Quantitative computed tomography analysis of bone microarchitecture is associated with rotator cuff healing

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Radiology

Background:

• Osteoporosis (OP) compromises rotator cuff repair outcomes, leading to poor tendon-to-bone healing and retears due to altered bone remodeling.
• Limited research exists on the correlation between computed tomography (CT)-based bone microarchitecture analysis and rotator cuff healing prognosis in osteoporotic patients.

Purpose of the Study:

• To investigate the efficacy of alendronate (ALN) in improving tendon-to-bone healing in an osteoporotic rat model.
• To assess the relationship between CT-based quantitative analysis of bone microarchitecture and rotator cuff healing outcomes.

Main Methods:

• An osteoporosis rat model was created using ovariectomy and dexamethasone, followed by supraspinatus tendon tear induction.
• Rats received either alendronate (ALN) or saline treatment for 8 weeks, with a non-osteoporotic control group.
• Histological, biomechanical, and quantitative micro-CT analyses of the humeral greater tuberosity were performed.

Main Results:

• Alendronate treatment improved tendon-bone healing, collagen alignment, and histological scores in osteoporotic rats.
• CT analysis revealed that ALN enhanced bone microarchitecture, and these parameters significantly correlated with histological tendon healing scores.
• While biomechanical differences were not significant, ALN treatment showed a trend towards reduced failure rates at the tendon-bone interface.

Conclusions:

• Tendon-bone healing is significantly impaired in osteoporosis but can be partially restored with alendronate treatment.
• CT-based quantitative analysis of bone microarchitecture in the humeral greater tuberosity is a potential indicator for predicting rotator cuff healing prognosis.
• This study highlights the role of bone quality in rotator cuff repair and suggests imaging-based assessment for improved patient outcomes.