Fibroblast Growth Factor Soaked Collagen Membrane Shows No Biomechanical or Histological Advantages in the Treatment of Chronic Rotator Cuff Tears in a Rabbit Model


Ali J., Pulatkan A., KARA D., Tezgel O., Misir A., UÇAN V., ...More

Arthroscopy - Journal of Arthroscopic and Related Surgery, vol.40, no.3, pp.683-691, 2024 (SCI-Expanded) identifier identifier

Abstract

Purpose: The aim of this study was to investigate the histological and biomechanical effects of a fibroblast growth factor (FGF-2)–soaked collagen membrane used to treat a full-thickness chronic rotator cuff (RC) rupture in a rabbit model. Methods: Forty-eight shoulders from 24 rabbits were used. At the beginning of the procedure, 8 rabbits were killed to assess the control group (Group IT) with intact tendons. To establish a chronic RC tear model, a full-thickness subscapularis tear was created on both shoulders of the remaining 16 rabbits and left for 3 months. The transosseous mattress suture technique was used to repair tears in the left shoulder (Group R). The tears in the right shoulder (Group CM) were treated using the same approach, with an FGF-soaked collagen membrane inserted and sutured over the repair site. Three months after the procedure, all rabbits were killed. Biomechanical testing was performed on the tendons to determine failure load, linear stiffness, elongation intervals, and displacement. Histologically, the modified Watkins score was used to evaluate tendon-bone healing. Results: There was no significant difference among the three groups in terms of failure load, displacement, linear stiffness, and elongation (P >.05). The total modified Watkins score was not affected by applying the FGF-soaked collagen membrane to the repair site (P >.05). Fibrocytes, parallel cells, large-diameter fibers, and the total modified Watkins score were significantly lower in both repair groups when compared to the intact tendon group (P <.05). Conclusion: In addition to tendon repair, FGF-2 soaked collagen membrane -application at the repair site provides neither biomechanical nor histological advantages in the treatment of chronic RC tears. Clinical Relevance: FGF-soaked collagen membrane augmentation provides no impact on the chronic RC tear healing tissue. The need to investigate alternative methods that may have a positive effect on healing in chronic RC repairs continues.