Basic scienceRotator cuff repair augmentation with local autogenous bone marrow via humeral cannulation in a rat model
Section snippets
Supraspinatus injury and repair
Twenty-eight adult male Sprague-Dawley rats (weight, 350-450 g) underwent bilateral rotator cuff surgeries performed by a single surgeon (C.S.A.). Upon surgical exposure, the distal-most end of the supraspinatus tendon was grasped with a suture and then sharply detached from the greater tuberosity.
Next, the proximal humerus was prepared for insertion of one of two 4.0-mm-long nitinol cylindrical implants (Memry, Bethel, CT, USA). One implant was solid and the other cannulated. Each implant had
Dimensional measurements
Supraspinatus tendon thickness increased significantly from 2.03 ± 0.4 mm at 4 weeks to 2.49 ± 0.6 mm at 8 weeks (P = .02). No statistically significant difference was observed between the solid and cannulated treatment cohorts (P = .76). Conversely, tendon width was unaffected by time and treatment (Fig. 3). Width showed a trend of increasing over time, but this trend did not achieve statistical significance (P = .06).
Biomechanical testing
Several modes of tendon failure were observed (Table II). The most common
Discussion
Biologic failure of rotator cuff repairs is typically due to a loss of tissue organization. After a cuff tear, the humeral enthesis substitutes normal fibrocartilage with weaker type III collagen.8, 41 Tendon healing cannot begin until bone grows into this fibrous interface between the bone and tendon.16, 38, 43 Rotator cuff healing is further complicated by decreasing vascularity as the tendon nears its insertion.4 Humeral cannulation could resolve both of these problems. It could enrich the
Conclusions
We found that a cannulated humeral implant does not strengthen rotator cuff repair in a rat model. Local autogenous bone marrow itself may improve healing, but the diminutive size of the cannulated implant used in the rats may have prevented sufficient marrow delivery in this study. We recommend that further study of this local autologous bone marrow delivery system be considered in a larger animal model.
Disclaimer
Funding and the custom animal implants for this project were provided by Stryker Orthopaedics, Project #S08-005. Representatives at Stryker also performed the histologic data collection and analysis for this study.
R.Z. is a paid employee of Stryker Orthopedics, who provided financial support and histologic analysis for this study. T.R.G. and C.S.A. have received research and institutional support from Stryker Orthopaedics and Arthrex Inc. The other authors, their immediate families, and any
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Cited by (14)
Greater Tuberosity Decortication Decreases Load to Failure of All-Suture Anchor Constructs in Rotator Cuff Repair
2018, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :These may lead to bone microvascularization at the tendon interface, which has been shown to be associated with increased healing potential.16 Multiple animal studies have attempted to evaluate the benefit of releasing endogenous bone marrow elements on rotator cuff healing.17,18 Overall, they have demonstrated mixed results.17,18
Effect of Footprint Preparation on Tendon-to-Bone Healing: A Histologic and Biomechanical Study in a Rat Rotator Cuff Repair Model
2017, Arthroscopy - Journal of Arthroscopic and Related SurgeryThe influence of testing angle on the biomechanical properties of the rat supraspinatus tendon
2016, Journal of BiomechanicsCitation Excerpt :Consequently, reports of the biomechanical properties of the supraspinatus tendon vary widely in literature (Carpenter et al., 1998; Gimbel et al., 2004, 2007a; Ross et al., 2015; Thomopoulos et al., 2003a). Previous studies have evaluated the rat supraspinatus tendon at a range of abduction angles, including −15°, 0°, 20°, 50° and 90° (Carpenter et al., 1998; Galatz et al., 2006; Levy et al., 2013; Peltz et al., 2010a; Thomopoulos et al., 2003a), as well as at unspecified angles (Cohen et al., 2006; Gimbel et al., 2004, 2007a; Mannava et al., 2011; Thomopoulos et al., 2003b). The supraspinatus tendon and enthesis may exhibit differential biomechanical properties at varying angles of abduction due to differences in fiber orientation and crimping frequency, but, to date, no data exists assessing this potential effect.
Suture Anchor Biomechanics after Rotator Cuff Footprint Decortication
2016, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :The drilled cohort had improved load-to-failure results after rotator cuff repair. Levy et al.44 recently tested a cannulated implant in a rat model and did not find histologic or mechanical benefit to the repaired tendon. Jo et al.45 have investigated the use of channeling during rotator cuff repair.
Does footprint preparation influence tendon-to-bone healing after rotator cuff repair in an animal model?
2014, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :For histologic analysis, the type II collagen–positive areas were statistically compared by use of the t test; all other parameters were qualitative in nature. The number of animals per histologic group (4 per group) was chosen in accordance with similar histologic investigations in several other publications.16,20,21 No animal was lost during the experiment or excluded from analysis.
Application of suture anchors for a clinically relevant rat model of rotator cuff tear
2022, Journal of Tissue Engineering and Regenerative Medicine
This project was approved by the Columbia University Institutional Animal Care and Use Committee, Protocol #AC–AAAD0571 (Y1 M00).