Purpose
To compare the effects of allogeneic dermal fibroblasts (ADFs) and platelet-rich plasma
(PRP) on tendon-to-bone healing in a rabbit model of chronic rotator cuff tear.
Methods
Thirty-two rabbits were divided into 4 groups (8 per group). In 2 groups, the supraspinatus
tendon was detached and was left as such for 6 weeks. At 6 weeks after creating the
tear model, we performed transosseous repair with 5 × 106 ADFs plus fibrin injection in the left shoulder and PRP plus fibrin in the right
shoulder. The relative expression of the COL1, COL3, BMP2, SCX, SOX9, and ACAN genes was assessed at 4 weeks (group A) and 12 weeks (group B) after repair. Histologic
and biomechanical evaluations of tendon-to-bone healing at 12 weeks were performed
with ADF injection in both shoulders in group C and PRP injection in group D.
Results
At 4 weeks, COL1 and BMP2 messenger RNA expression was higher in ADF-injected shoulders (1.6 ± 0.8 and 1.0
± 0.3, respectively) than in PRP-injected shoulders (1.0 ± 0.3 and 0.6 ± 0.3, respectively)
(P = .019 and P = .013, respectively); there were no differences in all genes in ADF- and PRP-injected
shoulders at 12 weeks (P > .05). Collagen continuity, orientation, and maturation of the tendon-to-bone interface
were better in group C than in group D (P = .024, P = .012, and P = .013, respectively) at 12 weeks, and mean load to failure was 37.4 ± 6.2 N/kg and
24.4 ± 5.2 N/kg in group C and group D, respectively (P = .015).
Conclusions
ADFs caused higher COL1 and BMP2 expression than PRP at 4 weeks and showed better histologic and biomechanical findings
at 12 weeks after rotator cuff repair of the rabbit model. ADFs enhanced healing better
than PRP in the rabbit model.
Clinical Relevance
This study could serve as a transitional study to show the effectiveness of ADFs in
achieving tendon-to-bone healing after repair of chronic rotator cuff tears in humans.
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Article info
Publication history
Published online: December 26, 2021
Accepted:
December 16,
2021
Received:
June 5,
2021
Footnotes
See commentary on page 2129
The authors report the following potential conflicts of interest or sources of funding: J.H.O. received a grant for this research from the Seoul National University Bundang Hospital research fund (14-2015-010; Effects of Allogeneic Dermal Fibroblasts on Rotator Cuff Healing in a Rabbit Model of Chronic Tear). Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2021 by the Arthroscopy Association of North America
