Repair process of surgically produced supraspinatus tendon tear

Abstract

REPAIR PROCESS OF SURGICALLY PRODUCED SUPRASPINATUS TENDON TEAR dun Kumagai, Hirotaka Sano, Hinoru Sakurai, Takashi Sawai% K i r i t i Sarkar ~ and Hans K.Uhthoff ~ Dept .of Orthop. Surg.and *Pathology, Tohoku Univ. and *~Univ. o f Ottawa This study was undertaken to f ind out the c e l l s c o n t r i b u t i n g to the repa i r of the supraspinatus tendon and col lagen types dur ing the process. A t ransverse i nc i s i on was made on the supraspinatus tendon on 37 adu l t female r a b b i t s . The animals were euthanized at 4 days, I , 2, 4 and 8 weeks. Besides the rou t ine s t a i n ings, immunostainings of col lagens ( type I and I I I ) and p r o l i f e r a t i n g ce l l nuclear ant igen (PCNA) were performed. At 4 days and 1 week a f t e r surgery, the stumps were covered only p a r t l y by p r o l i f e r a t i n g c e l l s coming most ly from both bursal s ides. At 2 weeks, the gap was not recognizable macroscop ica l ly . I t was br idged at 4 weeks and uni ted complete ly at 8 weeks. From the ea r l y stage, type I l l co l lagen was p o s i t i v e , wh i le type I appeared c l e a r l y a f t e r 2 weeks. PCNA were p o s i t i v e in the p r o l i f e r a t i n g c e l l s from bursal and a r t i c u l a r s ides, espec ia l l y around the vessels. This study shows tha t the c o n t r i b u t i n g ce l l s are coming mainly from the bursal side and tha t two types of co l lagen appear at the d i f f e r e n t per iod a f t e r the i n j u r i e s . COMPARISON WITH MODIFIED DEWAR'S PROCEDURE AND PERCUTANEOUS PINNING FOR COMPLETE DISLOCATION OF THE ACROMIOCLAVICULAR JOINT. K. Yamaguchi, H. Hanamura, H. Maeda, & N. Yasuhara. Kasugai Orthopedic Hospital, K. Ida. Nagoya University School of Allied Health Sciences Since 1982 we performed modified Dewar's procedure (D method) for complete dislocation of the acromioclavicular (A-C) joint in 18 cases, but since 1988 changed method into percutaneous pinning (P method) and treated 27 cases, In this study, we compared the results of two methods. We evaluated 13 patients (9 males and 4 females) in D method and 17 patients (16 males and 1 female) in P method. The average age was 34.1 years (D ~fiethod) , and 30.3 years (P method) . The average postoperative observation period was 8 years and 9 months (D method) , 2 years and 7 months (P method) . In the modified Dewar's procedure, we added temporary fixation of the A-C joint using Kirschner wire. In the percutaneous pinning, we fixed the A-C joint with two Kirschner wires, one of them was not passed through the A-C joint avoiding osteoarthritic change. According to Kawabe's score, D method was 92.3 points, f 3 method was 95.8 points in average. In Xray findings, subluxation were observed in 6 cases (46.2% D method) , and in 9 cases (52.9% P method) . OA change of the acromioclavicular joint were observed in 10 cases (76.9% D method) , and in 3 cases (17.6% P method) . The clinical results of P method were as good as thoses of D method. Therefore, we think percutaneous pinning is one of the useful methods for fresh dislocation of the acromioclavicular joint.