Bone marrow stimulation at the footprint of arthroscopic surface-holding repair advances cuff repair integrity

Does microvascularization of the footprint play a role in rotator cuff healing of the shoulder?

“…5,18,21,[23][24][25]28,36 In fact, cells coming from the footprint initiate the healing process, and investigating microvascularization of the footprint is a way to evaluate the biologic power of the bone. 3,14,17,23,33 Ficklscherer et al 10 reported that radiofrequency burning of the footprint commonly performed to clean the reinsertion site of the tendon results in poor histologic and biomechanical outcome. Snyder and Burns 31 have shown that bone marrow flow resulting from microfracture of the lateral footprint creates a blanket or ''Crimson duvet'' that enhances the healing process.…”

Imaging of the rabbit supraspinatus enthesis at 7 Tesla: a 4‐week time course after repair surgery and effect of channeling

“…10 Clinical studies which compared tendon repair with bone channeling have demonstrated higher healing rates compared with controls 11,12 and more favorable outcomes with respect to tendon integrity especially in large/massive tears. 13,14 Previous research has demonstrated a 20-fold increase in cellular proliferation peaking 1-2 weeks following tendon repair in an animal model. 9 Given the increase in cellular recruitment and activity over this time frame, the rationale for channeling 1 week before surgical repair was that stimulating the bone marrow would accelerate enthesis reformation by carrying out the repair at a time that coincides with this peak in cellular activity.…”

Biomechanic and histologic analysis of fibroblastic effects of tendon-to-bone healing by transforming growth factor β1 (TGF-β1) in rotator cuff tears

“…In recent years, numerous studies have shown large failure rates, causing concern about supraspinatus strangulation contractures from adhesion by fatty infiltration. Chen et al [30][31][32] investigated the effects of chitosan on Achilles tendon injury in rats 8 weeks after surgery. Gliding excursion and the content of collagen fibers were used to evaluate the effects of surgery.…”