Superior fulcrum reconstruction using autologous peroneus longus tendon for irreparable massive rotator cuff tears in rabbits: A comparative study.

BackgroundThe autologous peroneus longus tendon (PLT), which is a common graft in sports medicine. However, superior fulcrum reconstruction (SFR) using autologous PLT for irreparable massive rotator cuff tears (IMRCT) have not been reported. The objective of this study is to histologically evaluate the effect of the SFR using autologous PLT on tendon-to-bone healing.Methods30 mature New Zealand white rabbits were used in this study, and were used to build the model of irreparable massive rotator cuff tears, which were randomly divided into two groups of 15 rabbits in each group, with superior fulcrum reconstruction (SFR group) and superior capsule reconstruction (SCR group). Five rabbits in each group were sacrificed at 4, 8 and 12 weeks postoperatively for histological assessment.ResultsIn the histological analysis, there was no significant difference in the modified tendon maturation scoring system and semiquantitative evaluation of the cartilage staining area at 4 weeks. For 8 weeks and 12 weeks, SFR group confirmed a higher scoring level than SCR group. In the Immunohistochemical evaluation, the SFR group showed better angiogenesis and higher expression of collagen I compared to the SCR group at 8 weeks and 12 weeks.ConclusionThe superior fulcrum reconstruction using autologous PLT can promote a better biological healing process. It could be used as a clinical option for irreparable massive rotator cuff tears.