The ability of rotator cuff tendons to heal back to bone following injury is limited and incomplete healing of surgically repaired rotator cuff tears in humans has been reported in 20-70% of cases. Many factors outside of the surgeon's control contribute to the limited healing potential including patient age, tear size, and time from injury to repair. However, two important factors that are within the surgeon's control are surgical repair technique and post-operative rehabilitation protocol. Much research has been done on surgical repair technique including studies related to repair approach, strength of suturing methods, and security of anchoring techniques. Surprisingly, while post-operative rehabilitation protocols are generally understood to have a great influence on the fundamental mechanisms of the healing process and on the resulting function, very little data is available on this topic to guide the clinician. As a result, most post-operative protocols are based on anecdotal experiences of particular clinicians. In a recent study in our laboratory, we developed an animal model in which the healing of the rotator cuff tendon to bone insertion site could be carefully evaluated. Using this model, the overall objective of the current study is to investigate the healing process of the rotator cuff tendon to bone insertion site subject to immobilization and remobilization. Biomechanical and structural properties will be measured to evaluate the effect of the post-operative protocol on healing. In addition, histologic and molecular biologic assessments will be performed to begin to elucidate the mechanisms through which biomechanical and structural properties were altered.
The Specific Aims are: (1) following tendon to bone insertion site injury and repair, vary the immobilization period for a given set of remobilization period. (2) Following tendon to bone insertion site injury and repair, vary the remobilization period for a given set of immobilization period. We believe that a long remobilization period, following a sufficient immobilization period, will allow adequate integration of tendon fibers into bone and expression of appropriate ECM proteins to re-form the insertion site resulting in an insertion site with improved mechanical properties and more aligned collagen fibers. ? ?
| Peltz, Cathryn D; Hsu, Jason E; Zgonis, Miltiadis H et al. (2012) Intra-articular changes precede extra-articular changes in the biceps tendon after rotator cuff tears in a rat model. J Shoulder Elbow Surg 21:873-81 |
| Thomas, Stephen J; Miller, Kristin S; Soslowsky, Louis J (2012) The upper band of the subscapularis tendon in the rat has altered mechanical and histologic properties. J Shoulder Elbow Surg 21:1687-93 |
| Peltz, Cathryn D; Hsu, Jason E; Zgonis, Miltiadis H et al. (2011) Decreased loading after rotator cuff tears leads to improved biceps tendon properties in a rat model. J Shoulder Elbow Surg 20:698-707 |
| Dourte, LeAnn M; Perry, Stephanie M; Getz, Charles L et al. (2010) Tendon properties remain altered in a chronic rat rotator cuff model. Clin Orthop Relat Res 468:1485-92 |
| Sarver, Joseph J; Dishowitz, Michael I; Kim, Soung-Yon et al. (2010) Transient decreases in forelimb gait and ground reaction forces following rotator cuff injury and repair in a rat model. J Biomech 43:778-82 |
| Peltz, Cathryn D; Sarver, Joseph J; Dourte, Leann M et al. (2010) Exercise following a short immobilization period is detrimental to tendon properties and joint mechanics in a rat rotator cuff injury model. J Orthop Res 28:841-5 |
| Ward, Samuel R; Sarver, Joseph J; Eng, Carolyn M et al. (2010) Plasticity of muscle architecture after supraspinatus tears. J Orthop Sports Phys Ther 40:729-35 |
| Peltz, Cathryn D; Dourte, Leann M; Kuntz, Andrew F et al. (2009) The effect of postoperative passive motion on rotator cuff healing in a rat model. J Bone Joint Surg Am 91:2421-9 |
| Perry, Stephanie M; Getz, Charles L; Soslowsky, Louis J (2009) Alterations in function after rotator cuff tears in an animal model. J Shoulder Elbow Surg 18:296-304 |
| Perry, Stephanie M; Getz, Charles L; Soslowsky, Louis J (2009) After rotator cuff tears, the remaining (intact) tendons are mechanically altered. J Shoulder Elbow Surg 18:52-7 |
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