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Overuse Activity in the Presence of Scapular Dyskinesis Leads to Shoulder Tendon Damage in a Rat Model

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Abstract

Shoulder tendon injuries are common clinical conditions and are a significant source of pain and dysfunction. These conditions are more common in individuals who perform repetitive overhead activities and in individuals who have abnormal scapular kinematics, termed scapular dyskinesis (SD). However, the long term consequences associated with overuse activity in the presence of SD are unknown. Therefore, the objective of this study was to determine the effect of overuse in combination with SD on joint mechanics and properties of the rotator cuff and biceps tendons. A rat model of scapular dyskinesis was used. Ninety adult male Sprague–Dawley rats (400–450 g) were randomized into three groups: nerve transection (SD), sham nerve transection + overuse (OV), or nerve transection + overuse (SD + OV). Rats were sacrificed at 2, 4, and 8 weeks after surgery. Shoulder function and passive joint mechanics were evaluated over time and tendon properties (mechanical, histological, organizational, and compositional) were measured. Results demonstrated that overuse activity and SD are each independently detrimental to tendon properties (e.g., diminished mechanical properties, disorganized collagen). However, tendon damage caused by the addition of overuse may be worse, with more parameters altered, than damage caused by the addition of SD. This study helps define the mechanical mechanisms leading to tendon damage and provides a framework for distinguishing treatment strategies for active patients and those with abnormal scapular mechanics.

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Acknowledgments

The authors acknowledge Adam Pardes, Julianne Huegel, and Pankti Bhatt for their assistance with histology. The study was funded by NIH/NIAMS (R01AR056658) and the Penn Center for Musculoskeletal Disorders (P30AR050950).

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Authors and Affiliations

  1. McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, University of Pennsylvania, 424 Stemmler Hall, 36th and Hamilton Walk, Philadelphia, PA, 19104-6081, USA

    Katherine E. Reuther, Stephen J. Thomas, Jennica J. Tucker, Rameen P. Vafa, Joshua A. Gordon, Stephen S. Liu, Adam C. Caro, Sarah M. Yannascoli, Andrew F. Kuntz & Louis J. Soslowsky

  2. Department of Biomedical Engineering, Columbia University, New York, NY, USA

    Katherine E. Reuther

  3. Division of Nursing and Health Sciences, Neumann University, Aston, PA, USA

    Stephen J. Thomas

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  1. Katherine E. Reuther
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  3. Jennica J. Tucker
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  4. Rameen P. Vafa
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  5. Joshua A. Gordon
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  10. Louis J. Soslowsky
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Correspondence to Louis J. Soslowsky.

Additional information

Associate Editor Peter E. McHugh oversaw the review of this article.

Electronic supplementary material

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10439_2014_1137_MOESM1_ESM.jpg

S-Figure 1 Tendon histology was quantified for cell shape for regions of the biceps. A representative image for the biceps distal groove is displayed. Cell shape was significantly less rounded in the SD + OV group (C) compared to SD (A) and compared to OV (B) at 4 weeks post-injury. Note: For publication, filters (auto-tone, auto-contrast, and auto-color) were individually applied to images. (JPEG 786 kb)

10439_2014_1137_MOESM2_ESM.jpg

S-Figure 2 Tendon histology was quantified for cell shape for regions of the supraspinatus. A representative image for the supraspinatus mid-substance is displayed. Cell shape was significantly more rounded in the SD + OV group (B) compared to SD (A) at 8 weeks post-injury. Note: For publication, filters (auto-tone, auto-contrast, and auto-color) were individually applied to images. (JPEG 1188 kb)

10439_2014_1137_MOESM3_ESM.jpg

S-Figure 3 Tendon histology was quantified for cell density for regions of the supraspinatus and biceps. A representative image for the supraspinatus insertion is displayed. Cell density was significantly increased in the SD + OV group (B) compared to SD (A) at 8 weeks post-injury. Note: For publication, filters (auto-tone, auto-contrast, and auto-color) were individually applied to images. (JPEG 712 kb)

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Reuther, K.E., Thomas, S.J., Tucker, J.J. et al. Overuse Activity in the Presence of Scapular Dyskinesis Leads to Shoulder Tendon Damage in a Rat Model. Ann Biomed Eng 43, 917–928 (2015). https://doi.org/10.1007/s10439-014-1137-y

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