Our Summary

This research paper is about the effect of hyaluronic acid (HA), a substance naturally found in the body, on the healing of rotator cuff tears in the shoulder. The researchers used a laboratory study on rabbits to investigate this. In the experiment, the rotator cuff tendons of the rabbits were intentionally torn and then repaired. Before the surgical wound was closed, HA was applied to the repaired area in some rabbits, while a saline solution was used as a control in others.

The researchers found that at 4 and 8 weeks after the surgery, the HA group showed a significantly greater resistance to failure compared to the control group. This suggests that HA could help improve the strength of the repaired tendon during the healing process. However, there was no significant difference between the two groups 12 weeks after the surgery.

In addition to this, the study found that HA increased the formation of cartilage-like tissue at the tendon-bone interface and improved the maturity of collagen, a protein that contributes to the strength and flexibility of tendons. These effects were observed at 4 weeks after the surgery but were not significant at 8 and 12 weeks.

The researchers also found that HA increased the production of cartilage and the expression of certain genes related to cartilage formation in stem cells derived from the bone marrow of the rabbits. This suggests that HA may promote healing by activating these cells.

In conclusion, the study suggests that HA could potentially be used to accelerate the healing of rotator cuff tears, possibly reducing the number of repeat tears after surgery. However, more research is needed to confirm these findings and to investigate their potential application in clinical practice.

FAQs

  1. What is the purpose of applying hyaluronic acid (HA) to the repaired area in the rabbits?
  2. What were the key findings of the study on the effect of hyaluronic acid on rotator cuff tears?
  3. Can the findings of this study be used in clinical practice for humans?

Doctor’s Tip

A doctor might tell a patient undergoing tendon repair to follow a rehabilitation program that includes specific exercises to strengthen the repaired tendon and surrounding muscles. They may also recommend maintaining a healthy diet rich in nutrients that support tendon health, such as vitamin C, zinc, and collagen. Additionally, the doctor may advise the patient to avoid activities that put excessive strain on the tendon during the healing process to prevent re-injury.

Suitable For

Patients who have suffered from rotator cuff tears in the shoulder are typically recommended tendon repair. Rotator cuff tears can cause pain, weakness, and limited range of motion in the shoulder, making it difficult to perform daily activities. Tendon repair surgery is often recommended to reattach the torn tendon to the bone and restore function to the shoulder. In some cases, patients may also receive additional treatment such as physical therapy to help rehabilitate the shoulder and prevent future injuries.

Timeline

Overall, the timeline of a patient’s experience before and after tendon repair surgery can be summarized as follows:

Before surgery:

  • Patient experiences pain, weakness, and limited range of motion in the affected joint.
  • Patient undergoes imaging tests such as MRI to diagnose the tendon tear.
  • Patient may undergo physical therapy or corticosteroid injections to manage symptoms before surgery.

During surgery:

  • Tendon repair surgery is performed to reattach the torn tendon to the bone using sutures or anchors.
  • In some cases, HA or other biologic agents may be applied to the repaired tendon to promote healing.

After surgery:

  • Patient undergoes a period of immobilization and physical therapy to restore strength and range of motion in the affected joint.
  • Patient may experience post-operative pain and swelling, which can be managed with pain medication and ice therapy.
  • Patient gradually resumes normal activities and sports under the guidance of a healthcare provider.
  • Patient undergoes follow-up appointments to monitor healing progress and address any complications.

Overall, the recovery process after tendon repair surgery can vary depending on the extent of the injury and individual factors such as age and overall health. It is important for patients to follow their healthcare provider’s instructions and participate in rehabilitation programs to optimize outcomes and prevent re-injury.

What to Ask Your Doctor

Some questions a patient should ask their doctor about tendon repair include:

  1. Could hyaluronic acid be used as part of my tendon repair treatment?
  2. What are the potential benefits of using hyaluronic acid in my specific case?
  3. Are there any risks or side effects associated with using hyaluronic acid for tendon repair?
  4. How does hyaluronic acid work to improve tendon healing?
  5. Are there any alternative treatments or therapies that I should consider in addition to or instead of hyaluronic acid?
  6. What is the typical recovery process like for tendon repair, and how might hyaluronic acid affect this process?
  7. How long does it typically take for patients to see improvements in tendon healing when using hyaluronic acid?
  8. Are there any specific factors about my injury or medical history that might make hyaluronic acid more or less effective for me?
  9. Will I need any additional follow-up appointments or treatments if hyaluronic acid is used in my tendon repair?
  10. Are there any ongoing clinical trials or research studies related to hyaluronic acid and tendon repair that I should be aware of?

Reference

Authors: Honda H, Gotoh M, Kanazawa T, Ohzono H, Nakamura H, Ohta K, Nakamura KI, Fukuda K, Teramura T, Hashimoto T, Shichijo S, Shiba N. Journal: Am J Sports Med. 2017 Dec;45(14):3322-3330. doi: 10.1177/0363546517720199. Epub 2017 Sep 5. PMID: 28872895