Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss
Introduction. Repair of the torn rotator cuff tendon is a common procedure performed in the shoulder. In the clinical setting, a significant delay between rotator cuff tear and subsequent repair often exists. The purpose of this study was to investigate the biomechanical properties and bone density...
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| Veröffentlicht in: | Journal of orthopaedic research 2005-11, Vol.23 (6), p.1441-1447 |
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| creator | Galatz, L.M. Rothermich, S.Y. Zaegel, M. Silva, M.J. Havlioglu, N. Thomopoulos, S. |
| description | Introduction. Repair of the torn rotator cuff tendon is a common procedure performed in the shoulder. In the clinical setting, a significant delay between rotator cuff tear and subsequent repair often exists. The purpose of this study was to investigate the biomechanical properties and bone density of the tendon to bone repair site after acute and delayed repair.
Methods. The supraspinatus tendons in bilateral shoulders of 60 rats were transected from the bone. In the acute group, the tendons were immediately repaired with suture. In the delayed group, the tendons were allowed to retract and repaired in a second procedure after a 3-week delay. Cross sectional area and biomechanical properties were evaluated. Bone density of the humeral head was assessed using peripheral quantitative computed tomography. Histologic sections were obtained and examined.
Results. At 10 days the repair tissue displayed vascular and fibroblast proliferation accompanied by predominantly mononuclear infiltrate. At 28 days the inflammatory process gradually decreased. No significant histologic differences were noted between the acute and delayed repair specimens. Cross-sectional area was higher in the delayed group at the early time points (44% at 10 days and 31% at 28 days). Viscoelastic properties were greater in the acute group at the early time points and significantly less at the latest time point, compared to the delayed group. Bone density was markedly decreased (8% and 12%, 28 and 56 days respectively) in the delay group.
Discussion. Inferior rotator cuff healing was demonstrated when there was a delay between injury and repair. Viscoelastic properties of the acute repairs were increased compared to the delayed group at 10 days, indicating tendon stiffening during the 3-week delay before repair. Viscoelastic properties of the acute repairs were decreased compared to the delayed group at 56 days indicating deterioration of properties over time in the delayed group. The deterioration in properties in the delayed group coincide with bone density decreases in the greater tuberosity. These results indicate that bone loss may a significant factor in poor healing. |
| doi_str_mv | 10.1016/j.orthres.2005.05.005 |
| format | Article |
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Methods. The supraspinatus tendons in bilateral shoulders of 60 rats were transected from the bone. In the acute group, the tendons were immediately repaired with suture. In the delayed group, the tendons were allowed to retract and repaired in a second procedure after a 3-week delay. Cross sectional area and biomechanical properties were evaluated. Bone density of the humeral head was assessed using peripheral quantitative computed tomography. Histologic sections were obtained and examined.
Results. At 10 days the repair tissue displayed vascular and fibroblast proliferation accompanied by predominantly mononuclear infiltrate. At 28 days the inflammatory process gradually decreased. No significant histologic differences were noted between the acute and delayed repair specimens. Cross-sectional area was higher in the delayed group at the early time points (44% at 10 days and 31% at 28 days). Viscoelastic properties were greater in the acute group at the early time points and significantly less at the latest time point, compared to the delayed group. Bone density was markedly decreased (8% and 12%, 28 and 56 days respectively) in the delay group.
Discussion. Inferior rotator cuff healing was demonstrated when there was a delay between injury and repair. Viscoelastic properties of the acute repairs were increased compared to the delayed group at 10 days, indicating tendon stiffening during the 3-week delay before repair. Viscoelastic properties of the acute repairs were decreased compared to the delayed group at 56 days indicating deterioration of properties over time in the delayed group. The deterioration in properties in the delayed group coincide with bone density decreases in the greater tuberosity. These results indicate that bone loss may a significant factor in poor healing.</description><identifier>ISSN: 0736-0266</identifier><identifier>EISSN: 1554-527X</identifier><identifier>DOI: 10.1016/j.orthres.2005.05.005</identifier><identifier>PMID: 16055296</identifier><identifier>CODEN: JOREDR</identifier><language>eng</language><publisher>United States: Elsevier Ltd</publisher><subject>Animals ; Biomechanical Phenomena ; Bone Density ; Bone loss ; Chronic ; Enthesis ; Insertion site ; Male ; Osteoporosis - etiology ; Rats ; Rats, Sprague-Dawley ; Rotator cuff ; Rotator Cuff - physiopathology ; Rotator Cuff - surgery ; Shoulder ; Tendon ; Tendon Injuries - physiopathology ; Tendon Injuries - surgery ; Time Factors ; Wound Healing</subject><ispartof>Journal of orthopaedic research, 2005-11, Vol.23 (6), p.1441-1447</ispartof><rights>2005 Orthopaedic Research Society</rights><rights>Copyright Journal of Bone and Joint Surgery, Inc. Nov 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-8d2dacfd8651c9f19e827772fb65c377c5f2ded975f37dafe304a987f1ddda913</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16055296$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Galatz, L.M.</creatorcontrib><creatorcontrib>Rothermich, S.Y.</creatorcontrib><creatorcontrib>Zaegel, M.</creatorcontrib><creatorcontrib>Silva, M.J.</creatorcontrib><creatorcontrib>Havlioglu, N.</creatorcontrib><creatorcontrib>Thomopoulos, S.</creatorcontrib><title>Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss</title><title>Journal of orthopaedic research</title><addtitle>J Orthop Res</addtitle><description>Introduction. Repair of the torn rotator cuff tendon is a common procedure performed in the shoulder. In the clinical setting, a significant delay between rotator cuff tear and subsequent repair often exists. The purpose of this study was to investigate the biomechanical properties and bone density of the tendon to bone repair site after acute and delayed repair.
Methods. The supraspinatus tendons in bilateral shoulders of 60 rats were transected from the bone. In the acute group, the tendons were immediately repaired with suture. In the delayed group, the tendons were allowed to retract and repaired in a second procedure after a 3-week delay. Cross sectional area and biomechanical properties were evaluated. Bone density of the humeral head was assessed using peripheral quantitative computed tomography. Histologic sections were obtained and examined.
Results. At 10 days the repair tissue displayed vascular and fibroblast proliferation accompanied by predominantly mononuclear infiltrate. At 28 days the inflammatory process gradually decreased. No significant histologic differences were noted between the acute and delayed repair specimens. Cross-sectional area was higher in the delayed group at the early time points (44% at 10 days and 31% at 28 days). Viscoelastic properties were greater in the acute group at the early time points and significantly less at the latest time point, compared to the delayed group. Bone density was markedly decreased (8% and 12%, 28 and 56 days respectively) in the delay group.
Discussion. Inferior rotator cuff healing was demonstrated when there was a delay between injury and repair. Viscoelastic properties of the acute repairs were increased compared to the delayed group at 10 days, indicating tendon stiffening during the 3-week delay before repair. Viscoelastic properties of the acute repairs were decreased compared to the delayed group at 56 days indicating deterioration of properties over time in the delayed group. The deterioration in properties in the delayed group coincide with bone density decreases in the greater tuberosity. These results indicate that bone loss may a significant factor in poor healing.</description><subject>Animals</subject><subject>Biomechanical Phenomena</subject><subject>Bone Density</subject><subject>Bone loss</subject><subject>Chronic</subject><subject>Enthesis</subject><subject>Insertion site</subject><subject>Male</subject><subject>Osteoporosis - etiology</subject><subject>Rats</subject><subject>Rats, Sprague-Dawley</subject><subject>Rotator cuff</subject><subject>Rotator Cuff - physiopathology</subject><subject>Rotator Cuff - surgery</subject><subject>Shoulder</subject><subject>Tendon</subject><subject>Tendon Injuries - physiopathology</subject><subject>Tendon Injuries - surgery</subject><subject>Time Factors</subject><subject>Wound Healing</subject><issn>0736-0266</issn><issn>1554-527X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkU9r3DAQxUVpSDZpPkKL6aE3byR5JVmnENLmDwR6aaA3odWMiIxX2kp2Id8-MrsQ6KUwIBh-781oHiGfGV0zyuTVsE55eslY1pxSsV6Kig9kxYTYtIKr3x_JiqpOtpRLeUbOSxkopYrx_pScMUmF4FquiPuOo31FaDLubchN8s2EEVJsptRsU8QmxGHOAUszooWytAFdRluqaBvSDt2LjcHZsdnntMc8LayNcFCPqZRP5MTbseDl8b0gz3c_ft0-tE8_7x9vb55a12k6tT1wsM5DLwVz2jONPVdKcb-VwnVKOeE5IGglfKfAeuzoxupeeQYAVrPugnw7-NZF_sxYJrMLxeE42ohpLkb2UtNNxyv49R9wSHOOdTfDO8FYNdYVEgfI5fqHjN7sc9jZ_GoYNUsEZjDHCMwSgVmKiqr7cjSftzuEd9Xx5hW4PgBYb_E3YDbFBYwOIWR0k4EU_jPiDewym-4</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>Galatz, L.M.</creator><creator>Rothermich, S.Y.</creator><creator>Zaegel, M.</creator><creator>Silva, M.J.</creator><creator>Havlioglu, N.</creator><creator>Thomopoulos, S.</creator><general>Elsevier Ltd</general><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20051101</creationdate><title>Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss</title><author>Galatz, L.M. ; Rothermich, S.Y. ; Zaegel, M. ; Silva, M.J. ; Havlioglu, N. ; Thomopoulos, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-8d2dacfd8651c9f19e827772fb65c377c5f2ded975f37dafe304a987f1ddda913</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Animals</topic><topic>Biomechanical Phenomena</topic><topic>Bone Density</topic><topic>Bone loss</topic><topic>Chronic</topic><topic>Enthesis</topic><topic>Insertion site</topic><topic>Male</topic><topic>Osteoporosis - etiology</topic><topic>Rats</topic><topic>Rats, Sprague-Dawley</topic><topic>Rotator cuff</topic><topic>Rotator Cuff - physiopathology</topic><topic>Rotator Cuff - surgery</topic><topic>Shoulder</topic><topic>Tendon</topic><topic>Tendon Injuries - physiopathology</topic><topic>Tendon Injuries - surgery</topic><topic>Time Factors</topic><topic>Wound Healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Galatz, L.M.</creatorcontrib><creatorcontrib>Rothermich, S.Y.</creatorcontrib><creatorcontrib>Zaegel, M.</creatorcontrib><creatorcontrib>Silva, M.J.</creatorcontrib><creatorcontrib>Havlioglu, N.</creatorcontrib><creatorcontrib>Thomopoulos, S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of orthopaedic research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Galatz, L.M.</au><au>Rothermich, S.Y.</au><au>Zaegel, M.</au><au>Silva, M.J.</au><au>Havlioglu, N.</au><au>Thomopoulos, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss</atitle><jtitle>Journal of orthopaedic research</jtitle><addtitle>J Orthop Res</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>23</volume><issue>6</issue><spage>1441</spage><epage>1447</epage><pages>1441-1447</pages><issn>0736-0266</issn><eissn>1554-527X</eissn><coden>JOREDR</coden><abstract>Introduction. Repair of the torn rotator cuff tendon is a common procedure performed in the shoulder. In the clinical setting, a significant delay between rotator cuff tear and subsequent repair often exists. The purpose of this study was to investigate the biomechanical properties and bone density of the tendon to bone repair site after acute and delayed repair.
Methods. The supraspinatus tendons in bilateral shoulders of 60 rats were transected from the bone. In the acute group, the tendons were immediately repaired with suture. In the delayed group, the tendons were allowed to retract and repaired in a second procedure after a 3-week delay. Cross sectional area and biomechanical properties were evaluated. Bone density of the humeral head was assessed using peripheral quantitative computed tomography. Histologic sections were obtained and examined.
Results. At 10 days the repair tissue displayed vascular and fibroblast proliferation accompanied by predominantly mononuclear infiltrate. At 28 days the inflammatory process gradually decreased. No significant histologic differences were noted between the acute and delayed repair specimens. Cross-sectional area was higher in the delayed group at the early time points (44% at 10 days and 31% at 28 days). Viscoelastic properties were greater in the acute group at the early time points and significantly less at the latest time point, compared to the delayed group. Bone density was markedly decreased (8% and 12%, 28 and 56 days respectively) in the delay group.
Discussion. Inferior rotator cuff healing was demonstrated when there was a delay between injury and repair. Viscoelastic properties of the acute repairs were increased compared to the delayed group at 10 days, indicating tendon stiffening during the 3-week delay before repair. Viscoelastic properties of the acute repairs were decreased compared to the delayed group at 56 days indicating deterioration of properties over time in the delayed group. The deterioration in properties in the delayed group coincide with bone density decreases in the greater tuberosity. These results indicate that bone loss may a significant factor in poor healing.</abstract><cop>United States</cop><pub>Elsevier Ltd</pub><pmid>16055296</pmid><doi>10.1016/j.orthres.2005.05.005</doi><tpages>7</tpages></addata></record> |
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| subjects | Animals Biomechanical Phenomena Bone Density Bone loss Chronic Enthesis Insertion site Male Osteoporosis - etiology Rats Rats, Sprague-Dawley Rotator cuff Rotator Cuff - physiopathology Rotator Cuff - surgery Shoulder Tendon Tendon Injuries - physiopathology Tendon Injuries - surgery Time Factors Wound Healing |
| title | Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss |
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