Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing

Abstract Background Rotator cuff repair in patients with osteoporosis (OP) is often hindered by poor tendon-to-bone healing and a high rate of retears, largely due to compromised bone remodeling at the repair site. However, few studies have investigated the relationship between computed tomography (...

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Main Authors: Heyong Yin, Yufei Ding, Ziyang Feng, Zexing Yan, Ai Guo
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-06102-6
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author Heyong Yin
Yufei Ding
Ziyang Feng
Zexing Yan
Ai Guo
author_facet Heyong Yin
Yufei Ding
Ziyang Feng
Zexing Yan
Ai Guo
author_sort Heyong Yin
collection DOAJ
description Abstract Background Rotator cuff repair in patients with osteoporosis (OP) is often hindered by poor tendon-to-bone healing and a high rate of retears, largely due to compromised bone remodeling at the repair site. However, few studies have investigated the relationship between computed tomography (CT)-based quantitative analysis of bone microarchitecture and the prognosis of rotator cuff healing. Methods An OP rat model was established via bilateral ovariectomy combined with dexamethasone administration. A full-thickness supraspinatus tear was surgically induced, followed by an 8-week intervention with either alendronate (ALN) or saline. Non-osteoporotic rats served as control group. Histological analysis and biomechanical testing were performed to evaluate tendon-to-bone healing. Additionally, quantitative micro-CT analysis of the humeral greater tuberosity was conducted, and correlations with tendon healing outcomes were assessed. Results Histological analysis at 8 weeks revealed disorganized structure and poor fibrovascular tissue in the OP group, while the OP + ALN group exhibited improved tendon-bone healing with better collagen fiber alignment and higher histological scores. A decreased RANKL/OPG ratio suggested that ALN treatment modulated regional bone metabolism in the humeral greater tuberosity. The Young’s modulus was reduced in both osteoporotic groups compared to the Control group. Although the difference between the OP and OP + ALN groups was not statistically significant, a trend was observed: 50% of specimens in the OP group failed at the tendon-bone interface, compared to 33.3% in the OP + ALN group. CT analysis demonstrated that ALN treatment improved bone microarchitecture. Notably, bone microarchitectural parameters significantly correlated with histological scores of tendon healing. Conclusion Tendon-bone healing is impaired in the presence of OP but can be partially restored by ALN treatment. Furthermore, CT-based quantitative analysis of bone microarchitecture at the humeral greater tuberosity shows a significant correlation with rotator cuff healing. These results imply that such analysis might serve as a potential indicator of postoperative prognosis.
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spelling doaj-art-9cb3f1b46dfc4825bf2a12fc40093c212025-08-20T03:05:06ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-07-0120111210.1186/s13018-025-06102-6Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healingHeyong Yin0Yufei Ding1Ziyang Feng2Zexing Yan3Ai Guo4Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Orthopaedics, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Orthopaedics, Beijing Friendship Hospital, Capital Medical UniversityDepartment of Orthopaedics, Zhongda Hospital, Southeast UniversityDepartment of Orthopaedics, Beijing Friendship Hospital, Capital Medical UniversityAbstract Background Rotator cuff repair in patients with osteoporosis (OP) is often hindered by poor tendon-to-bone healing and a high rate of retears, largely due to compromised bone remodeling at the repair site. However, few studies have investigated the relationship between computed tomography (CT)-based quantitative analysis of bone microarchitecture and the prognosis of rotator cuff healing. Methods An OP rat model was established via bilateral ovariectomy combined with dexamethasone administration. A full-thickness supraspinatus tear was surgically induced, followed by an 8-week intervention with either alendronate (ALN) or saline. Non-osteoporotic rats served as control group. Histological analysis and biomechanical testing were performed to evaluate tendon-to-bone healing. Additionally, quantitative micro-CT analysis of the humeral greater tuberosity was conducted, and correlations with tendon healing outcomes were assessed. Results Histological analysis at 8 weeks revealed disorganized structure and poor fibrovascular tissue in the OP group, while the OP + ALN group exhibited improved tendon-bone healing with better collagen fiber alignment and higher histological scores. A decreased RANKL/OPG ratio suggested that ALN treatment modulated regional bone metabolism in the humeral greater tuberosity. The Young’s modulus was reduced in both osteoporotic groups compared to the Control group. Although the difference between the OP and OP + ALN groups was not statistically significant, a trend was observed: 50% of specimens in the OP group failed at the tendon-bone interface, compared to 33.3% in the OP + ALN group. CT analysis demonstrated that ALN treatment improved bone microarchitecture. Notably, bone microarchitectural parameters significantly correlated with histological scores of tendon healing. Conclusion Tendon-bone healing is impaired in the presence of OP but can be partially restored by ALN treatment. Furthermore, CT-based quantitative analysis of bone microarchitecture at the humeral greater tuberosity shows a significant correlation with rotator cuff healing. These results imply that such analysis might serve as a potential indicator of postoperative prognosis.https://doi.org/10.1186/s13018-025-06102-6Rotator cuff tearQuantitative computed tomographyBone microarchitectureOsteoporosis
spellingShingle Heyong Yin
Yufei Ding
Ziyang Feng
Zexing Yan
Ai Guo
Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing
Journal of Orthopaedic Surgery and Research
Rotator cuff tear
Quantitative computed tomography
Bone microarchitecture
Osteoporosis
title Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing
title_full Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing
title_fullStr Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing
title_full_unstemmed Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing
title_short Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing
title_sort quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing
topic Rotator cuff tear
Quantitative computed tomography
Bone microarchitecture
Osteoporosis
url https://doi.org/10.1186/s13018-025-06102-6
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