Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 12, pp 3884–3891 | Cite as

Impact of cyclic mechanical stimulation on the expression of extracellular matrix proteins in human primary rotator cuff fibroblasts

  • Birgit Lohberger
  • Heike Kaltenegger
  • Nicole Stuendl
  • Beate Rinner
  • Andreas Leithner
  • Patrick Sadoghi



Mechanical stimulation plays an important role in the development and remodelling of tendons. The aim of the study was to evaluate the effects of mechanical stimulation on the expression of extracellular matrix proteins in human primary rotator cuff (RC) fibroblasts.


RC fibroblasts were isolated from patients with degenerative RC tears and characterized using flow cytometry and immunohistochemistry. Cells were stimulated using the Flexcell FX5K™ Tension System. The stimulation regime was a uniaxial sinusoidal waveform with 10 % elongation and a frequency of 0.5 Hz, whereby each cycle consists of 10-s strain and 30-s relaxation. Data were normalized to mechanically unstimulated control groups for every experimental condition. RT-qPCR was performed to determine relative mRNA levels, and collagen production was measured by a colorimetric assay.


The positive expression of CD91 and CD10, and negativity for CD45 and CD4 confirmed the fibroblast phenotype of RC primary cells. RT-qPCR revealed that 10 % continuous cyclic strain for 7 and 14 days induced a significant increase in the mRNA expression both on the matrix metalloproteinases MMP1, MMP3, MMP13, and MMP14 and on the extracellular matrix proteins decorin, tenascin-C, and scleraxis. Furthermore, mechanically stimulated groups produced significantly higher amounts of total collagen.


These results may contribute to a better understanding of strain-induced tendon remodelling and will form the basis for the correct choice of applied force in rehabilitation after orthopaedic surgery. These findings underline the fact that early passive motion of the joint in order to induce remodelling of the tendon should be included within a rehabilitation protocol for rotator cuff repair.


Rotator cuff fibroblasts Mechanical stimulation Collagen Extracellular matrix proteins 



This study was supported by the Austrian Society of Orthopaedic Surgery Research Grant 2013 and the Medical University of Graz. No commercial benefits of any kind have been or will be received from institutions related directly or indirectly to the subject of the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2015

Authors and Affiliations

  • Birgit Lohberger
    • 1
  • Heike Kaltenegger
    • 1
  • Nicole Stuendl
    • 1
  • Beate Rinner
    • 2
  • Andreas Leithner
    • 1
  • Patrick Sadoghi
    • 1
  1. 1.Department of Orthopaedic SurgeryMedical University of GrazGrazAustria
  2. 2.Center for Medical ResearchMedical University of GrazGrazAustria

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