The effect of diclofenac on matrix metalloproteinase levels in the rotator cuff

Çabuk, Haluk; Avcı, Arzu; Durmaz, Huseyin; Çabuk, Fatmagül Kuşku; Ertem, Fatih; Şener, I. Muhittin

doi:10.1007/s00402-014-2099-0

Cited by 13 publications

(5 citation statements)

References 15 publications

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“…The rats were killed at post-operative weeks 1, 3, and 6. The humerus and supraspinatus muscle dissected from the rest of the body to form a tendon-humeral unity after exposing the acromial arc without giving any harm to the healing portion of the tendon 16 .…”

Section: Surgical Proceduresmentioning

confidence: 99%

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Effect of diclofenac on TNFα and HIF1α levels in rat supraspinatus tendon repair

Çabuk

2019

Muscle Ligaments and Tendons J

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Introduction: Tendon healing is influenced by proinflammatory cytokines such as tumour necrosis factor alpha (TNFα) and hypoxia-induced factor 1 alpha (HIF1α). We hypothese that diclofenac effects on HIF1α and TNFα levels during healing process. Methods: A supraspinatus tear model was created and repaired to its anatomic footprint with 42 male Winstar rats. Rats were randomized to study and control group. Diclofenac 1 mg/kg/day was administered to the study group in a subcutaneous way. The rats were killed at weeks 1, 3 and 6, and seven rats from each group underwent immunohistochemical examination with TNFα and HIF1α. Results: HIF1α was highest in the first week in both diclofenac and control group. HIF1α levels decreased significantly at the 6 th week in the control group (p=0.011) but in diclofenac group this decrease was observed at the 3 rd week (p=0.024). TNFα levels decrease significantly at 3 rd week in both groups (p<0.001), but in diclofenac group TNFα level was high at 6 th week compared to 3 rd week (p=0.051). Conclusion: Diclofenac could have effect on HIF1α and TNFα which are important in different phases of tendon healing. Level of evidence: basic science study.

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Section: Surgical Proceduresmentioning

confidence: 99%

“…For examining vascular proliferation, a 30.000 micron square meter was chosen at the tendon bone healing region where maximum vascularity exists. Newly formed vessels were counted and 0-5 vessels classified as 1, 6-20 classified as 2 and above 21 as 3 16,17 .…”

Section: Histologymentioning

confidence: 99%

Effect of diclofenac on TNFα and HIF1α levels in rat supraspinatus tendon repair

Çabuk

2019

Muscle Ligaments and Tendons J

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“…Traditional nonselective NSAIDs inhibit both COX1 and COX2, while selective NSAIDs only target COX2 (Table ). For rotator cuff repair, a number of NSAIDs, including diclofenac, meloxicam, ibuprofen, indomethacin, and celecoxib, showed largely detrimental effects on mechanical properties and tendon healing after acute injury . These effects may be somewhat time‐dependent; while most studies showed impaired healing with immediate delivery postinjury, delivery at later stages of healing did not seem to affect functional properties .…”

Section: Biomolecule‐based Therapies For Rotator Cuff Repairmentioning

confidence: 99%

“…For rotator cuff repair, a number of NSAIDs, including diclofenac, meloxicam, ibuprofen, indomethacin, and celecoxib, showed largely detrimental effects on mechanical properties and tendon healing after acute injury. [85][86][87][88] These effects may be somewhat time-dependent; while most studies showed impaired healing with immediate delivery postinjury, delivery at later stages of healing did not seem to affect functional properties. 87 Indeed, delayed repair coupled with licofelone injections (a dual COX and lipoxygenase inhibitor) improved mechanical properties and fibrocartilage deposition.…”

Section: Immunomodulatory Factorsmentioning

confidence: 99%

Biologics and stem cell‐based therapies for rotator cuff repair

Bianco

Moser

Galatz

et al. 2018

Annals of the New York Academy of Sciences

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The rotator cuff is composed of several distinct muscles and tendons that function in concert to coordinate shoulder motion. Injuries to these tendons frequently result in permanent dysfunction and persistent pain. Despite considerable advances in operation techniques, surgical repair alone still does not fully restore rotator cuff function. This review focuses on recent research in the use of biologics and stem cell-based therapies to augment repair, highlighting promising avenues for future work and remaining challenges. While a number of animal models are used for rotator cuff studies, the anatomy of the rotator cuff varies dramatically between species. Since the rodent rotator cuff shares the most anatomical features with the human, this review will focus primarily on rodent models to enable consistent interpretation of outcome measures.

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“…Of particular relevance in orthopaedic surgery, the use of the non-steroidal anti-inflammatory drug (NSAID) diclofenac was shown to significantly influence levels of MMP-2, MMP-3 and MMP-13 after rotator cuff repair in a rat model, eventually resulting in decreased biomechanical strength of the repair [ 29 ]. Cohen et al demonstrated inferior healing and lower rotator cuff repair loads to failure in rats receiving celecoxib and indomethacin compared to contols [ 30 ].…”

Section: Matrix Metalloproteinase (Mmp) Inhibitorsmentioning

confidence: 99%

The Role of Platelet Rich Plasma (PRP) and Other Biologics for Rotator Cuff Repair

Greenspoon

Moulton

Millett

et al. 2016

TOORTHJ

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Background:Surgical treatment of rotator cuff tears has consistently demonstrated good clinical and functional outcomes. However, in some cases, the rotator cuff fails to heal. While improvements in rotator cuff constructs and biomechanics have been made, the role of biologics to aid healing is currently being investigated.Methods:A selective literature search was performed and personal surgical experiences are reported.Results:Biologic augmentation of rotator cuff repairs can for example be performed wtableith platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs). Clinical results on PRP application have been controversial. Application of MSCs has shown promise in animal studies, but clinical data on its effectiveness is presently lacking. The role of Matrix Metalloproteinase (MMP) inhibitors is another interesting field for potential targeted drug therapy after rotator cuff repair.Conclusions:Large randomized clinical studies need to confirm the benefit of these approaches, in order to eventually lower retear rates and improve clinical outcomes after rotator cuff repair.

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The effect of diclofenac on matrix metalloproteinase levels in the rotator cuff

Abstract: Diclofenac has an impact on the levels of MMP-2, MMP-3 and MMP-13, which are needed for normal healing process, and it can also lead to disruption of tendon healing.

Cited by 13 publications

References 15 publications

Effect of diclofenac on TNFα and HIF1α levels in rat supraspinatus tendon repair

Effect of diclofenac on TNFα and HIF1α levels in rat supraspinatus tendon repair

Biologics and stem cell‐based therapies for rotator cuff repair

The Role of Platelet Rich Plasma (PRP) and Other Biologics for Rotator Cuff Repair

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