Synergic regenerative effects of polydeoxyribonucleotide and microcurrent on full-thickness rotator cuff healing in a rabbit model - 11/11/19

Doi : 10.1016/j.rehab.2019.09.010

Dong Rak Kwon ^a,^⁎ , Yong Suk Moon ^b
^a Department of Rehabilitation, School of Medicine, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-Gu, Daegu, South Korea
^b Department of Anatomy, School of Medicine, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-Gu, Daegu, South Korea

^⁎Corresponding author. Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine, 33 Duryugongwon-ro 17-gil, Nam-Gu, Daegu 42472, South Korea.Department of Rehabilitation Medicine, Catholic University of Daegu School of Medicine33 Duryugongwon-ro 17-gilNam-Gu, Daegu 42472South Korea

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Monday 11 November 2019
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Highlights

•	We lack effective treatment for chronic rotator cuff tear.
•	We evaluated combined treatment with polydeoxyribonucleotides and microcurrent in a rabbit model.
•	The combination treatment showed marked regeneration for rotator cuff tear in gross morphologic, histological, and motion analysis.
•	Combined treatment with polydeoxyribonucleotides and microcurrent is effective to treat chronic rotator cuff tear in a rabbit model.

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Abstract

Background

Rotator cuff tendon tears (RCTTs) are common adult injuries. We hypothesized that a local injection of polydeoxyribonucleotide (PDRN) and microcurrent therapy (MIC) would be more effective in regenerating a tendon tear than PDRN administration alone.

Objectives

To evaluate the effect of PDRN combined with MIC on the regeneration of RCTTs in a rabbit subscapularis tendon chronic RCTT model.

Methods

Rabbits (n=24) were allocated to 3 groups at 6 weeks after full-thickness RCTT (FTRCTT): 0.2mL normal saline (G1-SAL); 0.2mL PDRN with Sham MIC (G2-PDRN+Sham MIC); and 0.2mL PDRN with MIC (G3-PDRN+MIC). All treatments were performed under ultrasound guidance. PDRN was injected weekly for 4 weeks and sham MIC or MIC was applied daily for 4 weeks after the first PDRN injection.

Results

In the G3-PDRN+MIC group, the mean (SD) subscapularis tendon tear size was continuously reduced from 1 week post-treatment to 4 weeks and was significantly decreased as compared with the other 2 groups [6.0 (1.5) vs. G1: 11.5 (1.8) and G2: 9.1 (1.6) mm²; G3 vs. G1, P<0.001; G3 vs. G2, P=0.018]. The gross morphologic mean tendon tear size was significantly smaller in the G3-PDRN+MIC group than G1-SAL and G2-PDRN+ Sham MIC groups [8.8 (3.5) vs. 15.9 (2.3) and 12.4 (1.6) mm²; G3 vs. G1, P<0.001; G3 vs. G2, P=0.03]. Mean values for regenerated collagen type 1 fibers, angiogenesis, and walking parameters were all greater for the G3-PDRN+MIC group than the other 2 groups based on histological examination and motion analysis [collagen type 1, G3: 1.60 (0.80) vs. G1: 0.45 (0.60), G2: 1.10 (0.74), G3 vs. G1, P<0.001; G3 vs. G2, P=0.002] [angiogenesis, G3: 2.44 (0.73) vs. G1: 0.80 (0.82) and G2: 2.06 (0.81), G3 vs. G1, P<0.001; G3 vs. G2, P=0.006] [walking distance, G3: 6391.4 (196.9) vs. G1: 4852.8 (137.3) and G2: 5514.4 (257.3) cm; G3 vs. G1, P<0.001; G3 vs. G2, P<0.001].

Conclusions

On gross morphologic, histological, and motion analysis, combined PDRN with MIC therapy was more effective than PDRN alone treating a rabbit model of chronic traumatic FTRCTT.

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Keywords : Shoulder, Rotator cuff, Microcurrent, Polydeoxyribonucleotide, Injections, Ultrasonography