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Scientific Articles   |    
Development of Fatty Atrophy After Neurologic and Rotator Cuff Injuries in an Animal Model of Rotator Cuff Pathology
Kasra Rowshan, MD1; Scott Hadley, MD1; Khoa Pham, BS1; Vince Caiozzo, PhD1; Thay Q. Lee, PhD1; Ranjan Gupta, MD1
1 2226 Gillespie Neuroscience Research Facility, University of California at Irvine, Irvine, CA 92697-4292. E-mail address for R. Gupta: ranjang@uci.edu
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Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the National Institutes of Health, National Institute of Neurological Disorders and Stroke. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the University of California at Irvine, Irvine, California

Copyright © 2010 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Oct 06;92(13):2270-2278. doi: 10.2106/JBJS.I.00812
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Abstract

Update 

This article was updated on March 30, 2011, because the legend to Figure 5 did not state that the image had appeared in a previously published article. The statement "Reprinted from: Gupta R, Lee TQ. Contributions of the different rabbit models to our understanding of rotator cuff pathology. J Shoulder Elbow Surg. 2007;16(5 Suppl):S149-57" has been added to the legend.

Background: 

Detachment of a tendon from its osseous insertion, as can be the case with severe rotator cuff injuries, leads to atrophy of and increased fat in the corresponding muscle. We sought to validate a rotator cuff injury model in the rabbit and to test the hypothesis that tenotomy of a rotator cuff tendon would consistently create muscle atrophy and fatty degeneration analogous to the changes that occur after injury to a nerve innervating the same muscle.

Methods: 

New Zealand white rabbits were divided into three groups: (1) partial rotator cuff tear without retraction of the muscle, (2) complete rotator cuff tear with retraction of the muscle, and (3) nerve transection of the subscapular nerve. Animals were killed at two or six weeks after injury, and the muscles were analyzed for weight, cross-sectional area, myosin fiber-type composition, and fat content. In addition, the subscapular nerve was harvested at two weeks and evaluated for neuronal injury.

Results: 

At six weeks after injury, the rabbit muscles in the complete tenotomy and nerve transection groups had significant decreases in wet mass and increases in fat content relative to the control groups. Fat accumulation had a similar spatial pattern at six weeks in both the nerve transection and complete tenotomy groups. Such changes were not seen in the partial tenotomy group. No change was found in muscle myosin fiber-type composition. At two weeks after injury, subscapular nerves in the complete tenotomy group showed gross evidence of neuronal injury.

Conclusions: 

This study establishes the rabbit subscapularis muscle as a valid model to study the muscular changes associated with rotator cuff tears. Our data suggest that the muscular changes associated with complete tenotomy are comparable with those seen with denervation of the muscle and suggest that chronic rotator cuff tears may induce a neurologic injury.

Clinical Relevance: 

Chronic rotator cuff injuries are associated with neuronal injury of the affected muscle. As such, neuronal injury may explain the histopathologic changes that have been observed following chronic rotator cuff tears.

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    References

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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