Laminated tears of the human rotator cuff: A histologic and immunochemical study

Sonnabend, David H.; Yu, Yan; Howlett, C. R.; Harper, GD; Walsh, William R.

doi:10.1067/mse.2001.112882

Cited by 83 publications

(110 citation statements)

References 3 publications

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“…High strain, which produced matrix disruption that included severe fiber angulation and longitudinal fiber separation and increased MMP-13 level, were consistent with those of late-stage clinical tendinopathy [16,20,21,27,37]. By contrast, low strain, which or similar pathologic conditions [1,40,48].…”

Section: Discussionsupporting

confidence: 61%

Coordinate Regulation of IL-1β and MMP-13 in Rat Tendons Following Subrupture Fatigue Damage

Sun

Fung

et al. 2008

Clinical Orthopaedics &Amp; Related Research

103

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Mechanical overloading is a major causative factor of tendinopathy; however, its underlying mechanisms are unclear. We hypothesized mechanical overloading would damage tendons and alter genes associated with tendinopathy in a load-dependent manner. To test this hypothesis, we fatigue loaded rat patellar tendons in vivo and measured expression of the matrix-degrading enzyme MMP-13 and the inflammatory cytokine IL-1b. We also examined these responses in cultured tenocytes exposed to intermittent hydrostatic pressure in vitro. Additionally, we hypothesized load-induced changes in tenocyte MMP-13 expression would be dependent on expression of IL-1b. In vivo fatigue loading at 1.7% strain caused overt microstructural damage and upregulated expression of MMP-13 and IL-1b, while 0.6% strain produced only minor changes in matrix microstructure and downregulated expression of both MMP-13 and IL-1b. Loading of cultured tenocytes at 2.5 and 7.5 MPa produced comparable changes in expression to those of in vivo tendon loading. Blocking IL-1b expression with siRNA suppressed load-induced both MMP-13 mRNA expression and activity. The data suggest fatigue loading alters expression of MMP-13 and IL-1b in tendons in vivo and tenocytes in vitro in a load-dependent manner. The data also suggest MMP-13 is regulated by both IL-1b-dependent and IL-1b-independent pathways.

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Section: Discussionsupporting

confidence: 61%

Coordinate Regulation of IL-1β and MMP-13 in Rat Tendons Following Subrupture Fatigue Damage

Sun

Fung

et al. 2008

Clinical Orthopaedics &Amp; Related Research

103

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“…Therefore, extensive excision should be avoided. On the other hand, when margins are delaminated and therefore lined with a cellular layer that has an appearance suggestive of synovium, excision is recommended because, as previously reported [10], synovium does not usually adhere to synovium.…”

Section: Discussionmentioning

confidence: 95%

“…Although many papers have been published on histological studies of tear edges, it remains unclear whether they should be excised during surgical treatment. Sonnabend et al [10] observed that the margins of the tears are represented by an inflammatory and, in cases of large tears, by a synovial-like cell edge. They also observed a delamination of the margins that might compromise tendon healing.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory infiltrate of the edges of a torn rotator cuff

Gumina

Giorgio

Bertino

et al. 2006

International Orthopaedics (SICOT)

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There is still considerable controversy as to whether or not the inflamed margins of a cuff tear should be excised during surgical suture. We have tried to discover whether anti-inflammatory drugs used before surgical treatment could resolve this issue. Thirty-eight patients were randomly either treated with an anti-inflammatory drug for 2 weeks or not. During the subsequent arthroscopic repair, a few fragments of supraspinatus edge were excised and examined microscopically. No significant differences emerged among samples belonging to the two groups. In all cases, we observed inflammatory infiltratelined tear edges. Fibrocytes and newly formed vessels were detected near the margin. Dystrophic calcifications were observed in both groups. Away from the edge, the tendon appeared hypocellular; containing areas with myxoid or fatty degeneration. Our study demonstrates that an antiinflammatory drug is unable to resolve the inflammatory infiltrate. This failure is probably related to the poor blood supply to the cuff, which, in cases of rupture, is deprived of vessels coming from the humeral periosteum. Further studies are needed to understand how to eliminate the inflammatory process and clarify whether it might inhibit cuff healing and give rise to re-tearing of the sutured cuff.Résumé Quelle est la réponse à la controverse: faut-il exciser les tissus inflammatoires dans les lésions de la coiffe des rotateurs? Nous avons vérifié ce problème en invitant les patients à prendre un traitement inflammatoire avant le traitement chirurgical. Trente-huit patients ont été randomisés avec ou sans traitement anti-inflammatoire dans les quinze jours précédant l'intervention. Au cours de la réparation arthroscopique, de petits fragments sous épineux ont été excisés et étudiés microscopiquement sans différence significative entre les deux groupes. Dans tous les cas nous observons une infiltration inflammatoire des berges des lésions. Des fibrocytes et des néo-vaisseaux ont été détectés au niveau des marges, des calcifications ont été également observées dans les deux groupes. A distance des bords le tendon apparaît avec des lésions hypo-cellulaires, une dégénérescence mixoide ou graisseuse. Notre étude démontre que le traitement anti-inflammatoire n'est pas capable de résoudre le problème de l'infiltration inflammatoire, ceci est dû au fait que les lésions cicatricielles sont privées de vaisseaux venant du périoste huméral. Des études ultérieures seront nécessaires pour comprendre comment nous pouvons éliminer ce processus inflammatoire et permettre une meilleure cicatrisation de la coiffe après suture.

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“…Attempts to analyze tendon health have relied primarily on visual assessment. Morphological changes in the collagen fiber's organization are associated with tendon pathology [1][2][3]. Various techniques have been developed to assess collagen structural health.…”

Section: Introductionmentioning

confidence: 99%

Quantitative Analysis of Tendon Structural Integrity in Chickens using Fourier Transform-Second Harmonic Generation Imaging

Sivaguru¹

2014

Cell Dev Biol

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Degenerative changes in tendons are common in human and land-dwelling vertebrates of all species, and are associated with both age and use. Tendon rupture and inflammation are common causes of lameness in broilers and breeders at multiple ages and has become a very important issue in the poultry industry attempts to analyze tendon health have relied primarily on visual assessment. The ability to conduct meaningful experiments on causes and interventions would be much improved by a direct assay of tendon structural integrity. The objective of this study is to test whether we can use Fourier transform-second harmonic generation (FT-SHG) imaging technique to quantify the differences in collagen fiber organization and nuclei morphology between normal and injured chicken tendons. Tendon injury/degeneration was induced by rearing chickens in wire-floor pens and feeding them an oxidized fat diet. Injured tendons had greater collagen fiber degradation/degeneration; more randomly organized collagen fibers, higher cellularity and more circular-shaped nuclei than normal tendons, indicating loss of collagen tertiary structure and lateral compression in injured tendons. Therefore, analysis of collagen fiber organization and nuclear morphology using FT-SHG imaging is a potential diagnostic tool to evaluate tendon structural health and to test the effects of nutrients and intervention strategies on the structural development of tendons in chickens.

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Laminated tears of the human rotator cuff: A histologic and immunochemical study

Cited by 83 publications

References 3 publications

Coordinate Regulation of IL-1β and MMP-13 in Rat Tendons Following Subrupture Fatigue Damage

Coordinate Regulation of IL-1β and MMP-13 in Rat Tendons Following Subrupture Fatigue Damage

Inflammatory infiltrate of the edges of a torn rotator cuff

Quantitative Analysis of Tendon Structural Integrity in Chickens using Fourier Transform-Second Harmonic Generation Imaging

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