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Current research trends on the effect of diabetes mellitus on rotator cuff tendon healing/tendinopathy

  • Orthopaedic Surgery
  • Published:
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Abstract

Rotator cuff tendon tears are a leading cause of shoulder pain. They are challenging to treat, and tendon–bone healing has a high failure rate despite successful surgery. Tendons connect the muscles and bones, which make them important for the body’s overall mobility and stability. Metabolic diseases, including diabetes or high blood pressure, can affect the healing process after repair of a damaged tendon. With a global incidence of 9.3%, diabetes is considered as a significant risk factor for rotator cuff tendon healing because it causes structural, inflammatory, and vascular changes in the tendon. However, the mechanisms of how diabetes affects tendon healing remain unknown. Several factors have been suggested, including glycation product accumulation, adipokine dysregulation, increased levels of reactive oxygen species, apoptosis, inflammatory cytokines, imbalanced matrix-metalloproteinase-to-tissue-inhibitor ratio, and impaired angiogenesis and differentiation of the tendon sheath. Despite the effects of diabetes on tendon function and healing, few treatments are available to improve recovery in these patients. This review summarizes the current literature on the pathophysiological changes of the tendon in diabetes and hyperlipidemia. Preclinical and clinical evidence regarding the association between diabetes and tendon healing is presented. Moreover, current approaches to improve tendon healing in patients with diabetes are reviewed.

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Funding

This work has supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (NRF-2022R1A2C1005374). This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HR22C1832).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, 130 Dongdeok-Ro, Jung-Gu, Daegu, 41944, Korea

    Jong Pil Yoon, Sung-Jin Park, Dong-Hyun Kim, Hyun Joo Lee & Eugene Jae Jin Park

  2. Department of Carbon Hybrid Fiber Science, Kyungpook National University, Daegu, Korea

    Yoon Seong Choi

  3. Department of Orthopaedic Surgery, School of Medicine, Konkuk University Medical Center, Seoul, Korea

    Seok Won Chung

Authors
  1. Jong Pil Yoon
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  2. Sung-Jin Park
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  3. Yoon Seong Choi
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  4. Dong-Hyun Kim
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  5. Hyun Joo Lee
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  6. Eugene Jae Jin Park
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  7. Seok Won Chung
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Contributions

JPY: Main and study design. SJP: Main and corresponding author. YSC and DHK: Data collection and reviewed the literature. HJL, EJJP, and SWJ: Data collection and reviewed the manuscript.

Corresponding author

Correspondence to Sung-Jin Park.

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Yoon, J.P., Park, SJ., Choi, Y.S. et al. Current research trends on the effect of diabetes mellitus on rotator cuff tendon healing/tendinopathy. Arch Orthop Trauma Surg (2024). https://doi.org/10.1007/s00402-024-05350-1

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