title: The effect of diclofenac on matrix metalloproteinase levels in the rotator cuff.
abstract: BACKGROUND
  Matrix metalloproteinases (MMPs) are involved in physiological events such as restructuring of the tissue, morphogenesis, wound healing and normal developmental process. Use of diclofenac sodium following rotator cuff repair can disrupt healing of tendon through acting on MMPs.
  
  
  METHODS
  Supraspinatus tendons of rats (n = 84) were detached from their insertion on humerus, and repaired to anatomic footprint. Rats were divided into study group (n = 42) and control group (n = 42). Study group received a dose of 1 mg/kg daily diclofenac sodium subcutaneously. The rats were killed at weeks 1, 3 and 6, and seven rats from each groups were included in biomechanical and immunohistological examinations. Immunohistological staining of MMP-2, MMP-3 and MMP13 were used.
  
  
  RESULTS
  Maximum load was reduced in the study group at the end of week 1 (8.76 vs. 5.28 N) (p = 0.01). MMP-3 level was statistically significantly lower in the study group at the end of week 1. MMP-13 level and stiffness decreased towards week 6 in the study group while in the control group the level of MMP-2 decreased towards week 6.
  
  
  CONCLUSIONS
  Diclofenac has an impact on the levels of MMP-2, MMP-3 and MMP-13, which are needed for normal healing process, and it can also lead to disruption of tendon healing.
authors.affiliation: Department of Orthopedics and Traumatology, Okmeydanı and Research Hospital, Şişli, Turkey, halukcabuk@hotmail.com.
authors.forename: Haluk
authors.initials: H
authors.lastname: Cabuk
authors.forename: Arzu
authors.initials: A
authors.lastname: Avci
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Durmaz
authors.forename: Fatmagül Kuşku
authors.initials: FK
authors.lastname: Cabuk
authors.forename: Fatih
authors.initials: F
authors.lastname: Ertem
authors.forename: I
authors.initials: I
authors.lastname: Muhittin Şener
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D004008:Diclofenac / Q000494:pharmacology*; D007150:Immunohistochemistry; D008297:Male; D053509:Matrix Metalloproteinase 13 / Q000378:metabolism; D020778:Matrix Metalloproteinase 2 / Q000378:metabolism; D019278:Matrix Metalloproteinase 3 / Q000378:metabolism; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D009568:Nitrendipine; D017208:Rats, Wistar; D017006:Rotator Cuff / Q000201:enzymology* / Q000503:physiopathology / Q000601:surgery; D013710:Tendons / Q000601:surgery; D014945:Wound Healing / Q000187:drug effects* / Q000502:physiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D009568:Nitrendipine; D053509:Matrix Metalloproteinase 13; D020782:Matrix Metalloproteinases; D019278:Matrix Metalloproteinase 3; D020778:Matrix Metalloproteinase 2