PURPOSE: This study tested a bone-tendon allograft versus human dermis patch for reconstructing chronic rotator cuff repair by use of a canine model. METHODS: Mature research dogs (N = 15) were used. Radiopaque wire was placed in the infraspinatus tendon (IST) before its transection. Three weeks later, radiographs showed IST retraction. Each dog then underwent 1 IST treatment: debridement (D), direct repair of IST to bone with a suture bridge and human dermis patch augmentation (GJ), or bone-tendon allograft (BT) reconstruction. Outcome measures included lameness grading, radiographs, and ultrasonographic assessment. Dogs were killed 6 months after surgery and both shoulders assessed biomechanically and histologically. RESULTS: BT dogs were significantly (P = .01) less lame than the other groups. BT dogs had superior bone-tendon, tendon, and tendon-muscle integrity compared with D and GJ dogs. Biomechanical testing showed that the D group had significantly (P = .05) more elongation than the other groups whereas BT had stiffness and elongation characteristics that most closely matched normal controls. Radiographically, D and GJ dogs showed significantly more retraction than BT dogs (P = .003 and P = .045, respectively) Histologically, GJ dogs had lymphoplasmacytic infiltrates, tendon degeneration and hypocellularity, and poor tendon-bone integration. BT dogs showed complete incorporation of allograft bone into host bone, normal bone-tendon junctions, and well-integrated allograft tendon. CONCLUSIONS: The bone-tendon allograft technique re-establishes a functional IST bone-tendon-muscle unit and maintains integrity of repair in this model. CLINICAL RELEVANCE: Clinical trials using this bone-tendon allograft technique are warranted.
PURPOSE: This study tested a bone-tendon allograft versus human dermis patch for reconstructing chronic rotator cuff repair by use of a canine model. METHODS: Mature research dogs (N = 15) were used. Radiopaque wire was placed in the infraspinatus tendon (IST) before its transection. Three weeks later, radiographs showed IST retraction. Each dog then underwent 1 IST treatment: debridement (D), direct repair of IST to bone with a suture bridge and human dermis patch augmentation (GJ), or bone-tendon allograft (BT) reconstruction. Outcome measures included lameness grading, radiographs, and ultrasonographic assessment. Dogs were killed 6 months after surgery and both shoulders assessed biomechanically and histologically. RESULTS: BT dogs were significantly (P = .01) less lame than the other groups. BT dogs had superior bone-tendon, tendon, and tendon-muscle integrity compared with D and GJ dogs. Biomechanical testing showed that the D group had significantly (P = .05) more elongation than the other groups whereas BT had stiffness and elongation characteristics that most closely matched normal controls. Radiographically, D and GJ dogs showed significantly more retraction than BT dogs (P = .003 and P = .045, respectively) Histologically, GJ dogs had lymphoplasmacytic infiltrates, tendon degeneration and hypocellularity, and poor tendon-bone integration. BT dogs showed complete incorporation of allograft bone into host bone, normal bone-tendon junctions, and well-integrated allograft tendon. CONCLUSIONS: The bone-tendon allograft technique re-establishes a functional IST bone-tendon-muscle unit and maintains integrity of repair in this model. CLINICAL RELEVANCE: Clinical trials using this bone-tendon allograft technique are warranted.
Authors: Solaiman Tarafder; John A Brito; Sumeet Minhas; Linda Effiong; Stavros Thomopoulos; Chang H Lee Journal: Biofabrication Date: 2019-11-18 Impact factor: 9.954
Authors: Dai Fei Elmer Ker; Dan Wang; Anthony William Behn; Evelyna Tsi Hsin Wang; Xu Zhang; Benjamin Yamin Zhou; Ángel Enrique Mercado-Pagán; Sungwoo Kim; John Kleimeyer; Burhan Gharaibeh; Yaser Shanjani; Drew Nelson; Marc Safran; Emilie Cheung; Phil Campbell; Yunzhi Peter Yang Journal: Adv Funct Mater Date: 2018-03-30 Impact factor: 18.808
Authors: Xiaoxi Ji; Qingshan Chen; Andrew R Thoreson; Jin Qu; Kai-Nan An; Peter C Amadio; Scott P Steinmann; Chunfeng Zhao Journal: Clin Biomech (Bristol, Avon) Date: 2015-07-04 Impact factor: 2.063
Authors: Zhanwen Wang; Zeling Long; Peter C Amadio; Anne Gingery; Steven L Moran; Scott P Steinmann; Chunfeng Zhao Journal: Orthop J Sports Med Date: 2020-09-02