Arthroscopic Rotator Cuff Repair with Double-Row Fixation

Huijsmans, Pol E.; Pritchard, Mark P.; Berghs, Bart; Rooyen, Karin S. van; Beer, J.F. de; Wallace, Andrew L.

doi:10.2106/00004623-200706000-00013

Cited by 173 publications

(115 citation statements)

References 38 publications

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“…Thus alterations in collagen structure in torn tendons may disrupt these crosslinkages and thus impair the mechanics. This may account for the weakness and the inability to perform household tasks after development of tears of the rotator cuff, 34 and the improvement in function 35 and strength 36 seen after successful repair of the tendon.…”

Section: Discussionmentioning

confidence: 99%

Fourier transform infrared spectroscopic analysis of normal and torn rotator-cuff tendons

Chaudhury

Dicko

Burgess

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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We have used Fourier transform infrared spectroscopy (FTIR) to characterise the chemical and structural composition of the tendons of the rotator cuff and to identify structural differences among anatomically distinct tears. Such information may help to identify biomarkers of tears and to provide insight into the rates of healing of different sizes of tear. The infrared spectra of 81 partial, small, medium, large and massive tears were measured using FTIR and compared with 11 uninjured control tendons. All the spectra were classified using standard techniques of multivariate analysis. FTIR readily differentiates between normal and torn tendons, and different sizes of tear. We identified the key discriminating molecules and spectra altered in torn tendons to be carbohydrates/phospholipids (1030 cm(-1) to 1200 cm(-1)), collagen (1300 cm(-1) to 1700 cm(-1) and 3000 cm(-1) to 3350 cm(-1)) and lipids (2800 cm(-1) to 3000 cm(-1)). Our study has shown that FTIR spectroscopy can identify tears of the rotator cuff of varying size based upon distinguishable chemical and structural features. The onset of a tear is mainly associated with altered structural arrangements of collagen, with changes in lipids and carbohydrates. The approach described is rapid and has the potential to be used peri-operatively to determine the quality of the tendon and the extent of the disease, thus guiding surgical repair.

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Section: Discussionmentioning

confidence: 99%

Fourier transform infrared spectroscopic analysis of normal and torn rotator-cuff tendons

Chaudhury

Dicko

Burgess

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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“…Degeneration and tears of the supraspinatus tendon in the rotator cuff, resulting in impaired shoulder function, are very common and account for 30-70% of all shoulder pain (1,2). Although improvements have been made to surgical repair techniques and postoperative care, the rate of re-rupture remains as high as 75% (3)(4)(5). There is evidence that the progression of tears is characterized by cellular and extracellular matrix (ECM) changes including reduced cell number, decreased vascularization and poor matrix organization (3).…”

Section: Introductionmentioning

confidence: 99%

Distribution and expression of type VI collagen and elastic fibers in human rotator cuff tendon tears

Thakkar

Grant

Hakimi

et al. 2014

Connective Tissue Research

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There is increasing evidence for a progressive extracellular matrix change in rotator cuff disease progression. Directly surrounding the cell is the pericellular matrix, where assembly of matrix aggregates typically occurs making it critical in the response of tendon cells to pathological conditions. Studies in animal models have identified type VI collagen, fibrillin-1 and elastin to be located in the pericellular matrix of tendon and contribute in maintaining the structural and biomechanical integrity of tendon. However, there have been no reports on the localization of these proteins in human tendon biopsies. This study aimed to characterize the distribution of these ECM components in human rotator cuffs and gain greater insight into the relationship of pathology to tear size by analyzing the distribution and expression profiles of these ECM components. Confocal microscopy confirmed the localization of these structural molecules in the pericellular matrix of the human rotator cuff. Tendon degeneration led to an increased visibility of these components with a significant disorganization in the distribution of type VI collagen. At the genetic level, an increase in tear size was linked to an increased transcription of type VI collagen and fibrillin-1 with no significant alteration in the elastin levels. This is the first study to confirm the localization of type VI collagen, elastin and fibrillin-1 in the pericellular region of human supraspinatus tendon and assesses the effect of tendon degeneration on these structures, thus providing a useful insight into the composition of human rotator cuff tears which can be instrumental in predicting disease prognosis.

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“…For cases that have failed conservative treatment, a simple surgical re-attachment of the tendon to the bone with a non-absorbable suture is the most common option. However, the failure rate of these repairs is very high, estimated at up to 75 % (Galatz et al, 2004;Bishop et al, 2006;Huijsmans et al, 2007;Sugaya et al, 2007). A number of studies have shown that in late disease stages the tendon itself is extremely degenerate, with reduced cell numbers and poor matrix organisation (Cole et al, 2001;Benson et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

An electrospun polydioxanone patch for the localisation of biological therapies during tendon repair

Hakimi

Murphy²,

Stachewicz³

et al. 2012

eCM

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Rotator cuff tendon pathology is thought to account for 30-70 % of all shoulder pain. For cases that have failed conservative treatment, surgical re-attachment of the tendon to the bone with a non-absorbable suture is a common option. However, the failure rate of these repairs is high, estimated at up to 75 %. Studies have shown that in late disease stages the tendon itself is extremely degenerate, with reduced cell numbers and poor matrix organisation. Thus, it has been suggested that adding biological factors such as platelet rich plasma (PRP) and mesenchymal stem cells could improve healing. However, the articular capsule of the glenohumeral joint and the subacromial bursa are large spaces, and injecting beneficial factors into these sites does not ensure localisation to the area of tendon damage. Thus, the aim of this study was to develop a biocompatible patch for improving the healing rates of rotator cuff repairs. The patch will create a confinement around the repair area and will be used to guide injections to the vicinity of the surgical repair. Here, we characterised and tested a preliminary prototype of the patch utilising in vitro tools and primary tendon-derived cells, showing exceptional biocompatibility despite rapid degradation, improved cell attachment and that cells could migrate across the patch towards a chemoattractant. Finally, we showed the feasibility of detecting the patch using ultrasound and injecting liquid into the confinement ex vivo. There is a potential for using this scaffold in the surgical repair of interfaces such as the tendon insertion in the rotator cuff, in conjunction with beneficial factors.

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Arthroscopic Rotator Cuff Repair with Double-Row Fixation

Cited by 173 publications

References 38 publications

Fourier transform infrared spectroscopic analysis of normal and torn rotator-cuff tendons

Fourier transform infrared spectroscopic analysis of normal and torn rotator-cuff tendons

Distribution and expression of type VI collagen and elastic fibers in human rotator cuff tendon tears

An electrospun polydioxanone patch for the localisation of biological therapies during tendon repair

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