Department of Orthopaedic Surgery, UConn Health, Farmington, CT, U.S.A.; Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany.
Department of Orthopaedic Surgery, UConn Health, Farmington, CT, U.S.A.
Arthroscopy. 2020 Nov;36(11):2794-2802. doi: 10.1016/j.arthro.2020.06.008. Epub 2020 Jun 15.
To investigate the influence of patient demographics and rotator cuff tear characteristics on the cellular proliferation potential of subacromial bursa-derived cells (SBDCs).
Patients undergoing arthroscopic rotator cuff repair between December 2017 and February 2019 were considered for enrollment in the study. Basic demographic information as well as medical and surgical history were obtained for each patient. Subacromial bursa was harvested from over the rotator cuff tendon. Cellular proliferation was evaluated after 3 weeks of incubation by counting nucleated SBDCs. Fluorescence-activated cell sorting (FACS) analysis was performed to confirm the presence of mesenchymal stem cell (MSC) specific surface markers. Using preoperative radiographs and magnetic resonance imaging (MRI), acromiohumeral distance (AHD), severity of cuff tear arthropathy, and rotator cuff tear characteristics were evaluated.
Seventy-three patients (mean age: 57.2 ± 8.5 years) were included in the study. There was no significant difference in cellular proliferation of SBDCs when evaluating the influence of age, sex, body mass index (BMI), smoking status, and presence of systemic comorbidities (p > .05, respectively). Similarly, there was no significant difference in cellular proliferation of SBDCs when looking at rotator cuff tear characteristics (size, tendon retraction, fatty infiltration, muscle atrophy), AHD, or severity of cuff tear arthropathy (p > .05). FACS analysis confirmed nucleated SBDCs to have a high positive rate of MSC specific surface markers.
Subacromial bursa consistently demonstrated a high cellular proliferation potential regardless of patient demographics, rotator cuff tear characteristics, and severity of glenohumeral joint degeneration.
These findings may alleviate concerns that subacromial bursa might lose cellular proliferation potential when being used for biologic augmentation in massive and degenerated rotator cuff tears, thus assisting in predicting tendon healing and facilitating surgical decision-making.
研究患者人口统计学特征和肩袖撕裂特征对肩峰下囊源性细胞（SBDC）细胞增殖潜力的影响。
研究纳入了 2017 年 12 月至 2019 年 2 月期间接受关节镜肩袖修复的患者。每位患者均获得基本人口统计学信息以及医疗和手术史。从肩袖肌腱上方采集肩峰下囊。培养 3 周后，通过计数有核 SBDC 来评估细胞增殖。通过荧光激活细胞分选（FACS）分析确认间充质干细胞（MSC）特异性表面标志物的存在。使用术前 X 线和磁共振成像（MRI）评估肩峰肱骨头距离（AHD）、肩袖撕裂性关节炎的严重程度以及肩袖撕裂特征。
本研究共纳入 73 例患者（平均年龄：57.2±8.5 岁）。在评估年龄、性别、体重指数（BMI）、吸烟状况和是否存在系统性合并症对 SBDC 细胞增殖的影响时，SBDC 的细胞增殖无显著差异（p＞.05）。同样，在观察肩袖撕裂特征（大小、肌腱回缩、脂肪浸润、肌肉萎缩）、AHD 或肩袖撕裂性关节炎严重程度时，SBDC 的细胞增殖也无显著差异（p＞.05）。FACS 分析证实有核 SBDC 具有 MSC 特异性表面标志物的高阳性率。
无论患者的人口统计学特征、肩袖撕裂特征以及肱骨头关节退行性变的严重程度如何，肩峰下囊均表现出较高的细胞增殖潜力。
这些发现可能减轻了人们对肩峰下囊在用于治疗巨大和退行性肩袖撕裂的生物增强时可能丧失细胞增殖潜力的担忧，从而有助于预测肌腱愈合，并为手术决策提供帮助。
