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Interventions used to mitigate muscle fatty degeneration following the repair of massive rotator cuff tears. A systematic review of animal studies - 26/01/24

Doi : 10.1016/j.otsr.2023.103723 
Dimitrios Stamiris a, , Athanasios Valasidis a, Angeliki Cheva c, Kyriakos Papavasiliou b, Stavros Stamiris a, Michael Potoupnis b, Lazaros Poultsides b, Eleftherios Tsiridis b, Ioannis Sarris b
a Orthopedic Department, 424 Military Hospital, Thessaloniki, Hellas, Greece 
b Academic Orthopaedic Department, Papageorgiou General Hospital, Aristotle University Medical School, Thessaloniki, Hellas, Greece 
c Department of Pathology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece 

Corresponding author: Academic Orthopaedic Department, Papageorgiou General Hospital, Aristotle University Medical School, Hellas, Mikras Asias 18, 56334 Thessaloniki, Greece.Academic Orthopaedic Department, Papageorgiou General Hospital, Aristotle University Medical SchoolHellas, Mikras Asias 18Thessaloniki56334Greece

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Abstract

Background

Muscle fatty degeneration following rotator cuff tears has been unequivocally associated with poorer functional outcomes and increased risk for retear following rotator cuff repair. Promising results have emerged from animal studies, with the implementation of various interventions for biologic inhibition of this fatty muscle degeneration. The lack of high quality randomized human evidence on this topic, increases the impact of pooled results from animal literature. The aim of the present study was to systematically review the available published literature for animal studies evaluating the ability of several interventions used to mitigate muscle fatty degeneration following the repair of massive rotator cuff tears.

Patients and methods

A comprehensive search was conducted on Pubmed, Scopus and Google Scholar, covering the period from conception until 16th April 2022. Datasets were stratified based on the type of intervention performed. SYRCLE risk of bias instrument was implemented for quality assessment of the included studies.

Results

Rotator cuff repair augmentation with Adipose derived stem cells (ADSC's), Mesenchymal stem cells (MSC's) and Nandrolone was effective against fatty infiltration, but less effective against muscle atrophy. More beneficial effect was shown by the utilization of Beige adipose tissue – Fibroadipogenic progenitors (BAT-FAP) stimulation, using either Amibregon or BAT-FAPs transplantation. Both provided good results in mitigating muscle atrophy, fatty infiltration and fibrosis.

Discussion

ADSC's, MSC's, Nandrolone and BAT-FAP stimulation may have a role in mitigating muscle fatty degeneration following rotator cuff tears. Large scale human studies are required to further elucidate their role in the clinical setting.

Level of evidence

V; systematic review of pre-clinical studies.

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Keywords : Animal study, Systematic review, Muscle fatty degeneration, Rotator cuff tear

Abbreviations : RCT, RCR, PRISMA, PROSPERO, PICO, BMP, HIF PHD, ECM, ADSC, MSC, PRP, PSC, BAT-FAP, FAP, FAPB4, p38 MAPK, TGF-β, SS, IS, TM, CSA


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Vol 110 - N° 1

Artículo 103723- février 2024 Regresar al número
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