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      Botulinum toxin is detrimental to repair of a chronic rotator cuff tear in a rabbit model.

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          Abstract

          Re-tear continues to be a problem after rotator cuff repair. Intramuscular botulinum toxin (Botox) injection can help optimize tension at the repair site to promote healing but could have an adverse effect on the degenerated muscle in a chronic tear. We hypothesized that Botox injection would improve repair characteristics without adverse effect on the muscle in a chronic rotator cuff tear model. The supraspinatus tendon of both shoulders in 14 rabbits underwent delayed repair 12 weeks after transection. One shoulder was treated with intramuscular Botox injection and the other with a saline control injection. Six weeks after repair, outcomes were based on biomechanics, histology, and magnetic resonance imaging. Botox-treated repairs were significantly weaker (2.64 N) than control repairs (5.51 N, p = 0.03). Eighty percent of Botox-treated repairs and 40% of control repairs healed with some partial defect. Fatty infiltration of the supraspinatus was present in all shoulders (Goutallier Grade 3 or 4) but was increased in the setting of Botox. This study provides additional support for the rabbit supraspinatus model of chronic cuff tear, showing consistent fatty infiltration. Contrary to our hypothesis, Botox had a negative effect on repair strength and might increase fatty infiltration.

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          Author and article information

          Journal
          J. Orthop. Res.
          Journal of orthopaedic research : official publication of the Orthopaedic Research Society
          1554-527X
          0736-0266
          Aug 2015
          : 33
          : 8
          Affiliations
          [1 ] Department of Orthopaedics, University of Maryland, Maryland, Baltimore.
          Article
          10.1002/jor.22836
          25626677
          47758690-58c9-4eed-8c6a-347d69b7affb
          © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
          History

          botulinum toxin,chronic rotator cuff tear,fatty infiltration,rabbit model,rotator cuff repair

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