scholarly journals Recombinant Human Bone Morphogenetic Proteins-4 Enhanced the Tendon-to-bone Attachment Healing in a Murine Model of Rotator Cuff Tear: A Randomized Controlled Trial

2020 ◽  
Author(s):  
Huabin Chen ◽  
Zhanwen Wang ◽  
Li Zhou ◽  
Bing Wu ◽  
Hongbin Lu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Bone Morphogenetic Proteins ◽  
Murine Model ◽  
Controlled Trial ◽  
Supraspinatus Tendon ◽  
Control Group ◽  
Cuff Tear ◽  
Tendon Insertion ◽  
And Control

Abstract Background: Injuries on tendon-to-bone attachment (TBA) are common clinical dilemmas. Bone Morphogenetic Proteins-4 (BMP-4) has been found the potency in chondrogenesis. But there is rare studies focusing the influence of BMP-4 on the TBA healing. Thus, the objective of this study was to explore the effect of BMP-4 on the healing of TBA in murine model of rotator cuff tear.Methods: 120 mature C57BL/6 mice (12 weeks old) were randomly divided into BMP-4 group, noggin (an inhibitor of all BMP activities) group and control group after being established an injury model of supraspinatus tendon insertion. At week 2 and 4 after surgery, the supraspinatus tendon- humerus complex (SSTHC) were harvested for microradiographic, histologic, immunofluorescent and biomechanical evaluations.Results: Radiographic data showed that BMP-4 was able to improve the quality of subchondral bone, manifested as higher BV/TV, Tb.N, TB.Th, and lower Tb.Sp. Histologically, the BMP-4 group at week-2 and -4 showed better BTA healing interface, characterized by better organizational integration and remodeling, thicker fibrocartilage layer and more fibrocartilage cells. Immunoflorescence evaluation demonstrated the number of SOX 9 positive cells in the BMP-4 group was significantly more than that in the control or noggin group at postoperative weeks 2 and 4 (p<0.05 for all). Mechanical testing results demonstrated the failure load and stiffness in the BMP-4 group were significantly higher (p<0.05 for both), while in the noggin group were lower (p<0.05 for both), compared to the control group at postoperative weeks 4.Conclusion: BMP-4 might enhance the TBA healing by promoting the regeneration of fibrocartilaginous enthesis and mineralization, while noggin inhibited this process.Clinical Relevance: BMP-4 may be a potential therapy to augment TBA healing, and finally lead to more rapid rehabilitation and reduce risk of recurrent repair.

scholarly journals Dynamic scapulohumeral rhythm: Comparison between healthy shoulders and those with large or massive rotator cuff tear

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902098177
Author(s):  
Naoya Kozono ◽  
Naohide Takeuchi ◽  
Takamitsu Okada ◽  
Satoshi Hamai ◽  
Hidehiko Higaki ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
External Rotation ◽  
Three Dimensional ◽  
Control Group ◽  
Scapular Kinematics ◽  
Cuff Tear ◽  
And Control ◽  
Matching Techniques ◽  
Scapular Plane

Introduction: Assessment of scapular kinematics and the dynamics of the scapulohumeral rhythm (SHR) would be important for understanding pathologies of the shoulder and to inform treatment. Our aim in this study was to evaluate the SHR and scapular kinematics in patients with a rotator cuff tear (RCT), compared to a control group with healthy shoulders using image-matching techniques. Materials and Methods: The shoulder kinematics of large or massive RCT patients were evaluated and compared to a control group with healthy shoulders. Radiographic surveillance was performed throughout the full range of external rotation and scapular plane abduction. Computed tomography imaging of the shoulder complex was performed, with three-dimensional image reconstruction and matching to the radiographs to measure three-dimensional positions and orientations. SHR and angular values of the scapula were measured. Results: Scapular external rotation in the late phase of external rotation movement was greater in the RCT group than in the control group ( p < 0.05), but with no difference in the SHR. During scapular plane abduction, there were significant differences in SHR, scapular posterior tilt and scapular upward rotation between the RCT and control group ( p < 0.05). Conclusions: Regarding clinical relevance, this study clarified the differences of SHR and angular values of the scapula between the RCT and control group. These results underline the importance of assessment the SHR and scapular kinematics in individuals with a RCT. RCT is associated with specific compensation in the kinematics of the scapula and SHR during external rotation and scapular plane abduction, which could inform treatment.

scholarly journals DOES HYPERCHOLESTOLEMIA PREDISPOSE TO ROTATOR CUFF PATHOLOGIES?

2017 ◽  
Vol 10 (4) ◽  
pp. 373 ◽  
Author(s):  
Surendra Umesh Kamath ◽  
Sunil Murthy
Keyword(s):  
Rotator Cuff ◽  
Total Cholesterol ◽  
Rotator Cuff Tear ◽  
Indian Population ◽  
Statistical Significance ◽  
Elevated Serum ◽  
Density Lipoprotein ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Cuff Tear

Background:  Rotator cuff tear are one of most common orthopedic musculoskeletal problem gaining importance due to large health scale expenditure. Causes of rotator cuff tears are multifactorial and unclear.  Previous studies have suggested relation between elevated serum lipid profile and rotator cuff tear in western population. We therefore undertook study in our Indian population to correlate association of hypercholesterolemia with rotator cuff tear.Objective: To find association of rotator cuff pathology with hypercholesterolemia in Indian patients.Materials and methods: After obtaining clearance from institutional ethics committee. We prospectively collected fasting lipid samples of population who came to our hospitals with complaints of shoulder pain during our study period. 50 patients had rupture of rotator cuff which was confirmed by ultrasound of involved shoulder. 50 were seen for non-cuff related complaints.  We followed strict inclusion and exclusion criteria.Results: Total cholesterol, Triglycerides and low density lipoprotein concentration of patients with rotator cuff tendon tear were on higher side than control group. High density lipoprotein trend showed being lower than control group.  21 of 50 (42%) had high cholesterol (total cholesterol greater than 240mg/dl) than compared to 18 of 50 (36%) in control group. however P value=0.539 and showed no statistical significance between groups.Conclusion: In Indian population there was no correlation between hypercholesterolemia and rotator cuff tear which is statistically significant.Key words Rotator cuff tear, Hypercholesterolemia, Indian population.   

A Novel Acromion Radiological Classification and Its Clinical Application Study: Comparing Rockwood Tilt View with Arthroscopic Findings in 101 Shoulders

2020 ◽  
Vol 10 (5) ◽  
pp. 1184-1189
Author(s):  
Yingchun Zhu ◽  
Xuewen Jia ◽  
Zhanping Jin ◽  
Yunfeng Mi ◽  
Zheyang Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Classification System ◽  
Supraspinatus Tendon ◽  
New Classification ◽  
Tendon Tear ◽  
Cuff Tear ◽  
Observer Reliability ◽  
Traditional Classification

Background: It is estimated that more than 25% of general population more than 60 years old experience rotator cuff tear, acromial impingement syndrome is one of the most common causes. Morphology of acromion is an important extrinsic factor in the development of rotator cuff tear. The traditional classification of the acromion by Bigliani et al. based on supraspinatus outlet view has been widely used, but due to the high requirements for patients to obtain true supraspinatus outlet view and the poor inter-observer reliability, it brings lots of limitations to the clinical use of this classification. In our clinical work, we have noticed that the formation of acromial anterolateral spur on Rockwood tilt view has some relationship to a rotator cuff tear. Objectives: To develop a new classification of acromion based on the subacromial impingement theory and the Rockwood tilt view. And explore the application value of the new classification in the diagnosis and treatment of rotator cuff tear. Methods: From January 2017 to December 2017, 101 cases of shoulder arthroscopic surgeries for impingement syndrome or rotator cuff tear were retrospectively analyzed. We developed a new classification of the acromion based on the Rockwood tilt view as type I flat acromion, type II bump acromion and type III impingement acromion. The status of the supraspinatus tendon was also recorded as no tear, partial-thickness tear, and full-thickness tear. We tested the inter-observer and intra-observer reliability of the new classification system (Kappa value) and analyzed the correlation between the acromion morphology and the rupture of the supraspinatus tendon. Results: In all 101 cases, the most common type was the impingement acromion with 46 patients (45.5%), followed by bump acromion in 37 patients (36.6%), and the flat acromion in 18 patients (17.8%). The inter-observer reliability of the new classification system was significantly better than that of the traditional classification (0.826 vs. 0.281). The incidence of supraspinatus tendon tear in the patients with impingement acromion was significantly higher than that of the other two types of acromion (ϰ2 = 50.316,P < 0.05). Conclusion: The Rockwood tilt view can well demonstrate the exact architecture of the anterolateral acromion spur. The new classification based on Rockwood tilt view has high reliability and good reproducibility. The type III impingement acromion correlates highly with the supraspinatus tendon tear. Level of evidence: Level II.

scholarly journals Does the Interval Slide Procedure Reduce Supraspinatus Tendon Repair Tension?: A Biomechanical Cadaveric Study

2022 ◽  
Vol 10 (1) ◽  
pp. 232596712110668
Author(s):  
Felix Porschke ◽  
Philip Christian Nolte ◽  
Christian Knye ◽  
Christel Weiss ◽  
Stefan Studier-Fischer ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Intervention Group ◽  
Tendon Repair ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Full Thickness ◽  
Time Points ◽  
Tendon Tears ◽  
And Control

Background: The benefits of the interval slide (IS) procedure in retracted rotator cuff tears remain controversial. Purpose: The purpose was to evaluate the effect of the IS procedure on repair tension (RT). It was hypothesized that the IS procedure (anterior IS [AIS], posterior IS [PIS], and intra-articular capsular release [CR]) would reduce the RT of a supraspinatus tendon. Study Design: Controlled laboratory study. Methods: A total of 31 Thiel-embalmed human cadaveric shoulders (mean age, 74 years; range, 68-84 years) were tested. Full-thickness supraspinatus tendon tears were created, and 1 cm of tendon was resected to simulate a retracted defect. Shoulders were randomized into intervention (n = 16) and control (n = 15) groups. In all shoulders, the load during tendon reduction to footprint was measured, an endpoint was defined as maximum tendon lateralization before 50 N was reached, and the RT (load during lateralization to endpoint) of the native tendon (t1) was evaluated. In the intervention group, AIS (t2), PIS (t3), and CR (t4) were performed in order, with RT measurement after each step. In the control group, RT was assessed at the same time points without the intervention. Results: A complete reduction of the tendon was not achieved in any of the shoulders. Mean maximum lateralization was 6.7 ± 1.30 mm, with no significant differences between groups. In the intervention group, the overall IS procedure reduced RT about 47.0% (t1 vs t4: 38.7 ± 3.9 vs 20.5 ± 12.3 N; P < .001). AIS reduced RT significantly (t1 vs t2: 38.7 ± 3.9 vs 27.4 ± 10.5 N; P < .001), whereas subsequent PIS (t2 vs t3: 27.4 ± 10.5 vs 23.2 ± 12.4 N; P = .27) and CR (t3 vs t4: 23.2 ± 12.4 vs 20.5 ± 12.3 N; P = .655) did not additionally reduce tension. Comparison between groups at t4 revealed a reduction of RT of about 47.8% (control vs intervention: 39.3 ± 4.0 vs 20.5 ± 12.3 N; P < .001). Conclusion: The IS procedure reduces RT of the supraspinatus tendon in human cadaveric shoulders. However, performing PIS and CR subsequent to AIS does not reduce tension additionally. Clinical Relevance: These findings provide surgeons with a biomechanical rationale regarding the efficacy of the IS procedure.

TNF-α plays a role in sleep disturbance in patients with rotator cuff tear

2021 ◽  
Author(s):  
Chul-Hyun Cho ◽  
Du Hwan Kim ◽  
Eun Hee Baek ◽  
Du-Han Kim
Keyword(s):  
Rotator Cuff ◽  
Sleep Disturbance ◽  
Serum Levels ◽  
Control Group ◽  
Control Groups ◽  
Cuff Tear ◽  
Clinical Scores ◽  
Tnf Α ◽  
And Control ◽  
Concentration Levels

Abstract Background The purpose of this study was to determine serum levels of sleep-related cytokines in patients with rotator cuff tear (RCT) and to investigate the correlations between serum levels of sleep-related cytokines and clinical scores. Methods Peripheral blood samples were collected from 63 study participants were divided into three groups: RCT patients with sleep disturbance (sleep disturbance group; SD group) (n = 21), RCT patients without sleep disturbance (normal sleep group; NS group) (n = 21), and patients with shoulder instability (control group) (n = 21). Serum concentration levels of sleep-related cytokines including interleukin-1α (IL-1α), IL-1β, IL-2, IL-6, IL-8, IL-10, and tumor necrosis factor-α (TNF-α) were measured via enzyme-linked immunosorbent assay. The associations between serum levels of sleep-related cytokines and clinical scores including the Visual Analogue Scale (VAS) pain score, the University of California at Los Angeles (UCLA) score, and the Pittsburgh Sleep Quality Index (PSQI) were analyzed. Results Serum concentration levels of TNF-α were significantly higher in the SD group compared with those of the NS and control groups (P = < 0.001 and 0.05). Serum levels of IL-8 and IL-10 were significantly higher in the SD group compared with those of control group (P = 0.01 and = 0.05), but did not differ significantly from that of the NS group (P > 0.05). Serum level of IL-6 was significantly lower in the SD group compared with those of the NS and control groups (P = < 0.001 and 0.01). There were no associations between serum levels of sleep-related cytokines and all clinical scores including VAS pain, UCLA, and PSQI scores (all P > 0.05). Conclusion The current findings suggest that TNF-α may play a significant role in the pathophysiology of sleep disturbance in patients with RCT and be a possible therapeutic target to improve sleep disturbance in patients with RCT.

Supraspinatus tendon organizational and mechanical properties in a chronic rotator cuff tear animal model

2004 ◽  
Vol 37 (5) ◽  
pp. 739-749 ◽  
Author(s):  
Jonathan A. Gimbel ◽  
Jonathan P. Van Kleunen ◽  
Samir Mehta ◽  
Stephanie M. Perry ◽  
Gerald R. Williams ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Animal Model ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Supraspinatus Tendon ◽  
Cuff Tear

scholarly journals The Efficacy and Safety of Utilizing Mobile Phone–Based Programs and Motion-Capture Devices for Telerehabilitation After Arthroscopic Repair of Rotator Cuff Tear: Study Protocol for a Randomized Controlled Trial

2020 ◽  
Author(s):  
Yuanhao Zhang ◽  
Jingyi Hou ◽  
Fangqi Li ◽  
Congda Zhang ◽  
Yaping Yang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Mobile Phone ◽  
Range Of Motion ◽  
Motion Capture ◽  
Rotator Cuff Tear ◽  
Controlled Trial ◽  
Arthroscopic Repair ◽  
Cuff Tear ◽  
Randomized Controlled

Abstract Background: Rotator cuff tear is one of the most common diseases in orthopedics, which seriously affects the quality of patients’ lives. And the arthroscopic repair of rotator cuff has recently become more and more popular. Systematic rehabilitation makes great significance for improving the prognosis of postoperative patients. Yet, the traditional outpatient rehabilitation is hard to popularize in developing countries like China due to the limitation of traffic and geography. Given this, we plan to develop a telerehabilitation system to facilitate doctors' remote guidance on patients' rehabilitation.Methods/design: Our study is a single-center, prospective randomized controlled trial. 124 patients who underwent arthroscopic rotator cuff repair will be recruited for the study. They will be randomly divided into 2 groups (62 cases in each group) based on the stratification factors of the operator, operation and preoperative diagnosis. The patients in the control group will get clinic and booklet based rehabilitation treatment after operation. However, patients in the experimental group will receive mobile phone and motion-capture device based programs for telerehabilitation after surgery. The primary outcome will be measured by the American Shoulder and Elbow Surgeons (ASES). Secondary outcomes include the Range of motion (ROM), Visual Analogue Scales (VAS), EuroQol-5 Dimension health questionnaire (EQ-5D), University of California at Los Angeles（UCLA）and the retear rate.Discussion: We hypothesize that patients who utilized mobile phone and motion-capture device based telerehabilitation will benefit more in the range of motion and shoulder function than those who received outpatient and manual based rehabilitation. If the hypothesize was confirmed, we could facilitate telerehabilitation for doctors and overcome the geographical and traffic limitations of traditional clinical based rehabilitation.Trial registration: ChiCTR.org.cn, ChiCTR2000030150, Registered on 24 February 2020

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