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Structure of retracted tendons after staged repair following continuous traction

Farshad, Mazda ; Gerber, Christian ; Snedeker, Jess ; Frauenfelder, Thomas ; Meyer, Dominik

In: Knee Surgery, Sports Traumatology, Arthroscopy, 2011, vol. 19, no. 12, p. 2131-2137

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    Titre
    • Structure of retracted tendons after staged repair following continuous traction
    Auteur
    • Farshad, Mazda. Department of Orthopedics, University of Zürich, Balgrist University Hospital, Forchstrasse 340, 8008, Zürich, Switzerland
    • Gerber, Christian. Department of Orthopedics, University of Zürich, Balgrist University Hospital, Forchstrasse 340, 8008, Zürich, Switzerland
    • Snedeker, Jess. Department of Orthopedics, University of Zürich, Balgrist University Hospital, Forchstrasse 340, 8008, Zürich, Switzerland
    • Frauenfelder, Thomas. Department of Diagnostic Radiology, University of Zürich, University Hospital Zürich, Zürich, Switzerland
    • Meyer, Dominik. Department of Orthopedics, University of Zürich, Balgrist University Hospital, Forchstrasse 340, 8008, Zürich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Knee Surgery, Sports Traumatology, Arthroscopy, 2011, vol. 19, no. 12, p. 2131-2137. Springer-Verlag
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:322377
    Summary
    Purpose: The effect of staged repair involving continuous re-lengthening of the retracted musculotendinous unit after rotator cuff tear is not known. We quantified changes in chronically retracted tendons undergoing no repair or a staged repair involving an initial re-lengthening of the musculotendinous unit by traction in a sheep model of massive rotator cuff tear. Materials and methods: Infraspinatus tendons of 12 sheep were released and allowed to retract for 4months. Repair was performed after the retracted musculotendinous unit had been progressively returned to its original length through continuous traction in 8 sheep (group I). In the other 4 sheep (group II) traction was not successful and the tendons remained retracted. Tendon structure was assessed macroscopically, by MRI, histology, and TEM. Results: Normalized to their contralateral controls, at sacrifice, tendon thickness was unchanged in group I (116%, n.s) and increased in group II (129%, P<0.05), however with substantial shortening. Increased collagen fiber crimping and disorganization was found in group II, whereas in group I the differences from normal tendon were less pronounced. Conclusion: Retracted musculotendinous units have deteriorated tendons, characterized by increased collagen fiber crimp, and ultrastructural collagen fibril atrophy and disorganization. Continuous traction may arrest and partially restore degenerative changes in retracted tendon. The findings of this study might contribute to new approaches for the treatment of chronic "irreparable” rotator cuff tears