Original Article
The Effects of Fibroblast Growth Factor-2 on Rotator Cuff Reconstruction With Acellular Dermal Matrix Grafts

https://doi.org/10.1016/j.arthro.2008.11.011Get rights and content

Purpose

Our purpose was to determine whether the local application of fibroblast growth factor (FGF) 2 accelerates regeneration and remodeling of rotator cuff tendon defects reconstructed with acellular dermal matrix (ADM) grafts in rats.

Methods

Thirty adult male Sprague-Dawley rats were divided into equal groups undergoing FGF-treated and FGF-untreated repairs. All rats underwent placement of an ADM graft for the supraspinatus defect (3 × 5 mm). FGF-2 (100 μg/kg) in a fibrin sealant was applied to both shoulders in the FGF-treated group, whereas only fibrin sealant was applied in untreated group. At 2, 6, and 12 weeks after surgery, 5 rats (10 shoulders) in each group were sacrificed for histologic analysis (3 shoulders) and biomechanical testing (7 shoulders). The controls were 5 unoperated rats (3 histologic and 7 biomechanical control specimens).

Results

Unoperated control tendons inserted into the bone by direct insertion; there was a zone of fibrocartilage between the tendon and bone. At 2 weeks, the FGF-treated group had tendon maturing scores similar to those in the untreated group (P > .05). At 6 and 12 weeks, the FGF-treated group had significantly higher scores (P < .05). At 2 weeks, specimens in both the treated and untreated groups exhibited similar strength; the ultimate tensile failure load was 6.0 ± 4.0 N and 5.8 ± 2.0 N, respectively (P > .05). At 6 weeks, the FGF-treated specimens were stronger, with an ultimate tensile failure load of 10.2 ± 3.1 N compared with 7.2 ± 2.2 N in the untreated group (P = .02). At 12 weeks, the FGF-treated specimens were stronger, with an ultimate tensile failure load of 15.9 ± 1.6 N compared with 13.2 ± 2.0 N in the untreated group (P = .0072), and there were no significant differences in strength compared with the controls (17.8 ± 2.6 N) (P > .05).

Conclusions

The remodeling of ADM grafts placed in rat rotator cuff tendon defects was accelerated by the local administration of FGF-2.

Clinical Relevance

The application of FGF-2 may result in improved histologic characteristics and biomechanical strength in ADM graft constructs in humans.

Section snippets

Methods

This investigation was approved by the Animal Studies Committee of our institution and by the Institutional Animal Care and Use Committee.

Adult male Sprague-Dawley rats (mean weight, 501 g; SD, 40 g) were assigned to 2 groups of 15 rats each. The controls were 5 unoperated age- and weight-matched male Sprague-Dawley rats; they were sacrificed to obtain 3 histologic and 7 biomechanical control shoulder specimens. In all operated rats, a large rotator cuff defect measuring 3 × 5 mm was created on

Gross examination

The surgical site exhibited no signs of infection or wound dehiscence in any of the rats. Scar tissue was noted around the acromioclavicular joint, but there were no adhesions or contractures limiting the shoulder range of motion. At each time point, the defect was bridged by tissue in all specimens from both the FGF-treated and FGF-untreated groups. Macroscopic evaluation of specimens from both groups obtained at 6 and 12 weeks showed a tendon-like structure; it was similar in appearance to

Discussion

This study showed that the locally applied FGF-2 improved the strength and maturity of the regenerated tendon in Sprague-Dawley rats with rotator cuff defects reconstructed with GraftJacket. At 2 weeks after surgery, the FGF-treated and untreated specimens exhibited similar tendon maturity scores and strength. At 6 and 12 weeks, the FGF-treated group showed significantly higher scores and strength than the untreated group.

The management of large or massive rotator cuff tears presents a

Conclusions

The remodeling of ADM grafts placed in rat rotator cuff tendon defects was accelerated by the local administration of FGF-2.

Acknowledgment

The authors acknowledge the help of the Center for Animal Resources and Development of our institution. They also thank Kaken Pharmaceutical and Wright Medical Technology for providing the FGF-2 and GraftJacket ADM, respectively.

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    Supported by a 2006 grant from the Japan Sports Medicine Foundation. The authors report no conflict of interest.

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