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Effects of selective paralysis of the supraspinatus muscle using botulinum neurotoxin a in rotator cuff healing in rats
Author(s) -
Ficklscherer Andreas,
Hartl TessaKatharina,
Scharf Markus,
Sievers Birte,
Schröder Christian,
Milz Stefan,
Niethammer Thomas,
Pietschmann Matthias F.,
Müller Peter E.
Publication year - 2013
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.22260
Subject(s) - rotator cuff , medicine , saline , tendon , supraspinatus muscle , lesion , paralysis , rotator cuff injury , surgery , anesthesia
We hypothesized that a temporary rotator cuff paralysis using botulinum‐neurotoxin A (BoNtA) would lead to an improved tendon‐to‐bone healing after repair of supraspinatus lesions. One hundred sixty Sprague–Dawley rats were randomly assigned to either the BoNtA or the control (saline) group. BoNtA/saline‐solution was injected into the supraspinatus muscle 1 week prior to surgery. A supraspinatus defect was made; we distinguished between a lesion with normal and increased repair load. Furthermore, one subgroup had the operated shoulder immobilized in a cast. Histologic analysis and biomechanical testing followed. Specimens from the BoNtA‐group, which were treated with an increased repair load, showed less cellularity and more organization in the interface tissue compared to the saline control group. In addition, we found that the collagen 1–3 quotient in the BoNtA specimen was significantly ( p = 0.0051) higher than in the control group. Ultimate load at failure between the groups was not significantly different ( p > 0.05). We did not observe any significant differences between the mobilized and immobilized specimen ( p = 0.2079). The study shows that tendon‐to‐bone healing after rotator cuff repair can be altered positively using BoNtA pre‐operatively. Tears with increased repair load seem to benefit the most—at least histologically. © 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 31: 716–723, 2013