运动性肌腱损伤同种异体移植和外科修复的生物力学特征

背景：为了提高肌腱损伤后的缝合修复强度、尽早开始主被锻炼、防止肌腱粘连,研究者们在不断地寻找更牢固的缝合方法。大于3 cm的肌腱缺损．不能直接缝合,目前主要依靠自体、异体肌腱移植修复。目的：总结同种异体肌腱移植和外科修复运动性肌腱损伤涉及的生物力学研究现状。方法：应用计算机检索PubMed 数据库及中国期刊网全文数据库1994-01/2011-10 有关肌腱损伤的外科修复和同种异体肌腱移植修复的生物力学方面的文章,英文检索词为“tendon,biomechanical study,repair,suture,allogenetic tendon”,中文检索词为“肌腱,生物力学,同种异体移植,缝合”。排除重复性及非中英文语种研究,共保留34篇文献进行综述。结果与结论：对肌腱吻合方法进行生物力学测量,能了解哪种方法更能满足早期功能锻炼的需要,更能有效防止肌腱再断裂和吻合处间隙形成,以便在术后早期功能锻炼时有更大的安全性。深低温冷冻化和玻璃化保存同种异体肌腱移植在生物力学方面的表现与自体肌腱移植结果基本相同,可替代自体肌腱应用于移植修复肌腱缺损。

Biomechanical features of allogeneic transplantation and surgical repair for exercise-induced tendon injury

BACKGROUND: Researchers are seeking a fast suture method to elevate repair strength after tendon injury, to do exercises as early as possible, and to prevent tendon adhesion. A damaged tendon (> 3 cm) cannot be directly sutured. At present, it should be repaired by autologous and allogenic tendon transplantation. OBJECTIVE: To summarize the present biomechanics study regarding allogenic tendon transplantation and exercise-induced tendon injury repaired in surgery. METHODS: We retrieved PubMed Database and China National Knowledge Infrastructure for articles concerning biomechanics of surgical repair of tendon injury and allogenic tendon transplantation published from January 1994 to October 2011. The English key words were “tendon, biomechanical study, repair, suture, allogenetic tendon”. The Chinese key words were “tendon, biomechanics, allogenic transplantation, suture”. Repetitive studies or non-Chinese or non-English studies were excluded. Totally 34 articles were reviewed. RESULTS AND CONCLUSION: Tendon anastomosous method was detected by biomechanical measure. This can understand which method can satisfy the requirement of early-phase functional exercise, effectively prevent tendon re-breakage and interspace formation at anastomosous site so as to obtain a great safety during postoperative early-phase functional exercise. Deep-frozen and vitrification of allogeneic tendon exhibited similar results in biomechanics as autologous tendon transplantation. Allogeneic tendon can be used for tendon injury by transplantation, instead of autologous tendon.