ESTABLISHMENT OF MICROINVASIVE MODLE OF CHRONIC ROTATOR CUFF INJURY IN RATS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DINGShuchen ¹ , TIANZhen ¹ , MAChaoran ² , FANGXuewei ³ , YURongbin ² , QIUYusheng ⁴ , WANGLisha ¹ ,  YINZhanhai ⁴

1. Department of Clinical Medicine(7-year Program), Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710061, P. R. China;
2. Department of Epidemiology and Biostatistics, Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710061, P. R. China;
3. Department of Orthopedics of First Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710061, P. R. China;
4. Department of Mechanical Engineering, Xi'an Jiaotong University;

Corresponding author：

YINZhanhai, Email: zhanhai.yin@mail.xjtu.edu.cn

Keywords：

Chronic rotator cuff tear model; Subacromial impingement syndrome; Microinvasion; Rat

DOI：

10.7507/1002-1892.20140266

Video：

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Objective To establish a model of chronic rotator cuff injury by inducing subacromial impingement syndrome in rats, so as to lay a foundation for further study on the mechanism and treatment of chronic rotator cuff injury. Methods The polyether-ether-ketone implants were designed and made with three-dimensional printing technique. In 48 male Sprague Dawley rats[weighing, (277.25±22.03) g], one shoulder joint was selected randomly as the experimental group; in the experimental group, the implant was pierced into shoulder joint close tothe acromion medial side and was pierced out under acromion close to the deltoid trailing edge; the penetratingpartof implant was cut off after the implanting part was fixed with 4# braided silk suture. No any treatment was performed on the contralateral shoulder of 24 rats as control group; and the implants were immediately removed after they were pierced into the contralateral shoulder joint of the other 24 rats as sham-operation group. All the rats were exposed to 30 minutes of downhill running at 17 m/minute (-13.5°) every day at 4 days after operation and the general condition of rats was observed. At 2, 4, 6, and 8 weeks after operation, 12 rats were sacrificed to collect shoulder joint samples. The hardtissueslices was used for VanGieson staining and histological observation of the supraspinatus tendon. Results All ratssurvived to the end of experiment, without infection.The rats suffered limp at 2-3 daysafter operation, and the gait of most rats returned to normal at 4 days after operation.The histological results showed that the supraspinatus tendon had smooth edge, without split layers or breakage in the control group and sham-operation group. In the experimental group, the implants were positioned accurately without dislocation; 4 kinds of typical pathological changes were observed. Partial-thickness tear on bursal side appeared at 2 weeks (5 rats) and 4 weeks (2 rats), showing no significant difference between at 2 and 4 weeks (P > 0.05); intratendinous gap formed mainly at 4 weeks (10 rats) and 6 weeks (11 rats), showing significant differences when compared with that at 2 weeks (2 rats) (P < 0.05) and 8 weeks (2 rats) (P < 0.05); partial-thickness tear on articular side mainly appeared at 6 weeks (8 rats), showing significant difference when compared with that at other time points (P < 0.05); full-thickness tear was found mainly at 8 weeks (10 rats), showing significant differences when compared with that at other time points (P < 0.05). Conclusion A model of chronic rotator cuff injury is successfully established in rats through microinvasive implantation of subacromial impingement syndrome inducing implants and the pathological changes in this model are highly similar to the clinical pathological progress.

Citation： DINGShuchen, TIANZhen, MAChaoran, FANGXuewei, YURongbin, QIUYusheng, WANGLisha, YINZhanhai. ESTABLISHMENT OF MICROINVASIVE MODLE OF CHRONIC ROTATOR CUFF INJURY IN RATS. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(10): 1225-1230. doi: 10.7507/1002-1892.20140266 Copy

1.	刘国明, 黄富国, 秦廷武.巨大肩袖撕裂的治疗及研究进展.中国修复重建外科杂志, 2011, 25(1):61-65.
2.	丁舒晨, 马超然, 王哲洋, 等.前列腺E2在肩袖损伤中作用的研究.中国骨与关节杂志, 2013, 2(12):712-715.
3.	Contreras F, Brown HC, Marx RG.Predictors of success of corticosteroid injection for the management of rotator cuff disease.HSS J, 2013, 9(1):2-5.
4.	Arroll B, Goodyear-Smith F.Corticosteroid injections for painful shoulder:a meta-analysis.Br J Gen Pract, 2005, 55(512):224-228.
5.	Bell AD, Conaway D.Corticosteroid injections for painful shoulders.Int J Clin Pract, 2005, 59(10):1178-1186.
6.	Escamilla RF, Hooks TR, Wilk KE.Optimal management of shoulder impingement syndrome.Open Access J Sports Med, 2014, 5:13-24.
7.	Kim KC, Shin HD, Cha SM, et al.Clinical outcomes after arthroscopic trans-tendon suture-bridge technique in partial-thickness articular-side rotator cuff tear.Knee Surg Sports Traumatol Arthrosc, 2013, 21(5):1183-1188.
8.	Kim KC, Shin HD, Cha SM, et al.Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear:articular-versus bursal-side partial tears.Am J Sports Med, 2014, 42(2):451-456.
9.	Sethi PM, Rajaram A, Obopilwe E, et al.Partial articular-sided rotator cuff tears:in situ repair versus tear completion prior to repair.Orthopedics, 2013, 36(6):771-777.
10.	李奉龙, 姜春岩, 鲁谊, 等.兔肩袖损伤模型的建立及初步组织学研究.中国组织工程研究, 2012, 16(20):3685-3689.
11.	Rubino LJ, Sprott DC, Stills HF Jr, et al.Fatty infiltration does not progress after rotator cuff repair in a rabbit model.Arthroscopy, 2008, 24(8):936-940.
12.	Gerber C, Meyer DC, Nuss KM, et al.Anabolic steroids reduce muscle damage caused by rotator cuff tendon release in an experimental study in rabbits.J Bone Joint Surg (Am), 2011, 93(23):2189-2195.
13.	Turner AS.Experiences with sheep as an animal model for shoulder surgery:strengths and shortcomings.J Shoulder Elbow Surg, 2007, 16(5 Suppl):S158-S163.
14.	Hsu JE, Reuther KE, Sarver JJ, et al.Restoration of anterior-posterior rotator cuff force balance improves shoulder function in a rat model of chronic massive tears.J Orthop Res, 2011, 29(7):1028-1033.
15.	Schneeberger AG, Nyffeler RW, Gerber C.Structural changes of the rotator cuff caused by experimental subacromial impingement in the rat.J Shoulder Elbow Surg, 1998, 7(4):375-380.
16.	Enns DL, Tiidus PM.Estrogen influences satellite cell activation and proliferation following downhill running in rats.J Appl Physiol, 1985, 2008, 104(2):347-353.
17.	Björnsson HC, Norlin R, Johansson K, et al.The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears:structural and clinical outcomes after repair of 42 shoulders.Acta Orthop, 2011, 82(2):187-192.
18.	Zhang J, Wang JH.Production of PGE2 increases in tendons subjected to repetitive mechanical loading and induces differentiation of tendon stem cells into non-tenocytes.J Orthop Res, 2010, 28(2):198-203.
19.	Li Z, Yang G, Khan M, et al.Inflammatory response of human tendon fibroblasts to cyclic mechanical stretching.Am J Sports Med, 2004, 32(2):435-440.
20.	Zhang J, Wang JH.BMP-2 mediates PGE2-induced reduction of proliferation and osteogenic differentiation of human tendon stem cells.J Orthop Res, 2012, 30(1):47-52.
21.	Liu J, Chen L, Tao X, et al.Phosphoinositide 3-kinase/Akt signaling is essential for prostaglandin E2-induced osteogenic differentiation of rat tendon stem cells.Biochem Biophys Res Commun, 2013, 435(4):514-519.
22.	Huang CY, Wang VM, Pawluk RJ, et al.Inhomogeneous mechanical behavior of the human supraspinatus tendon under uniaxial loading.J Orthop Res, 2005, 23(4):924-930.
23.	邓纯博, 刘冬妍, 刘吉泉, 等.聚醚醚酮及其复合材料作为骨科植入物的研究进展.生物医学工程与临床, 2009, 13(5):473-476.
24.	Katzer A, Marquardt H, Westendorf J, et al.Polyetheretherketone-cytotoxicity and mutagenicity in vitro.Biomaterials, 2002, 23(8):1749-1759.
25.	Ma R, Tang T.Current strategies to improve the bioactivity of PEEK.Int J Mol Sci, 2014, 15(4):5426-5445.
26.	Ma R, Tang S, Tan H, et al.Preparation, characterization, in vitro bioactivity and cellular responses to a polyetheretherketone bioactive composite containing nano-calcium silicate for bone repair.ACS Appl Mater Interfaces, 2014.[Epub ahead of print].
27.	Nemoto O, Asazuma T, Yato Y, et al.Comparison of fusion rates following transforaminal lumbar interbody fusion using polyetheretherketone cages or titanium cages with transpedicular instrumentation.Eur Spine J, 2014.[Epub ahead of print].

1. 刘国明, 黄富国, 秦廷武.巨大肩袖撕裂的治疗及研究进展.中国修复重建外科杂志, 2011, 25(1):61-65.
2. 丁舒晨, 马超然, 王哲洋, 等.前列腺E2在肩袖损伤中作用的研究.中国骨与关节杂志, 2013, 2(12):712-715.
3. Contreras F, Brown HC, Marx RG.Predictors of success of corticosteroid injection for the management of rotator cuff disease.HSS J, 2013, 9(1):2-5.
4. Arroll B, Goodyear-Smith F.Corticosteroid injections for painful shoulder:a meta-analysis.Br J Gen Pract, 2005, 55(512):224-228.
5. Bell AD, Conaway D.Corticosteroid injections for painful shoulders.Int J Clin Pract, 2005, 59(10):1178-1186.
6. Escamilla RF, Hooks TR, Wilk KE.Optimal management of shoulder impingement syndrome.Open Access J Sports Med, 2014, 5:13-24.
7. Kim KC, Shin HD, Cha SM, et al.Clinical outcomes after arthroscopic trans-tendon suture-bridge technique in partial-thickness articular-side rotator cuff tear.Knee Surg Sports Traumatol Arthrosc, 2013, 21(5):1183-1188.
8. Kim KC, Shin HD, Cha SM, et al.Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear:articular-versus bursal-side partial tears.Am J Sports Med, 2014, 42(2):451-456.
9. Sethi PM, Rajaram A, Obopilwe E, et al.Partial articular-sided rotator cuff tears:in situ repair versus tear completion prior to repair.Orthopedics, 2013, 36(6):771-777.
10. 李奉龙, 姜春岩, 鲁谊, 等.兔肩袖损伤模型的建立及初步组织学研究.中国组织工程研究, 2012, 16(20):3685-3689.
11. Rubino LJ, Sprott DC, Stills HF Jr, et al.Fatty infiltration does not progress after rotator cuff repair in a rabbit model.Arthroscopy, 2008, 24(8):936-940.
12. Gerber C, Meyer DC, Nuss KM, et al.Anabolic steroids reduce muscle damage caused by rotator cuff tendon release in an experimental study in rabbits.J Bone Joint Surg (Am), 2011, 93(23):2189-2195.
13. Turner AS.Experiences with sheep as an animal model for shoulder surgery:strengths and shortcomings.J Shoulder Elbow Surg, 2007, 16(5 Suppl):S158-S163.
14. Hsu JE, Reuther KE, Sarver JJ, et al.Restoration of anterior-posterior rotator cuff force balance improves shoulder function in a rat model of chronic massive tears.J Orthop Res, 2011, 29(7):1028-1033.
15. Schneeberger AG, Nyffeler RW, Gerber C.Structural changes of the rotator cuff caused by experimental subacromial impingement in the rat.J Shoulder Elbow Surg, 1998, 7(4):375-380.
16. Enns DL, Tiidus PM.Estrogen influences satellite cell activation and proliferation following downhill running in rats.J Appl Physiol, 1985, 2008, 104(2):347-353.
17. Björnsson HC, Norlin R, Johansson K, et al.The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears:structural and clinical outcomes after repair of 42 shoulders.Acta Orthop, 2011, 82(2):187-192.
18. Zhang J, Wang JH.Production of PGE2 increases in tendons subjected to repetitive mechanical loading and induces differentiation of tendon stem cells into non-tenocytes.J Orthop Res, 2010, 28(2):198-203.
19. Li Z, Yang G, Khan M, et al.Inflammatory response of human tendon fibroblasts to cyclic mechanical stretching.Am J Sports Med, 2004, 32(2):435-440.
20. Zhang J, Wang JH.BMP-2 mediates PGE2-induced reduction of proliferation and osteogenic differentiation of human tendon stem cells.J Orthop Res, 2012, 30(1):47-52.
21. Liu J, Chen L, Tao X, et al.Phosphoinositide 3-kinase/Akt signaling is essential for prostaglandin E2-induced osteogenic differentiation of rat tendon stem cells.Biochem Biophys Res Commun, 2013, 435(4):514-519.
22. Huang CY, Wang VM, Pawluk RJ, et al.Inhomogeneous mechanical behavior of the human supraspinatus tendon under uniaxial loading.J Orthop Res, 2005, 23(4):924-930.
23. 邓纯博, 刘冬妍, 刘吉泉, 等.聚醚醚酮及其复合材料作为骨科植入物的研究进展.生物医学工程与临床, 2009, 13(5):473-476.
24. Katzer A, Marquardt H, Westendorf J, et al.Polyetheretherketone-cytotoxicity and mutagenicity in vitro.Biomaterials, 2002, 23(8):1749-1759.
25. Ma R, Tang T.Current strategies to improve the bioactivity of PEEK.Int J Mol Sci, 2014, 15(4):5426-5445.
26. Ma R, Tang S, Tan H, et al.Preparation, characterization, in vitro bioactivity and cellular responses to a polyetheretherketone bioactive composite containing nano-calcium silicate for bone repair.ACS Appl Mater Interfaces, 2014.[Epub ahead of print].
27. Nemoto O, Asazuma T, Yato Y, et al.Comparison of fusion rates following transforaminal lumbar interbody fusion using polyetheretherketone cages or titanium cages with transpedicular instrumentation.Eur Spine J, 2014.[Epub ahead of print].

Chinese Journal of Reparative and Reconstructive Surgery

ESTABLISHMENT OF MICROINVASIVE MODLE OF CHRONIC ROTATOR CUFF INJURY IN RATS

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