Background:

Biologic augmentation via extracellular matrix (ECM) scaffolds has been utilized to address rotator cuff tears with poor-quality tissue.

Purpose:

To evaluate the cellular changes in graft explants taken from patients treated with porcine dermal grafts for rotator cuff tears.

Study Design:

Case series; Level of evidence, 4

Methods:

Four graft biopsy specimens were obtained from patients treated with porcine dermal grafts in an interposition technique for rotator cuff tears and compared with a nonimplanted graft and a normal rotator cuff specimen. Biopsy of the graft site was performed at 18 days, 3 months, 7 months, and 10.5 months after implantation. Hematoxylin and eosin staining was used to evaluate for cellular and vascular changes. Picrosirius red (PSR) stain with 90° polarized light was performed to evaluate collagen fibril size and orientation. All biopsy specimens were analyzed by a pathologist.

Results:

There was evidence of progressive remodeling of the porcine dermal grafts. The most mature grafts demonstrated vessel infiltration and extensive remodeling without evidence of inflammation, foreign body reaction, or tissue rejection. PSR demonstrated increased organization of collagen domains, resembling normal tendon by 10.5 months postoperatively.

Conclusion:

This series suggests that ECM grafts may serve as an effective scaffold for host cell infiltration, collagen reorganization, and vascularization as a result of histologic changes demonstrated with retrieval of specimens from patients with rotator cuff tears that were augmented with porcine dermal grafts.

中文翻译：

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猪真皮移植瘤治疗肩袖撕裂的组织学分析

背景：

通过细胞外基质 (ECM) 支架进行的生物增强已被用于解决具有劣质组织的肩袖撕裂问题。

目的：

评估取自接受猪真皮移植治疗肩袖撕裂患者的移植外植体的细胞变化。

学习规划：

案例系列；证据等级，4

方法：

四个移植活检标本取自接受猪真皮移植治疗肩袖撕裂的插入技术的患者，并与非植入移植片和正常肩袖标本进行比较。移植部位的活检在植入后 18 天、3 个月、7 个月和 10.5 个月进行。苏木精和伊红染色用于评估细胞和血管变化。使用 90° 偏振光进行天狼星红 (PSR) 染色以评估胶原纤维的大小和方向。所有活检标本均由病理学家分析。

结果：

有证据表明猪真皮移植物逐渐重塑。最成熟的移植物表现出血管浸润和广泛重塑，没有炎症、异物反应或组织排斥的证据。PSR 证明胶原结构域的组织增加，在术后 10.5 个月时与正常肌腱相似。

结论：

该系列表明，ECM 移植物可作为宿主细胞浸润、胶原重组和血管形成的有效支架，这是由于从用猪真皮移植物增强的肩袖撕裂患者身上取回的标本所证明的组织学变化。