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The cause of the high failure rates often observed following rotator cuff tendon repairs, particularly massive tears, is not fully understood. Collagen structural changes have been shown to alter tendon thermal and mechanical properties. This study aimed to form a quantitative rather than qualitative assessment, of whether differences in collagen structure and integrity existed between small biopsies of normal, small, and massive rotator cuff tears using differential scanning calorimetry. Thermal properties were measured for 28 human biopsies taken intra-operatively from normal, small, and massive rotator cuff tendon tears in this powered study. Denaturation temperatures are represented by T(onset) (°C) and T(peak) (°C). The T(onset) is proposed to represent water-amide hydrogen bond breakage and resulting protein backbone mobility. T(peak) reportedly corresponds to the temperature at which the majority of proteins fall out of solution. Denaturation enthalpy (ΔH) should correlate with the amount of triple helical structure that is denatured. Fluorescence and confocal microscopy allowed quantitative validation. Small and massive rotator cuff tears had significantly higher T(onset), T(peak), and ΔH compared to controls. Polarized light microscopy of torn tendons confirmed greater collagen structural disruption compared to controls. These novel findings suggest greater quantifiable collagen structural disruption in rotator cuff tears, compared to controls. This study offers insight into possible mechanisms for the reduced strength of torn tendons and may explain why repaired tendons fail to heal.

Original publication

DOI

10.1002/jor.21450

Type

Journal article

Journal

Journal of orthopaedic research : official publication of the Orthopaedic Research Society

Publication Date

12/2011

Volume

29

Pages

1938 - 1943

Addresses

Nuffield Department of Orthopedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, United Kingdom. salmachaudhury@doctors.net.uk

Keywords

Rotator Cuff, Shoulder Joint, Humans, Tendon Injuries, Collagen, Body Temperature, Calorimetry, Differential Scanning, Severity of Illness Index, Weight-Bearing, Rotator Cuff Injuries