Purpose
To compare the effects of anatomical preservation (AP) and interpositional preservation
(IP) of subacromial bursa tissue on tendon-to-bone healing in a rat model of rotator
cuff tear.
Methods
In this study, 48 male Sprague–Dawley rats (average weight 283 g) underwent bilateral
supraspinatus tendons severed by sharp incision and repaired immediately. The subacromial
bursa tissues were completely removed in 16 rats, who served as the control (CON)
group. The other 32 rats were randomly divided into 2 groups AP and IP between tendon
and bone. Eight rats of each group were sacrificed for bilateral shoulders at 3 and
9 weeks after the operation, including 5 rats for biomechanical tests and 3 for histologic
analysis.
Results
No significant differences in terms of biomechanical properties were observed among
the groups 3 weeks after surgery. At 9 weeks, the maximum load and stiffness of the
AP (32.95 ± 6.33 N, P = .029; 12.49 ± 3.17 N/mm, P < .001; respectively) and IP (33.58 ± 8.47 N, P = .015; 11.63 ± 2.84 N/mm, P = .010, respectively) groups were significantly superior to that of the CON group
(26.59 ± 4.47 N; 8.42 ± 2.33 N/mm, respectively). More organized collagen and more
mature tendon insertion were observed in AP and IP groups at the interface at 9 weeks,
which means better tendon-to-bone healing compared with the CON group.
Conclusions
The subacromial bursa plays a positive role in tendon-bone healing. Either anatomical
preservation or interpositional preservation between tendon and bone can similarly
facilitate the process of healing.
Clinical Relevance
Considering the additional surgical time and surgical manipulation, preserving the
subacromial bursa at the anatomical position seems to be a better way to promote rotator
cuff healing.
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Article info
Publication history
Published online: December 07, 2022
Accepted:
November 11,
2022
Received:
May 10,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report the following potential conflicts of interest or sources of funding: This work was supported by the start-up research grant program for Ph.D. of Affiliated Hospital of Nantong University [No. Tdb2007], and Natural Science Foundation for the Youth of Jiangsu Province [No. BK20210843]. ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
