Purpose
To build upon previous literature to identify a complete analysis of cellular contents
of subacromial bursal tissue as well as the matrix surrounding the rotator cuff.
Methods
Samples of subacromial bursal tissue and surrounding matrix milieu from above the
rotator cuff tendon and above the rotator cuff muscle bellies were obtained from 10
patients undergoing arthroscopic rotator cuff repair. Samples were analyzed using
fluorescent-activated cell sorting and histologic analysis with staining protocols
(Oil Red O, Alcian Blue, and Picro-Sirius Red), for identification of matrix components,
including fat, proteoglycans, and collagen.
Results
Progenitor cells and fibroblast-type cells were present in significant amounts in
subacromial bursal tissue in both tissues obtained from over the tendinous and muscle
belly portions. Markers for neural tissue, myeloid cells, and megakaryocytes also
were present to a lesser extent. There were prominent amounts of fat and proteoglycans
present in the matrix, based on ImageJ analysis of stained histologic slides.
Conclusions
The subacromial bursal tissue and surrounding matrix of patients undergoing rotator
cuff repair contains progenitor cells in significant concentrations both over the
tendon and muscle belly of the rotator cuff.
Clinical Relevance
This presence of progenitor cells, in particular, in the subacromial bursal tissue
provides a potential basis for future applications of augmentation purposes in rotator
cuff healing, and calls into question the practice of routine bursectomy. As the potential
role of bursal tissue contents in growth and regeneration in the setting of rotator
cuff healing is more well understood, maintaining this tissue may become more relevant.
Concentration of these cellular components for use in autologous re-implantation is
also an avenue of interest.
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Article info
Publication history
Published online: November 09, 2021
Accepted:
October 19,
2021
Received:
May 8,
2021
See commentary on page 1124Footnotes
The authors report the following potential conflicts of interest or sources of funding: M.P.C. reports personal fees from AANA, outside the submitted work. A.D.M. reports grants from Arthrex, during the conduct of the study; and personal fees from Arthrex, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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