Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model Study

ABSTRACT Objective Rotator cuff retear after arthroscopy repair is a difficult complication that is often due to poor tendon–bone healing. Decellularized amniotic membrane (DAM) has a variety of bioactive substances which have great potential to enhance tendon–bone healing. However, DAM has three la...

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Main Authors: Jiangtao Wang, Chunbao Li, Jiating Zhang, Mingyang An, Gang Zhao, Samuel D. Stark, Yujie Liu
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Orthopaedic Surgery
Subjects:
Online Access:https://doi.org/10.1111/os.14316
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author Jiangtao Wang
Chunbao Li
Jiating Zhang
Mingyang An
Gang Zhao
Samuel D. Stark
Yujie Liu
author_facet Jiangtao Wang
Chunbao Li
Jiating Zhang
Mingyang An
Gang Zhao
Samuel D. Stark
Yujie Liu
author_sort Jiangtao Wang
collection DOAJ
description ABSTRACT Objective Rotator cuff retear after arthroscopy repair is a difficult complication that is often due to poor tendon–bone healing. Decellularized amniotic membrane (DAM) has a variety of bioactive substances which have great potential to enhance tendon–bone healing. However, DAM has three layers, of which the middle basement layer is dense and thick. Whether DAM will hinder tendon–bone healing of rotator cuff after surgical repair is unclear. Our study aims to investigate the effect of DAM on tendon–bone healing of the rotator cuff after surgical repair. Methods Thirty‐three Sprague–Dawley (SD) rats were selected to establish unilateral supraspinatus (ST) tear models and were randomly treated with only suturing repair (OSR group, n = 11), and suturing repair with DAM placed between the ST and bone (DAM group, n = 11). In the normal control group (NCT group, n = 11), the supraspinatus was only exposed but not detached or repaired. After 4 weeks the rats were sacrificed. The assessment of specimens was conducted by micro‐CT analysis, histopathological evaluation, and biomechanical testing. Results The DAM group had a significantly higher ultimate load to failure, new bone volume, and histological evaluation at 4 weeks after surgery than the OSR group. When comparing the DAM group to the NCT group, the DAM group performed slightly worse in biomechanical testing, micro‐CT analysis, and histological evaluation. Conclusion When placed between tendon and bone at the rotator cuff footprint, DAM, despite its dense and thick basement layer, does not impede tendon–bone healing after surgical repair for rotator cuff injury, but rather promotes increased healing quality and biomechanical properties. However, the healing quality and biomechanical properties are still lower than that of the normal rotator cuff, and further improvement should be made to the application strategy of a DAM.
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spelling doaj-art-ddec1d4ec0b14cb885c88c36cddbed812025-02-03T03:10:59ZengWileyOrthopaedic Surgery1757-78531757-78612025-02-0117257558210.1111/os.14316Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model StudyJiangtao Wang0Chunbao Li1Jiating Zhang2Mingyang An3Gang Zhao4Samuel D. Stark5Yujie Liu6Department of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaDepartment of Orthopedics The Third Medical Center of Chinese PLA General Hospital Beijing ChinaChinese PLA Medical School Beijing ChinaChinese PLA Medical School Beijing ChinaDepartment of Orthopedics, Foot & Ankle Section University of Colorado School of Medicine Aurora Colorado USADepartment of Orthopedics The Fourth Medical Center of Chinese PLA General Hospital Beijing ChinaABSTRACT Objective Rotator cuff retear after arthroscopy repair is a difficult complication that is often due to poor tendon–bone healing. Decellularized amniotic membrane (DAM) has a variety of bioactive substances which have great potential to enhance tendon–bone healing. However, DAM has three layers, of which the middle basement layer is dense and thick. Whether DAM will hinder tendon–bone healing of rotator cuff after surgical repair is unclear. Our study aims to investigate the effect of DAM on tendon–bone healing of the rotator cuff after surgical repair. Methods Thirty‐three Sprague–Dawley (SD) rats were selected to establish unilateral supraspinatus (ST) tear models and were randomly treated with only suturing repair (OSR group, n = 11), and suturing repair with DAM placed between the ST and bone (DAM group, n = 11). In the normal control group (NCT group, n = 11), the supraspinatus was only exposed but not detached or repaired. After 4 weeks the rats were sacrificed. The assessment of specimens was conducted by micro‐CT analysis, histopathological evaluation, and biomechanical testing. Results The DAM group had a significantly higher ultimate load to failure, new bone volume, and histological evaluation at 4 weeks after surgery than the OSR group. When comparing the DAM group to the NCT group, the DAM group performed slightly worse in biomechanical testing, micro‐CT analysis, and histological evaluation. Conclusion When placed between tendon and bone at the rotator cuff footprint, DAM, despite its dense and thick basement layer, does not impede tendon–bone healing after surgical repair for rotator cuff injury, but rather promotes increased healing quality and biomechanical properties. However, the healing quality and biomechanical properties are still lower than that of the normal rotator cuff, and further improvement should be made to the application strategy of a DAM.https://doi.org/10.1111/os.14316decellularized amniotic membraneretearrotator cuff injurysurgical repairtendon–bone healing
spellingShingle Jiangtao Wang
Chunbao Li
Jiating Zhang
Mingyang An
Gang Zhao
Samuel D. Stark
Yujie Liu
Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model Study
Orthopaedic Surgery
decellularized amniotic membrane
retear
rotator cuff injury
surgical repair
tendon–bone healing
title Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model Study
title_full Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model Study
title_fullStr Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model Study
title_full_unstemmed Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model Study
title_short Effect of Decellularized Amniotic Membrane on the Tendon–Bone Integration in Rotator Cuff Repair: A Comparative Rat Model Study
title_sort effect of decellularized amniotic membrane on the tendon bone integration in rotator cuff repair a comparative rat model study
topic decellularized amniotic membrane
retear
rotator cuff injury
surgical repair
tendon–bone healing
url https://doi.org/10.1111/os.14316
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