Small Subchondral Drill Holes Improve Marrow Stimulation of Rotator Cuff Repair in a Rabbit Model of Chronic Rotator Cuff Tear

Sun, Yucheng; Kwak, Jae-Man; Kholinne, Erica; Zhou, Youlang; Tan, Jun; Koh, Kyoung Hwan

doi:10.1177/0363546519896350

Cited by 24 publications

(18 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, rabbits were considered a suitable animal model to research rotator cuff pathology, especially that caused by extrinsic factor alterations (e.g., biomechanical changes) 22 . In recent years, rabbit models have been extensively applied in rotator cuff repair research 23 – 27 .…”

Section: Discussionmentioning

confidence: 99%

Postoperative malrotation of humerus shaft fracture causes degeneration of rotator cuff and cartilage

Wang

Liu

et al. 2021

Sci Rep

View full text Add to dashboard Cite

We hypothesized that postoperative malrotation of humeral shaft fractures can alter the bio-mechanical environment of the shoulder; thus, rotator cuff and cartilage degeneration could be induced. Therefore, we designed an animal experiment to evaluate the impact of malrotation deformities after minimally invasive surgery for humeral fractures on the rotator cuff and cartilage, which has rarely been described in previous studies. Twenty-four New Zealand white rabbits were randomly divided into the sham control group (A), negative control group (B) and malrotated group (C). A sham operation with surgical exposure alone was performed in group A. Humeral shaft osteotomy was performed in Group B and C. In Group B, the fractures were fixed in situ with plate -screw system. While in Group C, iatrogenic rotational deformity was created after the proximal end of the fracture being internally rotated by 20 degrees and then subsequently fixed. The animals with bone healing were sacrificed for pathological and biochemical examination. In group C, the modified Mankin scale for cartilage pathology evaluation and the modified Movin scale for tendon both showed highest score among groups with statistical significance (P < 0.05); Disordered alignment and proportion of collagen I/III of rotator cuff were confirmed with picrosirius red staining; Transmission electron microscopy also showed ultrastructural tendon damage. Immunohistochemistry showed that both MMP-1 and MMP-13 expression were significantly higher in group C than groups A and B(P < 0.05). Minimally invasive techniques for humerus shaft fracture might be cosmetically advantageous, but the consequent postoperative malrotation could increase the risk of rotator cuff and cartilage degeneration. This conclusion is supported here by primary evidence from animal experiments.

show abstract

Section: Discussionmentioning

confidence: 99%

Postoperative malrotation of humerus shaft fracture causes degeneration of rotator cuff and cartilage

Wang

Liu

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…The rabbit has emerged as a middle ground model for studying the mechanism and treatment of RC muscle pathology, because they do not require nerve injury to demonstrate fat accumulation after supraspinatus tenotomy, and do not suffer from the higher costs or management complexity ( Fabis et al, 1998 , 2000 ; Matsumoto et al, 2002 ; Uhthoff et al, 2003 ; Trudel et al, 2019 ). Furthermore, rabbit repair models have been utilized to study different RC surgical techniques ( Ozbaydar et al, 2008 ; Li et al, 2018 ; Su et al, 2018 ; Sun et al, 2020 ), augmentation strategies ( Chung et al, 2013 ), and biologic therapies ( Honda et al, 2017 ; Kwon et al, 2018 ; Yoon et al, 2018 ), in the hopes of improving retear rates and/or reversing fat accumulation and atrophy.…”

Section: Introductionmentioning

confidence: 99%

The “Second Hit” of Repair in a Rabbit Model of Chronic Rotator Cuff Tear

Gibbons

Esparza

et al. 2022

Front. Physiol.

View full text Add to dashboard Cite

The rabbit supraspinatus is a useful translational model for rotator cuff (RC) repair because it recapitulates muscle atrophy and fat accumulation observed in humans after a chronic tear (the “first hit”). However, a timeline of RC tissue response after repair, especially with regard to recent evidence of muscle degeneration and lack of regeneration, is currently unavailable. Thus, the purpose of this study was to characterize the progression of muscle and fat changes over time after the repair of a chronic RC tear in the rabbit model. Two rounds of experiments were conducted in 2017–2018 and 2019–2020 with N = 18 and 16 skeletally mature New Zealand White rabbits, respectively. Animals underwent left supraspinatus tenotomy with repair 8 weeks later. The unoperated right shoulder served as control. The rabbits were sacrificed at 1-, 2-, 4-, and 8-weeks post-repair for histological and biochemical analysis. Atrophy, measured by fiber cross-sectional area and muscle mass, was greatest around 2 weeks after repair. Active muscle degeneration peaked at the same time, involving 8% of slide areas. There was no significant regeneration at any timepoint. Fat accumulation and fibrosis were significantly increased across all time points compared to contralateral. Statement of Clinical Significance: These results demonstrate model reproducibility and a “second hit” phenomenon of repair-induced muscle atrophy and degeneration which partially recovers after a short time, while increased fat and fibrosis persist.

show abstract

“…Rotator cuff tendon (RCT) injuries are among the most commonly reported disorders of chronic shoulder pain and disability. 2,24 The incidence of RCT injury is approximately 22% in the general population 30 and has become a considerable clinical challenge because of its poor self-healing potential. 25 Currently, different therapeutic strategies are available for RCT tears, ranging from nonoperative treatment to diverse surgical reconstruction techniques, which are frequently the standard treatment choice, especially for massive rotator cuff tears (a complete tear with a diameter >5 cm or >2 tendons).…”

mentioning

confidence: 99%

Decellularized Human Umbilical Cord Wharton Jelly Scaffold Improves Tendon Regeneration in a Rabbit Rotator Cuff Tendon Defect Model

et al. 2021

View full text Add to dashboard Cite

Background: Owing to limited self-healing capacity, failure of rotator cuff tendon healing is a common complication after surgery. Biological scaffolds have garnered attention owing to their potential to enhance healing outcomes. Purpose: To verify the effect of the decellularized umbilical cord Wharton jelly (DUCWJ) scaffold as a bridging scaffold in a rabbit model of acute rotator cuff tendon defect. Study Design: Controlled laboratory study. Methods: We fabricated a DUCWJ scaffold using a physicochemical decellularized method, evaluating changes in the umbilical cord Wharton jelly before and after decellularization. Scanning electron microscopy and biomechanical testing were performed to determine the microstructure and mechanical properties. We assessed cytocompatibility and cell regulatory behavior of the scaffold toward tendon stem/progenitor cells (TSPCs). A supraspinatus tendon defect was created in 54 New Zealand White rabbits, allocated to the DUCWJ scaffold repair group and the negative control group (without scaffold). Histology, reverse transcription polymerase chain reaction, and biomechanical tensile strength were assessed at 4, 8, and 12 weeks postoperatively. Results: Decellularization completely removed cells from the umbilical cord Wharton jelly, retained a considerable amount of glycosaminoglycan and collagen, and preserved the microstructure and tensile strength. The DUCWJ scaffold facilitated migration and proliferation of TSPCs in vitro. Tendon-related gene expression revealed that the DUCWJ scaffold could maintain the tenocyte phenotype of TSPCs. In the in vivo study, the DUCWJ scaffold improved tendon healing and enhanced the biomechanical strength of repaired tendons. Histological evaluation scores of the DUCWJ group were significantly higher than those of the negative control at 4, 8, and 12 weeks after surgery ( P < .05). In repaired tendon tissues, reverse transcription polymerase chain reaction findings revealed that the DUCWJ scaffold stimulated tendon development and maturation. Furthermore, an overall increase in ultimate load and tensile modulus was noted over time; the DUCWJ group presented better results than the negative control group ( P < .05). Conclusion: The DUCWJ scaffold has an excellent 3-dimensional porous structure, good biocompatibility, and fundamental biomechanical characteristics, and it promotes migration, attachment, and proliferation of TSPCs. The in vivo animal study demonstrated that the DUCWJ scaffold has potential for tendon regeneration in an acute rotator cuff tendon defect model Clinical Relevance: DUCWJ scaffolds have potential as a regenerative material to augment rotator cuff healing in the clinical setting.

show abstract

Small Subchondral Drill Holes Improve Marrow Stimulation of Rotator Cuff Repair in a Rabbit Model of Chronic Rotator Cuff Tear

Cited by 24 publications

References 37 publications

Postoperative malrotation of humerus shaft fracture causes degeneration of rotator cuff and cartilage

Postoperative malrotation of humerus shaft fracture causes degeneration of rotator cuff and cartilage

The “Second Hit” of Repair in a Rabbit Model of Chronic Rotator Cuff Tear

Decellularized Human Umbilical Cord Wharton Jelly Scaffold Improves Tendon Regeneration in a Rabbit Rotator Cuff Tendon Defect Model

Contact Info

Product

Resources

About