Investigation of the effects of subacromial bursal tissue preservation and microfracture procedure on healing after rotator cuff repair in a rat model.

INTRODUCTION: The aim of this study is to compare the preservation of bursal tissue and microfracture techniques and to examine the effectiveness of the combination of the two methods in rotator cuff tear healing in the rat shoulder.

HYPOTHESIS: Bursal tissue preservation combined with microfracture is more effective in the rotator cuff repair.

MATERIALS AND METHODS: Twenty-three Male Sprague-Dawley rats were randomly divided into two groups. The bursal tissue was preserved in group 1 (n = 11) and excised in group 2 (n = 12). Groups were categorized into subgroups as L (left) and R (right) based on the shoulder side receiving microfracture (L received microfracture, R did not). Histopathological examination was performed using modified Bonar Score System.

RESULTS: Cell morphology grades of group 1 were lower than group 2 (p<0.05). In terms of collagen measurements, the grade of group 1L (bursa preservation + microfracture) was lower than groups 1R, 2L, and 2R, and the grade of group 1R was lower than groups 2L and 2R. Cellularity grades of group 2 were higher than group 1 (p<0.05). Extracellular matrix grades of group 1 were lower than group 2 (p<0.05). The overall grades were lower in group 1 than in group 2 (p<0.05).

DISCUSSION: Combined treatment of bursal tissue preservation and microfracture was the most efficient method as determined by healing findings in histopathological specimens. Preservation of bursal tissue was a more effective option in tendon healing than performing only microfracture.

LEVEL OF PROOF: II; Animal Research.