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Combination of autologous osteochondral and periosteum transplantation effectively promotes fibrocartilage regeneration at the tendon–bone junction of the rotator cuff in rabbits

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Rotator cuff tendon–bone healing often leads to scarring and low biomechanical strength, resulting in a tendency to re-tear. This study examined whether combining autologous osteochondral transplantation and periosteum transplantation increases fibrocartilage transition zone regeneration and improves biomechanical fixation.

Methods

A total of 48 New Zealand white rabbits were divided into the periosteum, autologous osteochondral, combination of autologous osteochondral and periosteum, and control groups. The supraspinatus tendon was cut from the greater tuberosity and repaired by different transplants. A total of 12 rabbits were used for histological examination (haematoxylin and eosin staining, Masson’s staining and Safranin-O staining) at 4, 8 and 12 weeks after the repair, and 36 rabbits were used for biomechanical tests (maximal failure load and stiffness).

Results

At 4 weeks following the operation, each group had a large tendon–bone gap with a small number of disordered collagen fibres. At 8 weeks, the tendon–bone gap was smaller than that before the operation, and the tendon–bone gap in each experimental group was smaller with neater and denser collagen fibres and chondrocytes than in the control group, with the osteochondral combined periosteum group having the best results. At 12 weeks, the typical tendon–bone transitional structure was observed in the osteochondral combined periosteum group, and more collagen fibres and chondrocytes were generated in each group. The osteochondral combined periosteum group had the largest staining area and the largest amount of cartilage. The maximum tensile strength and stiffness of each group increased over time. There was no significant difference in each group’s maximum tensile strength and stiffness at 4 weeks after the operation. However, the maximum tensile strength and stiffness of the osteochondral combined periosteum group at 8 and 12 weeks after operation were significantly higher than those of other groups (P < 0.05).

Conclusion

Histological and biomechanical results show that autologous osteochondral transplantation combined with periosteum transplantation can effectively promote the regeneration of fibrous cartilage in the tendon–bone junction of the rotator cuff. It is concluded that this technique is a new treatment method to promote tendon–bone healing in the rotator cuff.

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Data availability

The datasets generated during and analysed during the current study are available from the corresponding author on reasonable request.

Abbreviations

RCT:

Rotator cuff tear

ARCR:

Arthroscopic rotator cuff repair

HE:

Haematoxylin and eosin

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Acknowledgements

The authors thank the financial support of the Second Hospital of Lanzhou University, “Cuiying Technology Innovation” program, clinical top-notch technology research project, clinical study of autologous osteochondral transplantation for the treatment of recurrent shoulder dislocation in young adults, and the Gansu Provincial Department of Science and Technology, Natural Science Foundation Project, Study on the mechanism of autologous osteochondral transplantation in the treatment of recurrent shoulder dislocation.

Funding

This work was supported by the The Second Hospital of Lanzhou University, “Cuiying Technology Innovation” program, clinical top-notch technology research project, CY2019-BJ04, clinical study of autologous osteochondral transplantation for the treatment of recurrent shoulder dislocation in young adults, and the Gansu Provincial Department of Science and Technology, Natural Science Foundation Project, 20JR10RA723, Study on the mechanism of autologous osteochondral transplantation in the treatment of recurrent shoulder dislocation.

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Author notes

  1. Mingtao Zhang and Liangna Deng are co-first author.

Authors and Affiliations

  1. Department of Orthopaedics, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730000, Gansu, China

    Mingtao Zhang, Tao Liu, Zhitao Yang, Jiaxin Liu, Jin Jiang & Xiangdong Yun

  2. Department of Radiology, Lanzhou University Second Hospital, No. 82 Cuiyingmen, Chengguan District, Lanzhou, 730000, Gansu, China

    Liangna Deng

  3. Department of Orthopaedics, First People’s Hospital of Tianshui, Tianshui, 741000, Gansu, China

    Jianping Zhou

  4. People’s Hospital of Changwu County, Xianyang, 713600, Shanxi, China

    Yaofei Jia

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Contributions

MZ and LD collected the data and wrote the article. XY and JJ revised the article. MZ, JL, JZ and YJ designed the study. MZ, TL and ZY performed the rabbits experiment. LD prepared figures and tables. All authors contributed towards data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.

Corresponding authors

Correspondence to Jin Jiang or Xiangdong Yun.

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The authors, their immediate families and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.

Ethical approval

This study was approved by the local ethics committee (the Second Hospital of Lanzhou University, Approval No. D2021-016).

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Zhang, M., Deng, L., Zhou, J. et al. Combination of autologous osteochondral and periosteum transplantation effectively promotes fibrocartilage regeneration at the tendon–bone junction of the rotator cuff in rabbits. Knee Surg Sports Traumatol Arthrosc 31, 1953–1962 (2023). https://doi.org/10.1007/s00167-022-07250-6

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