Purpose
The aim of this study was to investigate the influence of footprint spongialization
and radiofrequency ablation on rotator cuff repair outcomes compared with an untreated
group in a rat model.
Methods
We randomly assigned 189 Sprague-Dawley rats to either a spongialization, radiofrequency
ablation, or untreated group. After separation of the supraspinatus tendon from the
greater tubercle, the footprint was prepared by removing the cortical bone with a
burr (spongialization), was prepared by ablating soft tissue with a radiofrequency
ablation device, or was left unaltered (untreated). Biomechanical testing (after 7
weeks, n = 165) and histologic analysis after 1 and 7 weeks (n = 24) followed reinsertion.
Results
The mean load to failure was 17.51 ± 4.46 N/mm2 in the spongialization group, 15.56 ± 4.85 N/mm2 in the radiofrequency ablation group, and 19.21 ± 5.19 N/mm2 in the untreated group. A significant difference was found between the spongialization
and radiofrequency ablation groups (P = .0409), as well as between the untreated and radiofrequency ablation groups (P = .0014). There was no significant difference between the spongialization and untreated
groups (P = .2456). The mean area of fibrocartilage transition, characterized by the presence
of type II collagen, was larger after 1 and 7 weeks in the spongialization group (0.57
± 0.1 mm2 and 0.58 ± 0.1 mm2, respectively) and untreated group (0.51 ± 0.1 mm2 and 0.51 ± 0.2 mm2, respectively) than in the radiofrequency ablation group (0.11 ± 0.1 mm2 and 0.4 ± 0.1 mm2, respectively) with P < .05 and P < .01.
Conclusions
The results of this study show that radiofrequency ablation of the footprint results
in a poor biomechanical and histologic outcome in an animal model. No preparation
of the footprint has the same effect as spongialization.
Clinical Relevance
Different techniques of footprint preparation in rotator cuff repair may influence
tendon-to-bone healing.
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Article info
Publication history
Accepted:
November 13,
2013
Received:
April 10,
2013
Footnotes
Andreas Ficklscherer and Thomas Loitsch contributed equally to this study.
The authors report the following potential conflict of interest or source of funding: This study was partly subsidized by the Friedrich-Baur-Stiftung, Ludwig-Maximilians-University of Munich, Munich, Germany (A.F., M.F.G., T.R.N., M.F.P., P.E.M.).
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
