Analysis of Patient Factors Affecting In Vitro Characteristics of Subacromial Bursal Connective Tissue Progenitor Cells during Rotator Cuff Repair

Abstract

Unsatisfactory failure rates following rotator cuff (RC) repair have led orthopaedic surgeons to explore biological augmentation of the healing enthesis. The subacromial bursa (SB) contains abundant connective tissue progenitor cells (CTPs) that may aid in this process. The purpose of the study was to investigate the influence of patient demographics and tear characteristics on the number of colony-forming units (CFUs) and nucleated cell count (NCC) of SB-derived CTPs. In this study, we harvested SB tissue over the supraspinatus tendon and muscle in 19 patients during arthroscopic RC repair. NCC of each sample was analyzed on the day of the procedure. After 14 days, CFUs were evaluated under a microscope. Spearman’s rank correlation coefficient was then used to determine the relationship between CFUs or NCC and patient demographics or tear characteristics. The study found no significant correlation between patient demographics and the number of CFUs or NCC of CTPs derived from the SB (p > 0.05). The study did significantly observe that increased tear size was negatively correlated with the number of CFUs (p < 0.05). These results indicated that increased tear size, but not patient demographics, may influence the viability of CTPs and should be considered when augmenting RCrepairs with SB.

The effect of augmenting suture material with magnesium and platelet-rich plasma on the in vitro adhesion and proliferation potential of subacromial bursa-derived progenitor cells

“…These observations expand the understanding of the biologic activity of SBDCs, which is subject to substantial interindividual variability and may be influenced by the vascularity and fatty infiltration of the bursal tissue as well as the size of the rotator cuff tear. 3 , 21 Of note, similar to the findings of the present study, Mg has been shown to promote the proliferation of bone marrow-derived mesenchymal stem cells. 7 …”

Subacromial Bursa: A Neglected Tissue Is Gaining More and More Attention in Clinical and Experimental Research

“…The isolation method either using enzymatic digestion or mechanical chopping, in all cases, provided sufficient MSC populations [ 59 ], but the age of the donors significantly affected the time to form colonies in culture [ 60 ], which is a typical phenomenon also for tenocytes of the rotator cuff [ 61 , 62 ]. Others reported that it was not patient characteristics but the size of the rotator cuff tear that affects the colony forming unit potential [ 63 ]. Altogether, the stem cell potential seems to be the most striking reason to preserve the subacromial bursa during shoulder surgery, as it can function as a reservoir for healing-promoting cells.…”