A prospective study comparing tendon-to-bone interface healing using an interposition bioresorbable scaffold with a vented anchor for primary rotator cuff repair in sheep

J Shoulder Elbow Surg. 2020 Jan;29(1):157-166. doi: 10.1016/j.jse.2019.05.024. Epub 2019 Aug 7.

Abstract

Background: The purpose of this study was to evaluate the biomechanical and histologic properties of rotator cuff repairs using a vented anchor attached to a bioresorbable interpositional scaffold composed of aligned PLGA (poly(l-lactide-co-glycoside)) microfibers in an animal model compared to standard anchors in an ovine model.

Methods: Fifty-six (n = 56) skeletally mature sheep were randomly assigned to a repair of an acute infraspinatus tendon detachment using a innovative anchor-PLGA scaffold device (Treatment) or a similar anchor without the scaffold (Control). Animals were humanely euthanized at 7 and 12 weeks post repair. Histologic and biomechanical properties of the repairs were evaluated and compared.

Results: The Treatment group had a significantly higher fibroblast count at 7 weeks compared to the Control group. The tendon bone repair distance, percentage perpendicular fibers, new bone formation at the tendon-bone interface, and collagen type III deposition was significantly greater for the Treatment group compared with the Control group at 12 weeks (P ≤ .05). A positive correlation was identified in the Treatment group between increased failure loads at 12 weeks and the following parameters: tendon-bone integration, new bone formation, and collagen type III. No statistically significant differences in biomechanical properties were identified between Treatment and Control Groups (P > .05).

Conclusions: Use of a vented anchor attached to a bioresorbable interpositional scaffold composed of aligned PLGA microfibers improves the histologic properties of rotator cuff repairs in a sheep model. Improved histology was correlated with improved final construct strength at the 12-week time point.

Keywords: PLGA scaffold; Rotator cuff repair; biomechanics; histology; ovine; rotator cuff tendon; suture anchor.

Publication types

  • Comparative Study

MeSH terms

  • Absorbable Implants
  • Animals
  • Biocompatible Materials / therapeutic use
  • Biomechanical Phenomena
  • Bone and Bones / physiology*
  • Bone and Bones / surgery
  • Cell Count
  • Collagen Type III / metabolism
  • Disease Models, Animal
  • Female
  • Fibroblasts
  • Osteogenesis
  • Polylactic Acid-Polyglycolic Acid Copolymer / therapeutic use
  • Prospective Studies
  • Rotator Cuff Injuries / pathology
  • Rotator Cuff Injuries / surgery*
  • Sheep
  • Suture Techniques
  • Tendons / physiology*
  • Tendons / surgery
  • Tissue Scaffolds*
  • Wound Healing*

Substances

  • Biocompatible Materials
  • Collagen Type III
  • Polylactic Acid-Polyglycolic Acid Copolymer