Mechanical properties of the different rotator cuff tendons in the rat are similarly and adversely affected by age

Newton, Joseph B.; Fryhofer, George W.; Rodriguez, Ashley B.; Kuntz, Andrew F.; Soslowsky, Louis J.

doi:10.1016/j.jbiomech.2021.110249

Cited by 7 publications

(10 citation statements)

References 49 publications

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“…Previous work has investigated changes to rotator cuff biomechanics secondary to aging in animals. Newton et al recently investigated purely biomechanical changes to rat rotator cuff tendons secondary to aging and revealed decreased secant and tangent moduli in geriatric animals across all four rotator cuff tendons; however, the supraspinatus tendon was not preferentially affected 17 . These results are interesting considering the data presented herein illustrate a preferential decrease in modulus within the supraspinatus tendon.…”

Section: Discussionsupporting

confidence: 60%

“…Specifically, there is a need to benchmark those properties when tendons are healthy (e.g., in younger population with low tear prominence) and diseased (e.g., in aged populations where tears are more prominent). Additionally, understanding that each tendon has unique biomechanical properties as a result of anatomical arrangement and function, [17][18][19] it would follow that scaffold properties may need to be specifically tailored to match the target tendon(s), especially in cases of massive rotator cuff tendon tears involving multiple tendons. Unfortunately, although some researchers have documented age-related changes to tendon biomechanical properties in animal models, 17 changes to all four rotator cuff tendons in humans secondary to aging have not yet been documented.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical and histological changes secondary to aging in the human rotator cuff: A preliminary analysis

Johnson

Stade

Gadomski

et al. 2023

Journal Orthopaedic Research

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The high failure rate of rotator cuff repair surgeries is positively correlated with age, yet the biomechanical changes to the tendons of the rotator cuff with age have not been described. As such, we sought to benchmark and characterize the biomechanical and histopathological properties with the accompanying gene expression of human rotator cuff tendons as a function of age and histopathological degeneration. All four rotator cuff tendons from fresh human cadaver shoulders underwent biomechanical, histopathological, and gene expression analyses. Following cadaver availability, samples were grouped into Younger (i.e., less than 36 years of age, n = 2 donors) and Aged (i.e., greater than 55 years of age, n = 3 donors) as a means of characterizing and quantifying the age‐related changes exhibited by the tendons. Biomechanical testing and subsequent computational modeling techniques revealed both differences in properties between tendons and greater Young's moduli in the Younger tendons (supraspinatus 3.06x, infraspinatus 1.76x, subscapularis 1.25x, and teres minor 1.32x). Histopathological scoring using the semi‐quantitative Bonar scoring scheme revealed a positive correlation with age across all tendons (r = 0.508, p < 0.001). These data contextualize the biomechanical and histopathological changes to tendons that occurs naturally with aging, highlighting the innate differences in biomechanical properties of all four rotator cuff tendons, as well as the difference in their degenerative trajectories. Additionally, the histopathological scoring revealed moderate signs of degeneration within the Younger supraspinatus tendons, suggesting tissue quality may decrease in this specific tendon in patients less than 40 years old, before clinical symptoms or tears.

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Section: Discussionsupporting

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Biomechanical and histological changes secondary to aging in the human rotator cuff: A preliminary analysis

Johnson

Stade

Gadomski

et al. 2023

Journal Orthopaedic Research

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“…The two significant mechanical properties that are critical to prevent tears or retears of the rotator cuff tendon are strength and toughness (energy absorption capability of the tissue which protects against failure following onset of injury or retears post‐repair) 38,39 . The toughness of the PEG‐IGF‐1m treatment group tissue reached 80% native tendon toughness, whereas the repair controls tissue showed only 31% toughness values compared to the native tendon.…”

Section: Discussionmentioning

confidence: 99%

Pegylated insulin‐like growth factor‐1 biotherapeutic delivery promotes rotator cuff regeneration in a rat model

Prabhath

Vernekar

Esdaille

et al. 2022

J Biomedical Materials Res

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Tears in the rotator cuff are challenging to repair because of the complex, hypocellular, hypovascular, and movement‐active nature of the tendon and its enthesis. Insulin‐like Growth Factor‐1 (IGF‐1) is a promising therapeutic for this repair. However, its unstable nature, short half‐life, and ability to disrupt homeostasis has limited its clinical translation. Pegylation has been shown to improve the stability and sustain IGF‐1 levels in the systemic circulation without disrupting homeostasis. To provide localized delivery of IGF‐1 in the repaired tendons, we encapsulated pegylated IGF‐1 mimic and its controls (unpegylated IGF‐1 mimic and recombinant human IGF‐1) in polycaprolactone‐based matrices and evaluated them in a pre‐clinical rodent model of rotator cuff repair. Pegylated‐IGF‐1 mimic delivery reestablished the characteristic tendon‐to‐bone enthesis structure and improved tendon tensile properties within 8 weeks of repair compared to controls, signifying the importance of pegylation in this complex tissue regeneration. These results demonstrate a simple and scalable biologic delivery technology alternative to tissue‐derived grafts for soft tissue repair.

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“… 37 In elderly people, the number of microvessels in the tendon is significantly lower than that in young people, which makes the rotator cuff tissue more prone to fibrovascular hyperplasia, fat formation, atrophy, and calcification, which all increase the risk for rotator cuff tears. 27 , 33 However, the specific causes of rotator cuff tear transformation and degeneration remain unclear. This study showed that patients with supraspinatus tears were older than those without rotator cuff tears (WMD, 3.36 [95% CI, 0.53-6.20]).…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Supraspinatus Tears: A Meta-analysis of Observational Studies

Zhao

Luo

Liang

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: The pathogenesis of rotator cuff tears remains unclear, and there is a lack of high-quality evidence-based research on the risk factors for supraspinatus tears. Purpose: To explore 10 potential risk factors for supraspinatus muscle tears. Study Design: Systematic review; Level of evidence, 3. Methods: This review was conducted according to the MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines. PubMed, Embase, and Web of Science were searched for cohort, case-control and cross-sectional studies published before January 2021 on supraspinatus tears. The following potential risk factors were analyzed: age, body mass index, male sex, female sex, arm dominance, diabetes mellitus, smoking, hypertension, thyroid disease, and the critical shoulder angle (CSA). Risk ratios (RRs) or weighted mean differences (WMDs) of related risk were calculated. The Egger test was used to evaluate publication bias. Results: A total of 9 articles from 8 countries were included; among the 3240 patients, 687 were included in the supraspinatus tear group, and 2553 were included in the nonsupraspinatus tear group. The meta-analysis showed that older age (WMD, 3.36 [95% confidence interval (CI), 0.53-6.20]; P = .02), male sex (RR, 0.87 [95% CI, 0.78-0.97]; P = .01), smoking (RR, 2.21 [95% CI, 1.56-3.14]; P < .00001), diabetes (RR, 1.67 [95% CI, 1.03-2.70]; P = .04), hypertension (RR, 1.51 [95% CI, 1.16-1.97]; P = .002), and the CSA (WMD, 2.25 [95% CI, 1.39-3.12]; P < .00001) were risk factors for supraspinatus tears. Conclusion: Older age, male sex, smoking, diabetes, hypertension, and a higher CSA were found to be risk factors for supraspinatus tears in this meta-analysis review. Identifying risk factors for supraspinatus tears early can help clinicians identify these high-risk patients and choose appropriate treatments.

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Mechanical properties of the different rotator cuff tendons in the rat are similarly and adversely affected by age

Cited by 7 publications

References 49 publications

Biomechanical and histological changes secondary to aging in the human rotator cuff: A preliminary analysis

Biomechanical and histological changes secondary to aging in the human rotator cuff: A preliminary analysis

Pegylated insulin‐like growth factor‐1 biotherapeutic delivery promotes rotator cuff regeneration in a rat model

Risk Factors for Supraspinatus Tears: A Meta-analysis of Observational Studies

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