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Clinical Orthopaedics and Related Research

, Volume 466, Issue 3, pp 622–633 | Cite as

Biological Augmentation of Rotator Cuff Tendon Repair

  • David Kovacevic
  • Scott A. Rodeo
Symposium: New Approaches to Shoulder Surgery

Abstract

A histologically normal insertion site does not regenerate following rotator cuff tendon-to-bone repair, which is likely due to abnormal or insufficient gene expression and/or cell differentiation at the repair site. Techniques to manipulate the biologic events following tendon repair may improve healing. We used a sheep infraspinatus repair model to evaluate the effect of osteoinductive growth factors and BMP-12 on tendon-to-bone healing. Magnetic resonance imaging and histology showed increased formation of new bone and fibrocartilage at the healing tendon attachment site in the treated animals, and biomechanical testing showed improved load-to-failure. Other techniques with potential to augment repair site biology include use of platelets isolated from autologous blood to deliver growth factors to a tendon repair site. Modalities that improve local vascularity, such as pulsed ultrasound, have the potential to augment rotator cuff healing. Important information about the biology of tendon healing can also be gained from studies of substances that inhibit healing, such as nicotine and antiinflammatory medications. Future approaches may include the use of stem cells and transcription factors to induce formation of the native tendon-bone insertion site after rotator cuff repair surgery.

Keywords

Rotator Cuff Rotator Cuff Repair Supraspinatus Tendon Collagen Sponge Tendon Repair 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  1. 1.Laboratory for Soft Tissue ResearchThe Hospital for Special SurgeryNew YorkUSA
  2. 2.Sports Medicine and Shoulder ServiceThe Hospital for Special SurgeryNew YorkUSA

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