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Lebaschi A, Kriscenski DE, Tamburini LM, McCarthy MB, Obopilwe E, Uyeki CL, Cote MP, Rodeo SA, Kumbar SG, Mazzocca AD. Subacromial bursa increases the failure force in a mouse model of supraspinatus detachment and repair. J Shoulder Elbow Surg 2022; 31:e519-e533. [PMID: 35690347 DOI: 10.1016/j.jse.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/28/2022] [Accepted: 05/07/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND It has been shown that subacromial bursa (SAB) harbors connective tissue progenitor cells. The purpose of this study was to evaluate the effects of implantation of SAB-derived cells (SBCs) suspended in a fibrin sealant bead and implantation of SAB tissue at rotator cuff repair site on biomechanical properties of the repair in a mouse (C57Bl/6) model of supraspinatus tendon (ST) detachment and repair. METHODS Part 1: Murine SAB tissue was harvested and cultured. Viability of SBCs suspended in 10 μL of fibrin sealant beads was confirmed in vitro and in vivo. Eighty mice underwent right ST detachment and repair augmented with either fibrin sealant bead (control group) or fibrin sealant bead with 100,000 SBCs (study group) applied at the repair site. Part 2: 120 mice underwent right ST detachment and repair and were randomized equally into 4 groups: (1) a tissue group, which received a piece of freshly harvested SAB tissue; (2) a cell group, which received SBCs suspended in fibrin sealant bead; (3) a fibrin sealant group, which received plain fibrin sealant bead without cells; and (4) a control group, which received nothing at the ST repair site. An equal number of mice in each group were killed at 2 and 4 weeks. Specimens underwent biomechanical testing to evaluate failure force (part 1 and 2) and histologic analysis of the repair site (part 1 only). RESULTS Part 1: The mean failure force in the study group was significantly higher than controls at 2 and 4 weeks (3.25 ± 1.03 N vs. 2.43 ± 0.56 N, P = .01, and 4.08 ± 0.99 N vs. 3.02 ± 0.8 N, P = .004, respectively). Mean cell density of the ST at the repair site was significantly lower in the study group at 2 weeks than in controls (18,292.13 ± 1706.41 vs. 29,501.90 ± 3627.49, P = .001). Study group specimens had lower proteoglycan contents than controls, but this difference was not statistically significant. Part 2: There was no difference in failure force between cell and tissue groups at the 2- and 4-week time points (P = .994 and P = .603, respectively). There was no difference in failure force between fibrin sealant bead and control groups at the 2- and 4-week time points (P = .978 and P = .752, respectively). CONCLUSION This study shows that the application of SBCs and SAB tissue at the rotator cuff repair site increases the strength of repair in a murine model of rotator cuff detachment and repair.
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Affiliation(s)
- Amir Lebaschi
- Department of Orthopedics and Sports Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Danielle E Kriscenski
- Department of Orthopedics and Sports Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Lisa M Tamburini
- Department of Orthopedics and Sports Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Mary Beth McCarthy
- Department of Orthopedics and Sports Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Elifho Obopilwe
- Department of Orthopedics and Sports Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Colin L Uyeki
- Department of Orthopedics and Sports Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Mark P Cote
- Department of Orthopedics and Sports Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Scott A Rodeo
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA
| | - Sangamesh G Kumbar
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | - Augustus D Mazzocca
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA; Shoulder and Elbow Surgery, Harvard Medical School, Boston, MA, USA.
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Abstract
PURPOSE/AIM The purpose of this study is to identify a cell population within the murine subcromial bursal-derived cells with characteristics compatible to an accepted mesenchymal stem cell description given by the International Society for Cellular Therapy (ISCT). MATERIALS AND METHODS Murine subacromial bursa was harvested using microsurgical technique. Subacromial bursal-derived cells were classified through colony-forming units, microscopic morphology, fluorescent-activated cell sorting, and differentiation into chondrogenic, adipogenic, and osteogenic lineages. RESULTS Subacromial bursal samples exhibited cell growth out of the tissue for an average of 115 ± 29 colony-forming units per 1 mL of complete media. Subacromial bursal-derived cells exhibited a long, spindle-shaped, fibroblast-like morphology. Subacromial bursal-derived cells positively expressed mesenchymal stem cell markers CD73, CD90, and CD105, and negatively expressed mesenchymal stem cell markers CD31 and CD45. Subacromial bursal-derived cells, examined by Image J analysis and quantitative gene expression, were found to differentiate into chondrogenic, adipogenic, and osteogenic lineages. CONCLUSIONS This study demonstrated the feasibility of harvesting murine subacromial bursal tissue and identified a cell population within the subacromial bursa with characteristics compatible to an accepted mesenchymal stem cell description. The results of this study suggest that the mouse subacromial bursal-derived cell population harbors mesenchymal stem cells. Murine subacromial bursal tissue is a potential source for obtaining cells with mesenchymal stem cell characteristics for future utilization in orthopedic research to look into treatment of rotator cuff pathology.
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Affiliation(s)
| | - Amir Lebaschi
- Department of Orthopaedics and Sports Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Lisa M Tamburini
- School of Medicine, University of Connecticut, Farmington, Connecticut, USA
| | - Mary Beth R McCarthy
- Department of Orthopaedics and Sports Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Mark P Cote
- Department of Orthopaedics and Sports Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Sangamesh G Kumbar
- Department of Orthopaedics and Sports Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.,Biomedical Engineering Department, University of Connecticut, Storrs, Connecticut, USA
| | - Augustus D Mazzocca
- Department of Orthopaedics and Sports Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
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Debieux P, Jimenez AE, Novaretti JV, Kaleka CC, Kriscenski DE, Astur DC, Obopilwe E, Tamburini LM, Muench LN, Cote MP, Cohen M, Coyner KJ. Medial meniscal extrusion greater than 4 mm reduces medial tibiofemoral compartment contact area: a biomechanical analysis of tibiofemoral contact area and pressures with varying amounts of meniscal extrusion. Knee Surg Sports Traumatol Arthrosc 2021; 29:3124-3132. [PMID: 33221933 DOI: 10.1007/s00167-020-06363-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 11/02/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The primary objective of this study is to evaluate the contact areas, contact pressures, and peak pressures in the medial compartment of the knee in six sequential testing conditions. The secondary objective is to establish how much the medial meniscus is able to extrude, secondary to soft tissue injury while keeping its roots intact. METHODS Ten cadaveric knees were dissected and tested in six conditions: (1) intact meniscus, (2) 2 mm extrusion, (3) 3 mm extrusion, (4) 4 mm extrusion, (5) maximum extrusion, (6) capsular based meniscal repair. Knees were loaded with a 1000-N axial compressive force at 0°, 30°, 60°, and 90° for each condition. Medial compartment contact area, average contact pressure, and peak contact pressure data were recorded. RESULTS When compared to the intact state, there was no statistically significant difference in medial compartment contact area at 2 mm of extrusion or 3 mm of extrusion (n.s.). There was a statistically significant decrease in contact area compared to the intact state at 4 mm (p = 0.015) and maximum extrusion (p < 0.001). The repair state was able to improve medial compartment contact area, and there was no statistically significant difference between the repair and the intact states (n.s.). No significant differences were found in the average contact pressure between the repair, intact, or maximum extrusion conditions at any flexion angle (n.s.). No significant differences were found in the peak contact pressure between the repair, intact, or maximum extrusion conditions at any flexion angle (n.s.). CONCLUSION In this in vitro model, medial meniscus extrusion greater than 4 mm reduced medial compartment contact area, but meniscal extrusion did not significantly increase pressure in the medial compartment. Additionally, meniscal centralization was effective in restoring the medial tibiofemoral contact area to intact state when the meniscal extrusion was secondary to meniscotibial ligament injury. The diagnosis of meniscal extrusion may not necessarily involve meniscal root injury. Since it is known that meniscal extrusion greater than 3 or 4 mm has a biomechanical impact on tibiofemoral compartment contact area and pressures, specific treatments can be established. Centralization restored medial compartment contact area to the intact state.
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Affiliation(s)
- Pedro Debieux
- Department of Orthopaedic Surgery, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.,Department of Orthopaedic Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil.,, Av Pedroso de Morais, 2567, Sao Paulo, SP, 01259-010, Brazil
| | - Andrew E Jimenez
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, 120 Dowling Way, Farmington, CT, 06030, USA.
| | - João Victor Novaretti
- Department of Orthopaedic Surgery, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.,Department of Orthopaedic Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Camila Cohen Kaleka
- Department of Orthopaedic Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Danielle E Kriscenski
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, 120 Dowling Way, Farmington, CT, 06030, USA
| | - Diego Costa Astur
- Department of Orthopaedic Surgery, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil
| | - Elifho Obopilwe
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, 120 Dowling Way, Farmington, CT, 06030, USA
| | - Lisa M Tamburini
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, 120 Dowling Way, Farmington, CT, 06030, USA
| | - Lukas N Muench
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, 120 Dowling Way, Farmington, CT, 06030, USA
| | - Mark P Cote
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, 120 Dowling Way, Farmington, CT, 06030, USA
| | - Moises Cohen
- Department of Orthopaedic Surgery, Universidade Federal de São Paulo, UNIFESP, São Paulo, Brazil.,Department of Orthopaedic Surgery, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Katherine J Coyner
- Department of Orthopaedic Surgery, UConn Musculoskeletal Institute, University of Connecticut, 120 Dowling Way, Farmington, CT, 06030, USA
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