process between the transected tear of a usual tendon and an L-shaped tear of the rotator cuff tendon because of the anatomical and functional characteristics of rotator cuff tendon. It is still unclear if active motion needs to be withheld until the formation of the Sharpey's fiber on the tendon-to-bone reattachment site after a tendon-to-tendon combined with a tendon-to-bone repair, and the time of active motion after a rotator cuff repair. The aim of this study was to evaluate the effect of active motion on tendon healing after a tendon-to-tendon combined with a tendon-to-bone repair, simulating a rotator cuff repair, and to compare the healing process after a tendon-to-tendon combined with tendon-to-bone repair with that of a tendon-to-bone repair using the Achilles tendons of rabbits. Forty-two rabbit Achilles tendons were tenotomized in an L-shape and reattached by a tendon-to-tendon combined with a tendon-to-bone repair (group A). They were divided into three subgroups according to the type of motion; active motion (group A1, n=18), limited active motion by a partial resection of the gastrocnemius muscle (group A2, n=18) and active motion after immobilization with a long leg cast for three weeks (group A3, n=6). Six Achilles tendons were transected from a calcaneal insertion and reattached by a tendon-to-bone repair (group B). Seven Achilles tendons were excluded from the analysis due to death or a wound infection. The results were evaluated histologically and biomechanically at 2, 4, 8 weeks after surgery. Histological sections were stained with hematoxylin and eosin. Light microscopic views were used to evaluate the cellular events and collagen fiber development. For a biomechanical evaluation, the maximum strain, tensile strength and Young's modulus of the repaired tendon were measured. The biomechanical data of groups A1, A2 and A3 were statistically analyzed using a Mann-Whitney test. The results are as follows: Macroscopically, mild to moderate adhesion and a gap at the repair site were observed with the findings being more prominent in group B. The histological findings showed more organized healing in groups A1 and A2 than with groups A3 and B. The specimens from group B were suspected of having delayed healing processes. On the biomechanical study, groups A1 and A2 were significantly stronger than group A3 (maximum strain at 8 weeks; 25.19, 27.03, 10.58 respectively, p


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