Biologic augmentation of rotator cuff repair

Montgomery, Scott R.; Petrigliano, Frank A.; Gamradt, Seth C.

doi:10.1007/s12178-011-9095-6

Cited by 35 publications

(22 citation statements)

References 84 publications

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“…Sämtliche bisher verfügbare Studien zum Effekt von Wachstumsfaktoren wurden an Tiermodellen durchgeführt [6,19,27,31]. So untersuchten Rodeo et al den Effekt von unterschiedlichen BMP, TGF-β und FGF in einem Tierversuch an Schafen.…”

Section: Wachstumsfaktorenunclassified

“…Trotz der angebotenen Produktvielfalt an Scaffolds gibt es nur wenig Evidenz in Bezug auf deren Verwendung in der RMChirurgie [7,27,30]. Viele Fragen in Bezug auf Indikation, Material, Applikationsform, Sicherheit etc.…”

Section: Rotatorcuff Repair · Growth Factors · Biologic Augmentation unclassified

“…Die Optimierung der Heilungsbedingungen ("healing enhancement") könnte eine bestmög-liche Wiederherstellung der embryologisch entstandenen Enthese ermöglichen [6,27,31]. Dabei gilt es, ein optimales Zusammenspiel zwischen den vielfältigen Wachstumsfaktoren, den zellulären Anteilen und der extrazellulären Matrix (ECM) zu erreichen.…”

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“…Zum jetzigen Zeitpunkt besteht jedoch noch keinerlei Konsensus über das optimale Verfahren zur biologischen Unterstützung der Heilung nach RM-Rekonstruktionen [6,27,31]. In dieser Übersicht liegt der Fokus v. a. auf klinischen Studien oder experimentellen Studien an Großtie-ren.…”

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“…Sie hat den Vorteil, dass durch die Vor-Ort-Produktion eine kontinuierliche Freisetzung auch über einen länge-ren Zeitraum gewährleistet werden kann. Zellen können ex vivo mittels Plasmiden oder Viren mit rekombinanter DNA beladen und nach Expansion in Zellkulturen wieder implantiert werden[6,19,27]. Die Arbeitsgruppe um Gulotta et al hat mit solch veränderten mesenchymalen Stammzellen mehrere Studien am Kleintiermodel durchgeführt.…”

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Möglichkeiten der biologischen Augmentation von RM-Rekonstruktionen

Beitzel

Mazzocca

2012

Arthroskopie

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Section: Wachstumsfaktorenunclassified

Section: Rotatorcuff Repair · Growth Factors · Biologic Augmentation unclassified

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Möglichkeiten der biologischen Augmentation von RM-Rekonstruktionen

Beitzel

Mazzocca

2012

Arthroskopie

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Refixation of the supraspinatus tendon in a rat model—influence of continuous growth factor application on tendon structure

Buchmann

Sandmann

Walz

et al. 2012

Journal Orthopaedic Research

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ABSTRACT:The purpose was to evaluate histological changes of the supraspinatus tendon (SSP) after refixation under continuous growth factor application over 20 days in comparison to the native healing process. In a chronic rat tendon tear model (15 rats/group), a transosseous SSP refixation was performed and growth factors (control, G-CSF, b-FGF, combination) were continuously released into the subacromial space by an osmotic pump. Tendon healing was evaluated histologically by a modified MOVIN-Score, and Collagen I/ III content was determined by immunohistology at 6 weeks. A modified MOVIN sum score showed significant lower counts for G-CSF and b-FGF in comparison to the control group (p ¼ 0.050/p ¼ 0.027) and the combined group (p ¼ 0.050/p ¼ 0.043). Collagen III was significantly reduced in the combined group compared to the control group (p ¼ 0.028). Collagen I showed no significant differences. The Collagen I/III ratio was nearly doubled for b-FGF and the combined group compared to the control. At the study endpoint, 33% of pump dislocations were detected. The continuous application of both isolated growth factors (G-CSF/b-FGF) achieved improved tendonremodeling. However, the continuous application via an osmotic pump showed a relative high dislocation rate when applied in the rat model. ß

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Effects of selective paralysis of the supraspinatus muscle using botulinum neurotoxin a in rotator cuff healing in rats

Ficklscherer

Hartl

Scharf

et al. 2012

Journal Orthopaedic Research

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We hypothesized that a temporary rotator cuff paralysis using botulinum-neurotoxin A (BoNtA) would lead to an improved tendon-to-bone healing after repair of supraspinatus lesions. One hundred sixty Sprague-Dawley rats were randomly assigned to either the BoNtA or the control (saline) group. BoNtA/saline-solution was injected into the supraspinatus muscle 1 week prior to surgery. A supraspinatus defect was made; we distinguished between a lesion with normal and increased repair load. Furthermore, one subgroup had the operated shoulder immobilized in a cast. Histologic analysis and biomechanical testing followed. Specimens from the BoNtA-group, which were treated with an increased repair load, showed less cellularity and more organization in the interface tissue compared to the saline control group. In addition, we found that the collagen 1-3 quotient in the BoNtA specimen was significantly (p ¼ 0.0051) higher than in the control group. Ultimate load at failure between the groups was not significantly different (p > 0.05). We did not observe any significant differences between the mobilized and immobilized specimen (p ¼ 0.2079). The study shows that tendon-to-bone healing after rotator cuff repair can be altered positively using BoNtA pre-operatively. Tears with increased repair load seem to benefit the most-at least histologically. Keywords: rotator cuff tear; tendon-healing; biologic tendon repair; bioprotection; botulinum neurotoxin A Rotator cuff tears are one of the most common degenerative diseases of the upper extremity and are seen in up to 30% of the population aged older than 65 years.

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Biologic augmentation of rotator cuff repair

Cited by 35 publications

References 84 publications

Möglichkeiten der biologischen Augmentation von RM-Rekonstruktionen

Möglichkeiten der biologischen Augmentation von RM-Rekonstruktionen

Refixation of the supraspinatus tendon in a rat model—influence of continuous growth factor application on tendon structure

Effects of selective paralysis of the supraspinatus muscle using botulinum neurotoxin a in rotator cuff healing in rats

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