David P Beason1, Jennica J Tucker2, Chang Soo Lee3, Lena Edelstein2, Joseph A Abboud4, Louis J Soslowsky5. 1. McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA; American Sports Medicine Institute, Birmingham, AL, USA. 2. McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA. 3. McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA; Department of Orthopaedic Surgery, Spine & Joint Institute Teun Teun Hospital, Goyang-si, Gyeonggi-do, South Korea. 4. Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA. 5. McKay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: soslowsk@upenn.edu.
Abstract
BACKGROUND: Rotator cuff tendon tears represent a major component of reported orthopaedic injuries. In addition, more than one quarter of U.S. adults either currently have high cholesterol levels or have reduced their previously high cholesterol levels through the use of pharmaceuticals. Our clinical data have already linked hypercholesterolemia to full-thickness rotator cuff tears, and experimental data from our laboratory have shown effects on native tendon properties in multiple species. The objective of this study was to evaluate healing of supraspinatus tendons in our rat rotator cuff injury model. We hypothesized that tendon healing would be inferior in rats receiving a high-cholesterol diet for 6 months compared with those receiving standard chow. METHODS: All animals were subjected to a unilateral supraspinatus detachment and repair surgery, with contralateral limbs serving as within-animal comparative data. Animals continued their respective diet courses, and their supraspinatus tendons were biomechanically or histologically evaluated at 2, 4, and 8 weeks postoperatively. RESULTS: Biomechanical testing revealed a significant reduction in normalized stiffness in hypercholesterolemic rats compared with controls at 4 weeks after injury, whereas histologic analyses showed no significant differences in collagen organization, cellularity, or cell shape between groups. CONCLUSION: On the basis of our findings, hypercholesterolemia may have a detrimental biomechanical effect on tendon healing in our rat rotator cuff injury and repair model. LEVEL OF EVIDENCE: Basic science study, animal model.
BACKGROUND: Rotator cuff tendon tears represent a major component of reported orthopaedic injuries. In addition, more than one quarter of U.S. adults either currently have high cholesterol levels or have reduced their previously high cholesterol levels through the use of pharmaceuticals. Our clinical data have already linked hypercholesterolemia to full-thickness rotator cuff tears, and experimental data from our laboratory have shown effects on native tendon properties in multiple species. The objective of this study was to evaluate healing of supraspinatus tendons in our ratrotator cuff injury model. We hypothesized that tendon healing would be inferior in rats receiving a high-cholesterol diet for 6 months compared with those receiving standard chow. METHODS: All animals were subjected to a unilateral supraspinatus detachment and repair surgery, with contralateral limbs serving as within-animal comparative data. Animals continued their respective diet courses, and their supraspinatus tendons were biomechanically or histologically evaluated at 2, 4, and 8 weeks postoperatively. RESULTS: Biomechanical testing revealed a significant reduction in normalized stiffness in hypercholesterolemicrats compared with controls at 4 weeks after injury, whereas histologic analyses showed no significant differences in collagen organization, cellularity, or cell shape between groups. CONCLUSION: On the basis of our findings, hypercholesterolemia may have a detrimental biomechanical effect on tendon healing in our ratrotator cuff injury and repair model. LEVEL OF EVIDENCE: Basic science study, animal model.
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