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Zoledronic acid improves healing of supraspinatus tendon repair in a rodent model
ESSKA Academy. Schanda J. Nov 8, 2019; 284410; epESA-15 Topic: Shoulder
Dr. Jakob Schanda
Dr. Jakob Schanda
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Zoledronic acid improves healing of supraspinatus tendon repair in a rodent model

ePoster - epESA-15

Topic: Biological Augmentation

Schanda J.1,2, Mittermayr R.1,2, Feichtinger X.1,2, Muschitz C.3, Redl H.2, Fialka C.1
1AUVA Traumacenter Meidling, Vienna, Austria, 2LBI for Experimental and Clinical Traumatology, Vienna, Austria, 3St. Vincent Hospital Vienna, II. Medical Department, Vienna, Austria

Introduction: Bone mineral density (BMD) is reduced at the humeral head in patients with chronic rotator cuff (RC) tears. Zoledronic acid (ZA) is commonly used in osteoporosis therapy to increase BMD and reduce fracture risk. Osteoporosis is an independent risk factor affecting healing after arthroscopic rotator cuff repair.
Objectives: Primary objective was (1) the biomechanical investigation of ZA on the supraspinatus (SSP) enthesis after surgical RC reconstruction. Secondary objectives were (2) the investigation of ZA on bone microarchitecture after surgical RC reconstruction of the SSP tendon, and (3) the evolvement of micro ribonucleic acid (miRNA) expression patterns during healing after surgical SSP tendon reconstruction and concomitant ZA treatment.
Aims: Investigation of effects of ZA on healing after SSP tendon detachment with a delayed RC reconstruction in a rodent model.
Methods: A total of 32 male Sprague-Dawley rats underwent unilateral (left side) SSP tendon detachment. Three weeks after surgery, RC reconstruction was performed. Rats were randomized to two groups of 16 animals: intervention group was treated with ZA, control group without specific therapy. Drug administration was performed on the first day after RC reconstruction. miRNAs were measured before first and second surgery as well as eight weeks later just before euthanasia to investigate changes in the expression patterns. After euthanasia, twelve rats of each group underwent micro-computed tomography (µCT) scans of both sides. In the same twelve rats of both groups the humeral head with the SSP tendon reconstruction was fixed for biomechanical testing. In the other four rats of each group biopsies of the muscle-tendon-bone interface were performed for histological and immunohistochemical analysis.
Results: Load to failure was higher in in the intervention group (p=0.000). Bone volume/tissue volume fraction at µCT was higher at the humeral head in the intervention group. Trabecular separation was higher in the control group (p=0.001). Muscle-specific miRNAs (hsa-miR-133a-3p, hsa-miR-133b, hsa-miR-499a-5p) were downregulated in the control group.
Conclusions: Single-dose ZA substitution for RC reconstruction increases BMD and load to failure rate in rats. These improvements can be visualized on a cellular level, since muscle-specific miRNAs regulating muscle development and fibre specification are downregulated in the control group.
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