Enhancing Rotator Cuff Repair in Rabbit Osteoporosis With Chitosan Quaternary Ammonium Salt-Coated Nickel-Titanium...

Area of Science:

• Biomaterials Science
• Orthopedic Surgery
• Regenerative Medicine

Background:

• Rotator cuff tears in patients with osteoporosis present treatment challenges due to poor bone quality.
• Current treatment consensus is lacking, with anchor material, structure, and number significantly impacting repair outcomes.

Purpose of the Study:

• To evaluate the efficacy of novel chitosan quaternary ammonium salt-coated nickel-titanium memory alloy (NTMA) anchors for rotator cuff repair in a rabbit osteoporosis model.

Main Methods:

• A novel winged NTMA anchor was designed and tested in vitro. Chitosan-sodium alginate composite coating was applied to NTMA anchors. An osteoporotic rabbit model was established and repaired using titanium, NTMA, and coated NTMA (CNTMA) anchors. Biomechanical testing, histology, and micro-CT were performed at 6 and 12 weeks post-surgery.

Main Results:

• NTMA anchors showed higher failure loads than titanium anchors in osteoporotic bone models. The CNTMA anchors demonstrated the greatest maximum failure load and promoted significant trabecular bone thickness and growth. The coating enhanced osteoblast proliferation and fixation strength.

Conclusions:

• Chitosan quaternary ammonium salt-coated NTMA anchors significantly enhance fixation strength and promote osteogenesis in osteoporotic bone, facilitating rotator cuff repair in compromised bone environments.