Repair of rotator cuff injuries using different composites

Rev Esp Cir Ortop Traumatol. Jan-Feb 2017;61(1):51-62. doi: 10.1016/j.recot.2016.07.002.
[Article in English, Spanish]


Aim: Rotator cuff repairs have shown a high level of re-ruptures. It is hypothesised that the use of rhBMP-2 in a carrier could improve the biomechanical and histological properties of the repair.

Material and methods: Controlled experimental study conducted on 40 rats with section and repair of the supraspinatus tendon and randomisation to one of five groups: Group 1 (control) only suture; Group 2 (double control), suture and alginate-chitin carrier; Group 3 (alginate-control), the rhBMP-2 was added to the alginate; Group 4 (chitin-control) application of the rhBMP-2 to the chitin, and Group 5 (double sample): The two components of the carrier (alginate and chitin) have rhBMP-2. A biomechanical and histological analysis was performed at 4 weeks.

Results: A gap was observed in all cases 4 weeks after supraspinatus detachment. The re-rupture rate was 7.5%, with 20% of them in the control-alginate Group. Histologically the best results were obtained in the double sample group: 4.5 (3.3-5.0). Double sample were also able to support higher loads to failure: 62.9N (59.8 to 69.4) with lower rigidity 12.7 (9.7 to 15.9).

Conclusions: The use of alginate-chitin carrier with rhBMP-2 improves the biomechanical and histological properties of the repair site in a chronic rotator cuff tear.

Keywords: Biomateriales; Biomaterials; Bone morphogenetic protein; Ingeniería tisular; Manguito rotador; Proteína morfogenética ósea; Repair; Reparación; Rotator cuff; Tissue engineering.

MeSH terms

  • Alginates*
  • Animals
  • Biocompatible Materials
  • Biomechanical Phenomena
  • Bone Morphogenetic Protein 2 / administration & dosage*
  • Bone Morphogenetic Protein 2 / therapeutic use
  • Chitin*
  • Drug Carriers*
  • Glucuronic Acid
  • Hexuronic Acids
  • Humans
  • Male
  • Orthopedic Procedures / methods*
  • Random Allocation
  • Rats
  • Rats, Sprague-Dawley
  • Recombinant Proteins / administration & dosage
  • Recombinant Proteins / therapeutic use
  • Recurrence
  • Rotator Cuff Injuries / pathology
  • Rotator Cuff Injuries / physiopathology
  • Rotator Cuff Injuries / surgery*
  • Transforming Growth Factor beta / administration & dosage*
  • Transforming Growth Factor beta / therapeutic use
  • Weight-Bearing


  • Alginates
  • Biocompatible Materials
  • Bone Morphogenetic Protein 2
  • Drug Carriers
  • Hexuronic Acids
  • Recombinant Proteins
  • Transforming Growth Factor beta
  • recombinant human bone morphogenetic protein-2
  • Chitin
  • Glucuronic Acid