Andreas Ficklscherer1, Thomas Loitsch2, Michaela Serr2, Mehmet F Gülecyüz2, Thomas R Niethammer2, Hans-Helge Müller3, Stefan Milz4, Matthias F Pietschmann2, Peter E Müller2. 1. Department of Orthopaedic Surgery, University Hospital of Munich-Campus Grosshadern, Munich, Germany. Electronic address: andreas.ficklscherer@med.uni-muenchen.de. 2. Department of Orthopaedic Surgery, University Hospital of Munich-Campus Grosshadern, Munich, Germany. 3. Department of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany. 4. Anatomische Anstalt, Ludwig-Maximilians-University, Munich, Germany.
Abstract
PURPOSE: The aim of this study was to investigate the influence of footprint spongialization and radiofrequency ablation on rotator cuff repair outcomes compared with an untreated group in a rat model. METHODS: We randomly assigned 189 Sprague-Dawley rats to either a spongialization, radiofrequency ablation, or untreated group. After separation of the supraspinatus tendon from the greater tubercle, the footprint was prepared by removing the cortical bone with a burr (spongialization), was prepared by ablating soft tissue with a radiofrequency ablation device, or was left unaltered (untreated). Biomechanical testing (after 7 weeks, n = 165) and histologic analysis after 1 and 7 weeks (n = 24) followed reinsertion. RESULTS: The mean load to failure was 17.51 ± 4.46 N/mm(2) in the spongialization group, 15.56 ± 4.85 N/mm(2) in the radiofrequency ablation group, and 19.21 ± 5.19 N/mm(2) in the untreated group. A significant difference was found between the spongialization and radiofrequency ablation groups (P = .0409), as well as between the untreated and radiofrequency ablation groups (P = .0014). There was no significant difference between the spongialization and untreated groups (P = .2456). The mean area of fibrocartilage transition, characterized by the presence of type II collagen, was larger after 1 and 7 weeks in the spongialization group (0.57 ± 0.1 mm(2) and 0.58 ± 0.1 mm(2), respectively) and untreated group (0.51 ± 0.1 mm(2) and 0.51 ± 0.2 mm(2), respectively) than in the radiofrequency ablation group (0.11 ± 0.1 mm(2) and 0.4 ± 0.1 mm(2), respectively) with P < .05 and P < .01. CONCLUSIONS: The results of this study show that radiofrequency ablation of the footprint results in a poor biomechanical and histologic outcome in an animal model. No preparation of the footprint has the same effect as spongialization. CLINICAL RELEVANCE: Different techniques of footprint preparation in rotator cuff repair may influence tendon-to-bone healing.
PURPOSE: The aim of this study was to investigate the influence of footprint spongialization and radiofrequency ablation on rotator cuff repair outcomes compared with an untreated group in a rat model. METHODS: We randomly assigned 189 Sprague-Dawley rats to either a spongialization, radiofrequency ablation, or untreated group. After separation of the supraspinatus tendon from the greater tubercle, the footprint was prepared by removing the cortical bone with a burr (spongialization), was prepared by ablating soft tissue with a radiofrequency ablation device, or was left unaltered (untreated). Biomechanical testing (after 7 weeks, n = 165) and histologic analysis after 1 and 7 weeks (n = 24) followed reinsertion. RESULTS: The mean load to failure was 17.51 ± 4.46 N/mm(2) in the spongialization group, 15.56 ± 4.85 N/mm(2) in the radiofrequency ablation group, and 19.21 ± 5.19 N/mm(2) in the untreated group. A significant difference was found between the spongialization and radiofrequency ablation groups (P = .0409), as well as between the untreated and radiofrequency ablation groups (P = .0014). There was no significant difference between the spongialization and untreated groups (P = .2456). The mean area of fibrocartilage transition, characterized by the presence of type II collagen, was larger after 1 and 7 weeks in the spongialization group (0.57 ± 0.1 mm(2) and 0.58 ± 0.1 mm(2), respectively) and untreated group (0.51 ± 0.1 mm(2) and 0.51 ± 0.2 mm(2), respectively) than in the radiofrequency ablation group (0.11 ± 0.1 mm(2) and 0.4 ± 0.1 mm(2), respectively) with P < .05 and P < .01. CONCLUSIONS: The results of this study show that radiofrequency ablation of the footprint results in a poor biomechanical and histologic outcome in an animal model. No preparation of the footprint has the same effect as spongialization. CLINICAL RELEVANCE: Different techniques of footprint preparation in rotator cuff repair may influence tendon-to-bone healing.
Authors: Mehmet F Güleçyüz; Konstanze Macha; Matthias F Pietschmann; Andreas Ficklscherer; Birte Sievers; Björn P Roßbach; Volkmar Jansson; Peter E Müller Journal: Stem Cell Rev Rep Date: 2018-12 Impact factor: 5.739
Authors: Benjamin B Rothrauff; Thierry Pauyo; Richard E Debski; Mark W Rodosky; Rocky S Tuan; Volker Musahl Journal: Tissue Eng Part B Rev Date: 2017-02-09 Impact factor: 6.389