Hyperbaric oxygen treatment promotes tendon–bone interface healing in a rabbit model of rotator cuff tears

Li, Hongqiu1,#; Xiao, Meiling2,#; Yang, Feng3; Zhao, Zhonghai2; Liang, A1,*.

¹Department of Orthopedics, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning Province, China²Department of Rehabilitation, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning Province, China³Department of Medical Imaging, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning Province, China

Abstract

Due to the high-intensity pressure that the shoulder cuff endures, it is prone to traumas and tears. The main critical function of the shoulder cuff muscles is to effectively facilitate shoulder movement and securely maintain the humeral head in the precise center of the joint cavity to prevent superior migration during abduction processes. Shoulder cuff injuries typically involve the muscle–tendon–bone interface, but existing repair techniques do not always guarantee complete and secure healing, leading to retears. Hyperbaric oxygen therapy, as an auxiliary treatment, can significantly promote the muscle–tendon–bone healing process. To explore the impact of hyperbaric oxygen therapy on the bone–tendon interface healing process in a rabbit model specifically designed for shoulder cuff tears, an experiment was conducted on New Zealand white rabbits by performing a full-thickness tear of the supraspinatus tendon in the left shoulder, followed by 2 hours per day of 100% oxygen treatment at 2 absolute atmospheres for 5 days. The results indicate that hyperbaric oxygen therapy significantly enhances vascularization at the interface between the shoulder cuff and tendon–bone, promotes collagen fiber regeneration in the tendon, improves the tensile strength of the tendon–bone complex, and does not have a significant effect on biomechanical stability. This suggests that hyperbaric oxygen therapy has a significant positive impact on the histological and biomechanical healing of shoulder cuff tears in rabbits, expediting the healing process of the tendon–bone interface.

摘要：由于肩袖承受着高强度的压力，因而容易受到创伤和撕裂。肩袖肌肉的主要和关键功能是有效地促进肩部的运动，并将肱骨头牢牢地保持在关节腔内的精确中心，以防止外展过程中的上平移。肩袖损伤通常涉及肌腱-骨界面，然而现有的修复技术并不总是能保证彻底和完全安全的愈合，从而导致撕裂复发。高压氧治疗作为一种辅助疗法，可显著促进肌-腱骨愈合过程。为探索高压氧治疗对肩袖撕裂设计的兔模型骨-肌腱界面愈合过程的影响，实验对新西兰白兔左肩冈上肌腱行全层撕裂，随后5天进行2个绝对大气压下100%氧气治疗2h/d。结果表明，高压氧治疗可显著促进肩袖和肌腱骨之间界面的血管生成和肌腱胶原纤维再生，并提高肌腱-骨复合物的抗拉强度，且对生物力学稳定性没有明显影响。提示高压氧治疗对肌袖撕裂兔组织学和生物力学愈合都有显著的积极影响，可显著加快肌腱-骨的愈合过程。