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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue 5, 680-684.
doi: 10.1302/0301-620X.90B5.20013  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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Identifying the cellular basis for reimplantation failure in repair of the rotator cuff

D. W. N. Simon, MBBS, BSc, FRCS(Trauma & Orth), Locum Consultant Orthopaedic Surgeon1; C. E. Clarkin, BSc, PhD, Postdoctoral Research Assistant2; V. Das-Gupta, BSc, PhD, Research Associate2; S. C. F. Rawlinson, BSc, PhD, Assistant Lecturer2; R. J. Emery, MS, FRCS, Reader in Surgery3; and A. A. Pitsillides, BSc, PhD, Reader in Cell-Matrix Biology2

1 Department of Trauma and Orthopaedic Surgery King’s College Hospital, Denmark Hill, London SE5 9RS, UK.
2 Department of Veterinary Basic Sciences, Royal Veterinary College, Royal College Street, London NW1 0TU, UK.
3 Department of Trauma and Orthopaedic Surgery, St Mary’s Hospital, Praed Street, London W2 1NY, UK.

Correspondence should be sent to Mr D. W. N. Simon; e-mail: domsimon{at}doctors.org.uk

We examined cultured osteoblasts derived from paired samples from the greater tuberosity and acromion from eight patients with large chronic tears of the rotator cuff.

We found that osteoblasts from the tuberosity had no apparent response to mechanical stimulation, whereas those derived from the acromion showed an increase in alkaline phosphatase activity and nitric oxide release which is normally a response of bone cells to mechanical strain. By contrast, we found that cells from both regions were able to respond to dexamethasone, a well-established promoter of osteoblastic differentiation, with the expected increase in alkaline phosphatase activity.

Our findings indicate that the failure of repair of the rotator cuff may be due, at least in part, to a compromised capacity for mechanoadaptation within the greater tuberosity. It remains to be seen whether this apparent decrease in the sensitivity of bone cells to mechanical stimulation is the specific consequence of the reduced load-bearing history of the greater tuberosity in these patients.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General