ポリ-L-乳酸フェルト (PLLA felt)移植により再建された肩腱板の引張り強度と組織反応

抄録

We noted the bio-absorbable material for rotator cuff reconstruction, and devised a poly-L-lactic acid felt (PLLA felt). The infraspinatus tendons of beagle dogs were reconstructed with a PLLA felt. Tensile properties and histocompatibillity of the reconstructed tendons were examined at eight, sixteen, and postoperative thirty-two weeks. All specimens except one rupture case had healed. The ultimate strength of the specimens increased triple compared to that of the PLLA felt material at sixteen postoperative weeks. Stiffness increased five times at sixteen postoperative weeks. These increases were statistically significant (p<0.01). Rupture of all specimens occurred at the junction between the bone and the PLLA felt. Histological examination demonstrated infiltration of fibrous tissue between the PLLA felt fibers. Connection between the infraspinatus tendon and PLLA felt with a scar tissue was tight, however, connective tissue between bone and PTFE felt fibers was sparse even at sixteen or thirty-two postoperative weeks. There were a few deteriorated PLLA felt fibers at thirty-two postoperative week. Postoperative tensile properties of the PLLA felt graft recovered similar to those of PTFE felt graft, however, PLLA felt did not demonstrate the characteristic features of a bioabsorbable material up to thirty-two postoperative weeks.