The influence of different footprint preparation techniques on tissue regeneration in rotator cuff repair in an animal model

Abstract

IntroductionRotator cuff tears are common diseases of the upper extremity. There are no recommendations to the surgeon on how to prepare the footprint to ensure optimal tendon-to-bone healing. However, biologic augmentation using stem cells and growth factors is considered to encourage the healing process of the tendon. The aim of the study was to investigate the biomechanical and histological outcome of different footprint preparations in rotator cuff repair.Material and methodsOne hundred and eighty-nine Sprague-Dawley rats were randomly assigned to either spongialization, radiofrequency ablation or an untreated control group. Rats were killed after 1 or 7 weeks for histological evaluation or after 7 weeks for biomechanical testing.ResultsHistological evaluation showed better tissue organization in the control and spongialization group compared to the radiofrequency ablation group. The highest collagen I to collagen III quotient was found in the control group, followed closely by the spongialization group. Measured quotients showed a decrease in the values after 1 week compared to the values after 7 weeks, except in the radiofrequency ablation group, where an increase was detected. A significant difference was found in the load to failure test comparing the radiofrequency ablation group to the spongialization group (p = 0.0409) and control group (p = 0.014), but not comparing the spongialization group to the control group (p = 0.2456).ConclusionsThe results of this study suggest that spongialization of the footprint before attaching the torn supraspinatus tendon can lead to better structural properties and higher quality of tendon-to-bone restoration at the insertion area when compared with radiofrequency ablation.

Substantial Biomechanical Improvement by Extracorporeal Shockwave Therapy After Surgical Repair of Rodent Chronic Rotator Cuff Tears

“…The effect of footprint preparation techniques on the outcome of rotator cuff reconstruction was investigated in earlier studies. 2,11,34 Based on these results, debridement of the SSP tendon insertion area was performed in this study.…”

Does Greater Trochanter Decortication Affect Suture Anchor Pullout Strength in Abductor Tendon Repairs? A Biomechanical Study

“…However, results from the literature have been inconclusive on whether decortication biologically improves bone to tendon healing and whether the biomechanical risks of decortication merit the theoretical biological benefits. 7,21 Kida et al 31 used a rat supraspinatus repair model to show that drilling into the greater tuberosity releases bone marrow–derived stem cells and improves postsurgical rotator cuff healing. In contrast, in a goat rotator cuff repair model, St Pierre et al 43 did not find any histological or biomechanical difference in cancellous versus cortical tendon-to-bone healing sites.…”

Medium- to long-term clinical and functional outcomes of isolated and combined subscapularis tears repaired arthroscopically

“…The reinsertion of the subscapularis tendon was performed by either 1 or 2 screw-type anchors (TWINFIX Ultra HA Suture Anchor 5.5 mm × 20 mm, Smith & Nephew) depending on the inferior extension of the tear, fitted with 2 double-mounted sutures. In order to enhance tendon-to-bone healing, a previous adequate spongialization of the footprint was carried out [20]. After the reinsertion, coracoplasty was performed in a minority of the cases with a coracohumeral distance of less than 7 mm to prevent coracoid impingement syndrome [21][22][23][24].…”