This article is more than 5 years old. Information may no longer be current.
Chemical changes at heart of rotator cuff tendon tear pathology
Click Here to Manage Email Alerts
MADRID — The onset of rotator cuff tendon tear pathology is mainly due to an alteration of collagenous structural arrangements with associated changes in lipids and carbohydrates, according to a recently presented study.
The findings, obtained through analysis via Fourier transform infrared (FTIR) spectroscopy, were presented by Salma Chaudhury, MB, BChir, MA, MRCS, at the EFORT Congress 2010, here.
Chaudhury reported that partial tears show an early onset of chemical changes — particularly in collagen III — which could be used to identify earlier stages of disease.
“We believe that the key to understanding and reducing failure rates is understanding the biology that is underpinning it, so we can then direct our treatments appropriately,” she said. “Ideally, if we could identify biomarkers, we could not only identify the disease earlier but perhaps … identify which patients are likely to have poorer outcomes.”
Tissue spectra collection
Fourier transform infrared spectroscopy can, Chaudhury said, provide unique biochemical fingerprints of tissue specimens. Molecules are excited to higher vibrational states at specific wavelengths, and researchers use this process to identify the chemical composition of tissues.
Chaudhury’s team measured the chemical composition of 55 formalin-fixed rotator cuff tendons from patients aged 20 to 89 years. Torn cuffs were classified according to size, with 10 each of small, medium, large and massive tears. Five partial tears were also assessed, and all were compared to 10 uninjured rotator cuff tendons.
Spectra were collected with a diamond-attenuated total reflectance accessory in conjunction with an FTIR spectrometer, then reduced and classified using standard multivariate analysis.
Clear differentiations
Chaudhury said the hierarchal cluster demonstrated that normal and torn tendons could be clearly differentiated and that rotator cuff tendons could also be distinguished by their tear size. In addition, partial tears were “clearly distinguishable” from normal rotator cuff tendons.
The team used a genetic algorithm to identify spectral regions of importance that accounted for most of the features that discriminated between normal and torn tendons:
- 1,030 cm-1 to 1,200 cm-1: carbohydrates, phospholipids;
- 1,300 cm-1 to 1,700 cm-1, 3,000 cm-1 to 3,350 cm-1: collagenous structural conformation; and
- 2,800 cm-1 to 3,000 cm-1: lipids.
“We have shown that this technique can differentiate normal from different torn rotator cuff tendons, but also that partial tears are shown only with certain chemical changes,” Chaudhury said, adding that the technique could be used intraoperatively to help physicians determine the quality of the tendon and extent of disease as well as assist in the guidance of surgical repairs and monitoring of disease progression or response to treatments. – by Robert Press
Reference:
- Chaudhury S, Dicko C, Vollrath F, Carr A. Identifying differentiating features between normal and torn rotator cuff tendons using Fourier transform infrared spectroscopy. Paper F683. Presented at the 2010 EFORT Congress. June 2-5, 2010. Madrid.
- Salma Chaudhury, MB, BChir, MA, MRCS, can be reached at Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Center, Oxford, OX3 0BA, United Kingdom; +0(44)1865 737 834; e-mail: salmachaudhury@doctors.org.uk.
