title: Tissue characteristics in tendon-to-bone healing change after rotator cuff repair using botulinumneurotoxin A for temporary paralysis of the supraspinatus muscle in rats.
abstract: We hypothesized that botulinumneurotoxin A (BoNtA) positively influences tissue characteristics at the re-insertion site when used as an adjuvant prior to rotator cuff repair. One hundred and sixty Sprague-Dawley rats were randomly assigned to either a BoNtA or saline-injected control group. BoNtA or saline solution was injected into the supraspinatus muscle one week prior to repair of an artificially created supraspinatus tendon defect. Post-operatively, one subgroup was immobilized using a cast on the operated shoulder while the other had immediate mobilization. Histologically, the fibrocartilage transition zone was more prominent and better organized in the BoNtA groups when compared to the saline control group. In the immediately mobilized BoNtA groups significantly more collagen 2 at the insertion was detected than in the control groups (p<0.05). Fiber orientation of all BoNtA groups was better organized and more perpendicular to the epiphysis compared with control groups. Tendon stiffness differed significantly (p<0.05) between casted BoNtA and casted saline groups. Tendon viscoelasticity was significantly higher (p<0.05) in the immobilized saline groups no matter if repaired with increased or normal repair load. The results of this study suggest that reduction of load at the healing tendon-to-bone interface leads to improved repair tissue properties.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital of Munich (LMU) - Campus Grosshadern , Munich , Germany and.
authors.forename: A
authors.initials: A
authors.lastname: Ficklscherer
authors.forename: M
authors.initials: M
authors.lastname: Scharf
authors.forename: T K
authors.initials: TK
authors.lastname: Hartl
authors.forename: C
authors.initials: C
authors.lastname: Schröder
authors.forename: S
authors.initials: S
authors.lastname: Milz
authors.forename: B P
authors.initials: BP
authors.lastname: Roßbach
authors.forename: M F
authors.initials: MF
authors.lastname: Gülecyüz
authors.forename: M F
authors.initials: MF
authors.lastname: Pietschmann
authors.forename: P E
authors.initials: PE
authors.lastname: Müller
mesh_terms: D000818:Animals; D019274:Botulinum Toxins, Type A / Q000494:pharmacology*; D004838:Epiphyses / Q000378:metabolism / Q000473:pathology; D009465:Neuromuscular Agents / Q000494:pharmacology*; D010291:Paresis / Q000139:chemically induced*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012038:Regeneration / Q000187:drug effects*; D017006:Rotator Cuff / Q000378:metabolism / Q000473:pathology; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000378:metabolism / Q000473:pathology
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A