This study evaluated dorsal root ganglia from C3-C7, analyzed gait, and compared the expression of calcitonin generelated peptide (CGRP) which was a marker of inflammatory pain in a rat rotator cuff tear model in which the supraspinatus and infraspinatus tendons were detached; comparisons were made to a sham group in which only the tendons were exposed. Fluorogold was injected into the glenohumeral joint 21 days after surgery in both groups, and saline, steroids, or hyaluronic acid was injected into the glenohumeral joint in the rotator cuff tear group 26 days after surgery. The proportions of CGRP-immunoreactive neurons were higher and the gait parameters were impaired in the rotator cuff tear group compared to in the sham group. However, the CGRP expression was reduced and the gait was improved with steroid or hyaluronic acid injection compared to saline, suggesting that both hyaluronic acid and steroid injections suppressed of inflammation which thought to be provided pain relief. While there were no significant differences, the suppression of CGRP expression and the improved gait after hyaluronic acid and steroid injections suggested that both methods were effective for rat rotator cuff tear model. Keywords: rotator cuff tear model; pain relief; hyaluronic acid; dorsal root ganglion; CatWalkThe main symptoms of a rotator cuff tear (RCT) are shoulder pain and limited range of motion. Conservative treatment for RCT consists of medication, fomentation, or injections into the subacromial bursa (SAB) or glenohumeral joint (GHJ). In addition, physical rehabilitation has also been used. Although both steroid 1-3 and hyaluronic acid (HA) injections have been commonly used as a conservative treatment for RCT, it remains unknown which method is more effective for pain relief 2,4-6 Moreover, repeated steroid injections may result in local tissue degradation, including tendon tearing and steroid arthropathy. 1 Although the cause of pain in shoulder pathology has not been fully clarified, calcitonin gene-related peptide (CGRP) was found to be highly expressed in both the GHJ and SAB in a rat contracture shoulder model. These results indicate that up-regulation of CGRP might be closely related to the cause of pain in frozen shoulder; 7 the same mechanism of up-regulation of CGRP has also been hypothesized to be related to RCT of inflammatory pain. For both the GHJ and SAB, sensory information is transmitted from free nerve endings through the dorsal root ganglia (DRG) at C3-C7 to the spinal cord and brain. 8 For investigation of inflammation-related pain, evaluation at the level of the DRG is important especially the expression of CGRP.The purpose of the present study was (i) to evaluate DRG neurons innervating the GHJ and SAB using immunohistochemistry for CGRP in a rat RCT model and (ii) to determine whether steroid or HA injection would provide more effective in rotator cuff tear model.
MATERIALS AND METHODSAll animal protocols were approved by the Ethics Committee of Chiba University and conducted in accorda...