Effect of intramuscular botulinum toxin-A in a rat rotator cuff repair model: an experimental study

Abstract

Objective: Rotator cuff repair is associated with multiple complications, significant morbidity, and re-intervention, which could be mitigated by postoperative chemodeneveration with botulinum toxin-A (BTX-A). This study evaluated the antinociceptive and paralytic effects of BTX-A on an experimental supraspinatus repair rat model and its effect on functional outcomes (running performance).
Methods: Thirty rats were grouped into the surgical repair group (group A), repair + intramuscular BTX-A group (group B), or control group (group C). At the end of the 3-month follow-up, running performance of the rats on a motorized treadmill was evaluated in four time periods (0–30 min, 30–60 min, 60–90 min, and 90–110 min), and penalty points (i.e., number of shock stimuli per lane) were recorded. Afterwards, the supraspinatus muscles were removed and evaluated histologically.
Results: Regarding running performance, group B received significantly fewer penalty points than did group A (p<0.05). The penalty points received were not significantly different between groups B and C in the first three time periods, but were significantly higher in group B at the 90–110-min interval than in group C. On necropsy, all repaired tendons were intact, with no sign of failure at the repair site. Histological evaluation revealed marked degeneration and necrosis of muscles in both repair groups, which was much less evident in group B. Groups A and B had less fatty infiltration than group C.
Conclusion: BTX-A injections resulted in a better function based on running performance, probably due to decreased tissue tension at the repair site and less pain. Further studies on humans are needed to demonstrate this effect clinically.

 

DOI: 10.3944/AOTT.2015.14.0296

Keywords

• Animal study, antinociceptive effect; botulinum toxin A (BTX-A); rotator cuff injury; shoulder rehabilitation.

İntramüsküler botulinum toksin-a’nın etkisi: sıçan rotator manşet tamir modelinde deneysel bir çalışma

Öz

Giriş: Bu çalışmada, deneysel olarak oluşturulan supraspinatus tamir modelinde Botulinum toxin- A (BTX-A)’ nın antinosiseptif (ağrı azaltıcı) ve paralitik özellikleri değerlendirildi ve sıçanların koşu performansına olan etkisi araştırıldı.

Metodlar: 30 adet sıçan, tamir grubu (Grup A), tamir + intramüsküler BTX-A grubu (grup B) ve kontrol grubu (grup C) olarak üç adet sınıfa ayrıldı. Üç aylık takip sonrasında, sıçanların motorlu koşu bandı üzerinde koşu performansı dört zaman dilimli egzersiz protokolü uygulanarak (0-30 dk., 30-60 dk., 60-90 dk., 90-110 dk.) değerlendirildi ve ceza puanları kaydedildi. Sonrasında supraspinatus kasları ayrılarak histolojik açıdan incelendi.

Sonuçlar: Koşu performansına göre değerlendirildiğinde, B grubu, A grubuna göre anlamlı şekilde daha az ceza puanı aldı (p<0, 05). İlk üç zaman dilimine bakıldığında B grubu ve C grubu arasında ceza puanı açısından anlamlı bir fark bulunmadı. 90-110 dk zaman dilimine bakıldığında B grubu sıçanlar C grubuna göre daha fazla ceza puanı aldılar ve anlamlı bir fark olduğu görüldü. Nekropsi sırasında tamir edilen tüm tendonların sağlam olduğu görüldü ve tamir alanında bozulma izlenmedi. Histolojik değerlendirmede B grubunda daha az olmakla beraber her iki tamir grubunda da kasların dejenere ve nekroze olduğu görüldü. A ve B grubunda yağ infiltrasyonu daha azdı.

Çıkarımlar: Botulinum toxin- A (BTX-A)’ nın antinosiseptif (ağrı azaltıcı) ve paralitik etkisi koşu performansının daha iyi olmasına sebep olmuştur. Bu durum tamir alanında doku gerginliğinin ve ağrının daha az olması ile ilişkilendirilebilir. Klinikte etkisini görmek için birçok insan çalışmasına ihtiyaç vardır.

Anahtar kelimeler: Botulinum toxin A (BTX-A), rotator manşet yaralanması, omuz rehabilitasyonu, hayvan çalışması.

 

DOI: 10.3944/AOTT.2015.14.0296

Bu özet, makalenin henüz redaksiyonu tamamlanmamış haline aittir ve bilgi verme amaçlıdır. Yayın aşamasında değişiklik gösterebilir.

Anahtar Kelimeler

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