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Huang S, Tam MY, Ho WHC, Wong HK, Zhou M, Zeng C, Xie D, Elmer Ker DF, Ling SK, Tuan RS, Wang DM. Establishing a rabbit model with massive supraspinatus tendon defect for investigating scaffold-assisted tendon repair. Biol Proced Online 2024; 26:31. [PMID: 39367314 PMCID: PMC11453025 DOI: 10.1186/s12575-024-00256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Accepted: 09/04/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND Shoulder pain and disability from rotator cuff tears remain challenging clinical problem despite advancements in surgical techniques and materials. To advance our understanding of injury progression and develop effective therapeutics using tissue engineering and regenerative medicine approaches, it is crucial to develop and utilize animal models that closely resemble the anatomy and display the pathophysiology of the human rotator cuff. Among various animal models, the rabbit shoulder defect model is particularly favored due to its similarity to human rotator cuff pathology. However, a standardized protocol for creating a massive rotator cuff defect in the rabbits is not well defined. Therefore, the objective of our study was to establish a robust and reproducible model of a rotator cuff defect to evaluate the regenerative efficacy of scaffolds. RESULTS In our study, we successfully developed a rabbit model with a massive supraspinatus tendon defect that closely resembles the common rotator cuff injuries observed in humans. This defect involved a complete transection of the tendon, spanning 10 mm in length and encompassing its full thickness and width. To ensure stable scaffolding, we employed an innovative bridging suture technique that utilized a modified Mason-Allen suture as a structural support. Moreover, to assess the therapeutic effectiveness of the model, we utilized different scaffolds, including a bovine tendon extracellular matrix (ECM) scaffold and a commercial acellular dermal matrix (ADM) scaffold. Throughout the observation period, no scaffold damage was observed. Notably, comprehensive histological analysis demonstrated that the regenerative tissue in the tendon ECM scaffold group exhibited an organized and aligned fiber structure, indicating tendon-like tissue regeneration while the tissue in the ADM group showed comparatively less organization. CONCLUSIONS This study presents a comprehensive description of the implemented procedures for the development of a highly reproducible animal model that induces massive segmental defects in rotator cuff tendons. This protocol can be universally implemented with alternative scaffolds to investigate extensive tendon defects and evaluate the efficacy of regenerative treatments. The application of our animal model offers a standardized and reproducible platform, enabling researchers to systematically evaluate, compare, and optimize scaffold designs. This approach holds significant importance in advancing the development of tissue engineering strategies for effectively repairing extensive tendon defects.
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Affiliation(s)
- Shuting Huang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Hong Kong SAR, China
| | - Ming Yik Tam
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wai Hon Caleb Ho
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hong Ki Wong
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Meng Zhou
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chun Zeng
- Department of Orthopedic Surgery, Center for Orthopedic Surgery, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Denghui Xie
- Department of Orthopedic Surgery, Center for Orthopedic Surgery, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Dai Fei Elmer Ker
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Hong Kong SAR, China
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Samuel Kk Ling
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Rocky S Tuan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Hong Kong SAR, China
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Dan Michelle Wang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Center for Neuromusculoskeletal Restorative Medicine, Hong Kong Science Park, Hong Kong SAR, China.
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
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Nyffeler RW, Lustenberger A, Bissig P. [Can a fall onto the shoulder (direct impact) cause a rotator cuff tear?]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:195-200. [PMID: 38374440 PMCID: PMC10896884 DOI: 10.1007/s00132-024-04474-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/21/2024]
Abstract
The question of whether a fall directly onto the shoulder can cause a rotator cuff tear has occupied doctors (and courts) for many years. Experts who rely on the medical insurance literature usually reject the causality of the incident. There are no scientific studies on this. The report below describes a typical case in which a fall directly onto the shoulder caused a massive rotator cuff tear.
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Affiliation(s)
- Richard W Nyffeler
- Orthopädie Sonnenhof KLG, Salvisbergstrasse 4, 3006, Bern, Schweiz.
- Campus Stiftung Lindenhof Bern (Campus SLB), Salvisbergstrasse 4, 3006, Bern, Schweiz.
| | | | - Philipp Bissig
- Orthomed, Orthopädische Chirurgie Biel-Seeland, Bifangweg 1, 3270, Aarberg, Schweiz
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Lante E, Jany R. Isolated traumatic full-thickness supraspinatus tear with intact glenohumeral capsule: a case report. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:81-85. [PMID: 38323200 PMCID: PMC10840580 DOI: 10.1016/j.xrrt.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Affiliation(s)
- Erica Lante
- Department of Orthopedic Surgery and Traumatology, Riviera Chablais Hospital, Rennaz, Switzerland (CH)
| | - Richard Jany
- Department of Orthopedic Surgery, Saint Loup Hospital, Etablissements hospitaliers du Nord Vaudois, Pompaples, Switzerland (CH)
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Combination of autologous osteochondral and periosteum transplantation effectively promotes fibrocartilage regeneration at the tendon-bone junction of the rotator cuff in rabbits. Knee Surg Sports Traumatol Arthrosc 2022; 31:1953-1962. [PMID: 36515732 DOI: 10.1007/s00167-022-07250-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Rotator cuff tendon-bone healing often leads to scarring and low biomechanical strength, resulting in a tendency to re-tear. This study examined whether combining autologous osteochondral transplantation and periosteum transplantation increases fibrocartilage transition zone regeneration and improves biomechanical fixation. METHODS A total of 48 New Zealand white rabbits were divided into the periosteum, autologous osteochondral, combination of autologous osteochondral and periosteum, and control groups. The supraspinatus tendon was cut from the greater tuberosity and repaired by different transplants. A total of 12 rabbits were used for histological examination (haematoxylin and eosin staining, Masson's staining and Safranin-O staining) at 4, 8 and 12 weeks after the repair, and 36 rabbits were used for biomechanical tests (maximal failure load and stiffness). RESULTS At 4 weeks following the operation, each group had a large tendon-bone gap with a small number of disordered collagen fibres. At 8 weeks, the tendon-bone gap was smaller than that before the operation, and the tendon-bone gap in each experimental group was smaller with neater and denser collagen fibres and chondrocytes than in the control group, with the osteochondral combined periosteum group having the best results. At 12 weeks, the typical tendon-bone transitional structure was observed in the osteochondral combined periosteum group, and more collagen fibres and chondrocytes were generated in each group. The osteochondral combined periosteum group had the largest staining area and the largest amount of cartilage. The maximum tensile strength and stiffness of each group increased over time. There was no significant difference in each group's maximum tensile strength and stiffness at 4 weeks after the operation. However, the maximum tensile strength and stiffness of the osteochondral combined periosteum group at 8 and 12 weeks after operation were significantly higher than those of other groups (P < 0.05). CONCLUSION Histological and biomechanical results show that autologous osteochondral transplantation combined with periosteum transplantation can effectively promote the regeneration of fibrous cartilage in the tendon-bone junction of the rotator cuff. It is concluded that this technique is a new treatment method to promote tendon-bone healing in the rotator cuff.
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宁 梓, 施 政, 杨 光, 钟 瑞, 余 鸿, 王 扬, 王 国, 李 彦. [Evaluation methods of postoperative healing of supraspinatus tendon tear]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:1172-1177. [PMID: 36111482 PMCID: PMC9626287 DOI: 10.7507/1002-1892.202206054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
Objective To summarize the evaluation methods of postoperative healing of supraspinatus tendon tear in recent years, in order to provide reference for clinic. Methods CNKI, Wanfang, PubMed, and Foreign Medical Literature Retrieval Service (FMRS) databases were used to search the literatures between 2005 and 2022. The literature related to the diagnosis and postoperative healing of supraspinatus tendon tear was included. Finally, 50 articles were reviewed. Results Supraspinatus tendon tear is a common shoulder disease. Physical examination, clinical score, and imaging examination are used to predict and evaluate the postoperative healing. Among them, physical examination and clinical score are non-invasive and the most economical methods, but their accuracy and sensitivity are lower than imaging examination, so they can only be used as auxiliary methods. The acromio-humeral distance (AHD) and upward migration index (UMI) measured by X-ray films can directly reflect the change of supraspinatus tendon thickness, but they are impossible to distinguish whether there is tear or not. Ultrasound and MRI are the main methods for the clinical diagnosis of supraspinatus tendon tear, but the commonly used MRI sequence can not accurately judge the internal healing of the tendon. Shear wave elastrography (SWE) and ultrashort-echo-time (UTE) techniques are the latest research directions in recent years, but different studies have shown opposite conclusions on the application of SWE technique. This conclusion shows that the principle of SWE technique and its relationship with tendons need to be further studied. UTE technique has good clinical effect, and the T2* value obtained by UTE technique is more accurate than that of traditional Sugaya typing, but there are still few research samples. Conclusion AHD and UMI measured by X-ray film and T2* value measured by UTE technique can be used as effective methods for evaluating the healing of supraspinatus tendon tear after repairing, and can be used as a follow-up evaluation method combined with physical examination and clinical score for patients with supraspinatus tendon tear.
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Affiliation(s)
- 梓文 宁
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
| | - 政良 施
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
| | - 光 杨
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
| | - 瑞颖 钟
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
| | - 鸿 余
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
| | - 扬 王
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
| | - 国梁 王
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
| | - 彦林 李
- 昆明医科大学第一附属医院运动医学科(昆明 650032)Department of Sports Medicine, the First Affiliated Hospital of Kunming Medical University, Kunming Yunnan, 650032, P. R. China
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