The science of rotator cuff tears: translating animal models to clinical recommendations using simulation analysis |
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Authors: | Sandeep Mannava Johannes F Plate Christopher J Tuohy Thorsten M Seyler Patrick W Whitlock Walton W Curl Thomas L Smith Katherine R Saul |
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Institution: | 1. Department of Orthopaedic Surgery, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1070, USA 2. The Neuroscience Program, Medical Center Boulevard, Wake Forest University Graduate School of Arts and Sciences, Winston-Salem, NC, 27157-1070, USA 3. Department of Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA 4. Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
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Abstract: | Purpose The purpose of this article is to review basic science studies using various animal models for rotator cuff research and to describe structural, biomechanical, and functional changes to muscle following rotator cuff tears. The use of computational simulations to translate the findings from animal models to human scale is further detailed. Methods A comprehensive review was performed of the basic science literature describing the use of animal models and simulation analysis to examine muscle function following rotator cuff injury and repair in the ageing population. Results The findings from various studies of rotator cuff pathology emphasize the importance of preventing permanent muscular changes with detrimental results. In vivo muscle function, electromyography, and passive muscle–tendon unit properties were studied before and after supraspinatus tenotomy in a rodent rotator cuff injury model (acute vs chronic). Then, a series of simulation experiments were conducted using a validated computational human musculoskeletal shoulder model to assess both passive and active tension of rotator cuff repairs based on surgical positioning. Conclusion Outcomes of rotator cuff repair may be improved by earlier surgical intervention, with lower surgical repair tensions and fewer electromyographic neuromuscular changes. An integrated approach of animal experiments, computer simulation analyses, and clinical studies may allow us to gain a fundamental understanding of the underlying pathology and interpret the results for clinical translation. |
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