Variation in Humeral Head Bone Marrow Characteristics and Their Associations with Rotator Cuff Repair Healing

项目摘要 肩袖修复(RCR)后的愈合仍然是一个重大的临床挑战，修复失败率为20%- 30%的人继续被报道。到目前为止，人们只把有限的注意力集中在了解 机械因素可能导致RCR后不同的愈合率。这项建议的目的是 RCR患者肱骨头骨髓变异性的量化及预后检验 结缔组织前体细胞的局部浓度对肌腱愈合的意义。我们的方法 将招募50名接受RCR的患者。在RCR的时候，将从RCR的 用于定量祖细胞分析的肱骨头。将收集肌腱修复足迹的核心活组织检查 用于骨髓成分的组织学分析。肌腱愈合情况将通过MRI(Sugaya评分)在 6个月随访，大部分再撕裂发生骨髓变异的时间段 将描述患者的特征(目标1)及其与肩袖肌腱愈合的相关性 被调查(目标2)。该提案寻求将研究范式转变为内在的患者生物学 因素，一个基本的和未被研究的潜在的RCR愈合预后因素领域。 证明与RCR后再撕裂相关的肱骨头特征将支持未来的工作 开发工具以筛选患者骨髓以预测RCR成败和进展的特征 促进祖细胞局部浓缩或移植以增加RCR的新方法。

Project Summary Healing following rotator cuff repair (RCR) remains a significant clinical challenge, and repair failure rates of 20- 30% continue to be reported. To date limited attention has been directed toward understanding how intrinsic mechanistic factors may contribute to variable healing rates following RCR. The objective of this proposal is to quantify the variability of the humeral head bone marrow in patients undergoing RCR and test the prognostic significance of the local concentration of connective tissue progenitors (CTPs) for tendon healing. Our approach will be to enroll 50 patients undergoing RCR. At the time of RCR, 8 ml of bone marrow will be aspirated from the humeral head for quantitative progenitor cell assays. A core biopsy at the tendon repair footprint will be collected for histologic analysis of bone marrow composition. Tendon healing will be assessed by MRI (Sugaya score) at 6 months follow-up, the timeframe in which majority of re-tears occur The variation of bone marrow characteristics among patients will be described (Aim 1) and their correlation with rotator cuff tendon healing will be investigated (Aim 2). The proposal seeks to shift the investigational paradigm to intrinsic patient biologic factors, a fundamental and under-investigated realm of potential prognostic factors of RCR healing. Demonstrating that humeral head characteristics associate with re-tear after RCR will support future work to develop tools to screen patient bone marrow for characteristics predictive of RCR success or failure and advance novel methods that promote local enrichment or transplantation of progenitor cells to augment RCR.