The effectiveness of demineralized cortical bone matrix in a chronic rotator cuff tear model

J Shoulder Elbow Surg. 2017 Apr;26(4):619-626. doi: 10.1016/j.jse.2017.01.003. Epub 2017 Feb 2.


Background: The purpose of this study was to assess the effect of demineralized bone matrix (DBM) on rotator cuff tendon-bone healing. The hypothesis was that compared with a commercially available dermal matrix scaffold, DBM would result in a higher bone mineral density and regenerate a morphologically superior enthesis in a rat model of chronic rotator cuff degeneration.

Methods: Eighteen female Wistar rats underwent unilateral detachment of the supraspinatus tendon. Three weeks later, tendon repair was carried out in animals randomized into 3 groups: group 1 animals were repaired with DBM (n = 6); group 2 received augmentation with the dermal scaffold (n = 6); and group 3 (controls) underwent nonaugmented tendon-bone repair (n = 6). Specimens were retrieved at 6 weeks postoperatively for histologic analysis and evaluation of bone mineral density.

Results: No failures of tendon-bone healing were noted throughout the study. All groups demonstrated closure of the tendon-bone gap with a fibrocartilaginous interface. Dermal collagen specimens exhibited a disorganized structure with significantly more abnormal collagen fiber arrangement and cellularity than in the DBM-based repairs. Nonaugmented repairs exhibited a significantly higher bone mineral density than in DBM and the dermal collagen specimens and were not significantly different from control limbs that were not operated on.

Conclusion: The application of DBM to a rat model of chronic rotator cuff degeneration did not improve the composition of the healing enthesis compared with nonaugmented controls and a commercially available scaffold. However, perhaps the most important finding of this study was that the control group demonstrated a similar outcome to augmented repairs.

Keywords: Animal model; enthesis healing; rotator cuff; scaffold; shoulder; tendon-bone; tissue engineering.

MeSH terms

  • Acellular Dermis
  • Animals
  • Biocompatible Materials
  • Bone Density
  • Bone Matrix*
  • Chronic Disease
  • Cortical Bone
  • Female
  • Rats
  • Rats, Wistar
  • Rotator Cuff Injuries / surgery
  • Rotator Cuff Injuries / therapy*
  • Tissue Scaffolds*
  • Wound Healing*


  • Biocompatible Materials