Effect of Corticosteroids on the Biomechanical Strength of Rat Rotator Cuff Tendon

Mikolyzk, David K.; Wei, Anthony S.; Tonino, Pietro; Marra, Guido; Williams, Denis; Himes, Ryan D.; Wezeman, Frederick H.; Callaci, John J.

doi:10.2106/jbjs.h.00191

Cited by 96 publications

(95 citation statements)

References 38 publications

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“…On the other hand, Hossain et al 26 showed that induction of apoptosis was observed in tenocytes when 25 and 50 mg/ml doses of dexamethasone were administered. In an in vivo study, Mikolyzk et al 27 reported that steroids reduced the biomechanical properties of rotator cuff tendons. However, the deleterious effect of corticosteroids on the biomechanical properties of the exposed supraspinatus tendon was temporary, and the properties of these tendons returned to control levels in 3 weeks.…”

Section: Discussionmentioning

confidence: 99%

Platelet‐rich plasma protects rotator cuff‐derived cells from the deleterious effects of triamcinolone acetonide

Muto

Kokubu

Mifune

et al. 2012

Journal Orthopaedic Research

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Triamcinolone acetonide (TA) injections are widely used to treat enthesopathy, but they may induce adverse effects such as tendon impairment and rupture. Platelet-rich plasma (PRP) is a blood fraction containing high platelet concentrations and various growth factors that play a role in tissue repair processes. The purpose of this study is to investigate whether TA has deleterious effects on human rotator cuff-derived cells, and if PRP can protect these cells from the effects of TA. Human rotator cuff-derived cells were cultured with and without TA and PRP, and the culture without any additive served as the control. Cell morphology was assessed at days 7 and 21. Cell viability was evaluated at days 1, 7, 14, and 21 by a water-soluble tetrazolium salt assay. Induction of apoptosis was measured by immunofluorescence staining and flow cytometry at day 7. Induction of cleaved caspase-3 was measured by immunofluorescence staining at day 7. The cells cultured with TA had a flattened and polygonal shape at day 7. The cells cultured with both TA and PRP were similar in appearance to control cells. Exposure to TA also significantly decreased cell viability, but cell viability did not decrease when PRP was added along with TA. The number of apoptotic cells increased with TA exposure, while addition of PRP prevented cell apoptosis. In conclusion, the deleterious effect of TA was prevented by PRP, which can be used as a protective agent for patients receiving local TA injections. Keywords: triamcinolone acetonide (TA); platelet-rich plasma (PRP); rotator cuff-derived cells; apoptosis; cell viability Enthesopathy caused by rotator cuff injury clinically impairs joint function. Rotator cuff disease represents a spectrum of pathological conditions ranging from tendinosis to full-thickness tears. Conservative therapy, including rest, physical therapy, non-steroidal anti-inflammatory medications, and steroid injections are the primary treatments for these conditions. 1,2The effectiveness of subacromial steroid injections for treatment of rotator cuff tendinosis has been equivocal. 3,4 Some clinical studies have demonstrated improvement in shoulder function and decrease in shoulder pain following steroid injection.3,5 However, other studies have shown that steroids afford no clinical benefits over those provided by injections of lidocaine alone 4 or physical therapy alone. 6 Triamcinolone acetonide (TA) injections are widely used for treatment of rotator cuff tendinosis, but they may cause tendon impairment and rupture; many cases of tendon rupture after TA injections have been reported. 7-11Despite previous studies on the deleterious histological and biomechanical changes in tendons after TA injections, 8,12 TA administration is still considered to be a conservative treatment option.Platelet-rich plasma (PRP) is an autologs concentration of platelets that contains many growth factors, including platelet-derived growth factor (PDGF), transforming growth factor b (TGF-b), fibroblastic growth factor (FGF), vascular endoth...

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Section: Discussionmentioning

confidence: 99%

Platelet‐rich plasma protects rotator cuff‐derived cells from the deleterious effects of triamcinolone acetonide

Muto

Kokubu

Mifune

et al. 2012

Journal Orthopaedic Research

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show abstract

“…The corticosteroid injection soon after the baseline tests resolved the joint effusion in our participant, and thereby improved the mechanical conditions for recovery of the tendon-muscle complex. However, there are also reports on adverse effects of local corticosteroid injections on tendon strength, but this may be transient (16).…”

Section: Discussionmentioning

confidence: 99%

Adverse changes in tendon–muscle physiology and physical function caused by an isolated acute rheumatoid knee effusion: A case study

Matschke

Thom

Lemmey

et al. 2011

Arthritis Care & Research

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“…Mikolyzk and colleagues [2] showed a maximal load decrease of 27% and a stiffness decrease of 32% in intact uninjured tendons after a single injection. The study by Maman and colleagues [1] demonstrated a noteworthy decrease in the strength of normal uninjured rat rotator cuff tendon 1 week after exposure to repeated corticosteroid injections.…”

Section: Corr Insightsmentioning

confidence: 96%

“…More recent studies [1,2] investigated the biomechanical effects of corticosteroid exposure on both uninjured and injured rotator cuff tendons in rats. Mikolyzk and colleagues [2] showed a maximal load decrease of 27% and a stiffness decrease of 32% in intact uninjured tendons after a single injection.…”

Section: Corr Insightsmentioning

confidence: 99%

CORR Insights®: Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis

Gelber¹

2017

Clinical Orthopaedics &Amp; Related Research

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Effect of Corticosteroids on the Biomechanical Strength of Rat Rotator Cuff Tendon

Abstract: A single dose of corticosteroids significantly weakens both intact and injured rat rotator cuff tendons at one week. This effect is transient as the biomechanical properties of the steroid-exposed groups returned to control levels by three weeks.

Cited by 96 publications

References 38 publications

Platelet‐rich plasma protects rotator cuff‐derived cells from the deleterious effects of triamcinolone acetonide

Platelet‐rich plasma protects rotator cuff‐derived cells from the deleterious effects of triamcinolone acetonide

Adverse changes in tendon–muscle physiology and physical function caused by an isolated acute rheumatoid knee effusion: A case study

CORR Insights®: Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis

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