CC BY-NC-ND 4.0 · Joints 2018; 06(02): 100-103
DOI: 10.1055/s-0038-1660789
Original Article
Georg Thieme Verlag KG Stuttgart · New York

The Effect of Three Different Suture Anchors for Rotator Cuff Repair on Primary Cultures of Human Bone Marrow Mesenchymal Stem Cells

Gabriele Thiébat
1   Sport Traumatology Centre, Istituto Ortopedico Galeazzi, Milano, Italy
Paolo Capitani
1   Sport Traumatology Centre, Istituto Ortopedico Galeazzi, Milano, Italy
Laura de Girolamo
2   Orthopaedic Biotechnology Laboratory, Istituto Ortopedico Galeazzi, Milano, Italy
Carlotta Perucca Orfei
2   Orthopaedic Biotechnology Laboratory, Istituto Ortopedico Galeazzi, Milano, Italy
Francesca Facchini
1   Sport Traumatology Centre, Istituto Ortopedico Galeazzi, Milano, Italy
Herbert Schoenhuber
1   Sport Traumatology Centre, Istituto Ortopedico Galeazzi, Milano, Italy
Marco Viganò
2   Orthopaedic Biotechnology Laboratory, Istituto Ortopedico Galeazzi, Milano, Italy
› Author Affiliations
Further Information

Publication History

05 September 2017

02 May 2018

Publication Date:
14 June 2018 (online)


Purpose The purpose of this study is to investigate the in vitro biocompatibility of three different suture anchors (all-suture anchor, metal anchor, and polyetheretherketone anchor), commonly used for the rotator cuff repair.

Methods To assess the biocompatibility of the anchors, the possible cytotoxicity and the immunogenicity of the devices were assessed by cell viability assay and cell count on cultures of bone marrow stem cells (BMSCs) and peripheral blood leucocytes (PBLs), respectively. The possible inhibitory effect of the devices on BMSCs osteogenic potential was evaluated by alkaline phosphatase activity and matrix deposition assay.

Results The viability of BMSCs was slightly reduced when cultured in the presence of the devices (−24 ± 3%). Nevertheless, they were able to differentiate toward the osteogenic lineage in all culture conditions. The proliferation of PBLs and the production of interleukin-2 were not enhanced by the presence of any device.

Conclusion The analyzed devices did not significantly affect the normal cells functions when directly cultured with human primary BMSCs or PBLs, in terms of osteogenic differentiation and inflammatory reaction.

Clinical Relevance A deeper knowledge of the biological reactions to different devices used in rotator cuff surgeries would improve the clinical outcome of these procedures.

  • References

  • 1 DeHaan AM, Axelrad TW, Kaye E, Silvestri L, Puskas B, Foster TE. Does double-row rotator cuff repair improve functional outcome of patients compared with single-row technique? A systematic review. Am J Sports Med 2012; 40 (05) 1176-1185
  • 2 Randelli P, Randelli F, Compagnoni R. , et al. Revision reverse shoulder arthroplasty in failed shoulder arthroplasties for rotator cuff deficiency. Joints 2015; 3 (01) 31-37
  • 3 Saccomanno MF, Sircana G, Cazzato G, Donati F, Randelli P, Milano G. Prognostic factors influencing the outcome of rotator cuff repair: a systematic review. Knee Surg Sports Traumatol Arthrosc 2016; 24 (12) 3809-3819
  • 4 Nagra NSN, Zargar N, Smith RDJ, Carr AJ. Mechanical properties of all-suture anchors for rotator cuff repair. Bone Joint Res 2017; 6 (02) 82-89
  • 5 Esquivel AO, Duncan DD, Dobrasevic N, Marsh SM, Lemos SE. Load to failure and stiffness: anchor placement and suture pattern effects on load to failure in rotator cuff repairs. Orthop J Sports Med 2015; 3 (04) 2325967115579052
  • 6 Goeminne S, Debeer P. Delayed migration of a metal suture anchor into the glenohumeral joint. Acta Orthop Belg 2010; 76 (06) 834-837
  • 7 Dhawan A, Ghodadra N, Karas V, Salata MJ, Cole BJ. Complications of bioabsorbable suture anchors in the shoulder. Am J Sports Med 2012; 40 (06) 1424-1430
  • 8 Kelly II JD. Disintegration of an absorbable rotator cuff anchor six weeks after implantation. Arthroscopy 2005; 21 (04) 495-497
  • 9 Park AY, Hatch JD. Proximal humerus osteolysis after revision rotator cuff repair with bioabsorbable suture anchors. Am J Orthop 2011; 40 (03) 139-141
  • 10 Kim SH, Oh JH, Lee OS, Lee HR, Hargens AR. Postoperative imaging of bioabsorbable anchors in rotator cuff repair. Am J Sports Med 2014; 42 (03) 552-557
  • 11 McCarty III LP, Buss DD, Datta MW, Freehill MQ, Giveans MR. Complications observed following labral or rotator cuff repair with use of poly-L-lactic acid implants. J Bone Joint Surg Am 2013; 95 (06) 507-511
  • 12 Medina G, Garofo G, D'Elia CO, Bitar AC, Castropil W, Schor B. Bioabsorbable suture anchor migration to the acromioclavicular joint: how far can these implants go?. Case Rep Orthop 2014; 2014: 834896
  • 13 Randelli P, Stoppani CA, Zaolino C, Menon A, Randelli F, Cabitza P. Advantages of arthroscopic rotator cuff repair with a transosseous duture technique: a prospective randomized controlled trial. Am J Sports Med 2017; 45 (09) 2000-2009
  • 14 Luyckx T, Debeer P. Management of full thickness rotator cuff tears. A survey amongst members of the Flemish Elbow and Shoulder Surgeons Society (FLESSS). Acta Orthop Belg 2010; 76 (01) 14-21
  • 15 Zhang H, Lewis CG, Aronow MS, Gronowicz GA. The effects of patient age on human osteoblasts' response to Ti-6Al-4V implants in vitro. J Orthop Res 2004; 22 (01) 30-38
  • 16 Maffulli N, Ewen SW, Waterston SW, Reaper J, Barrass V. Tenocytes from ruptured and tendinopathic Achilles tendons produce greater quantities of type III collagen than tenocytes from normal achilles tendons. An in vitro model of human tendon healing. Am J Sports Med 2000; 28 (04) 499-505
  • 17 Zreiqat H, Akin FA, Howlett CR. , et al. Differentiation of human bone-derived cells grown on GRGDSP-peptide bound titanium surfaces. J Biomed Mater Res A 2003; 64 (01) 105-113
  • 18 Mazzocca AD, McCarthy MB, Arciero C. , et al. Tendon and bone responses to a collagen-coated suture material. J Shoulder Elbow Surg 2007; 16 (5, Suppl): S222-S230