Shoulder1.com: Great Information, Real Community, Better Living.
 Register
 Login
 Main Page
 Shoulder News
Feature Story
Shoulder Technology
Real Life Recoveries
 Education Center
Conditions
Procedures
 Shoulder  Hero™
Dr. Evan Flatow:
Innovating Shoulder Surgery
About Heroes
 Join the Discussion in  Our Forums
 Community
Shoulder1 Forums
Patient Stories
Shoulder Journals
 Reference
Ask an Expert
FAQ's
Locate a Doctor
Reference Library
Anatomy
Video Library
 Bookmark Us
 
advertisement
Search the Body1 Network
March 03, 2021  
SHOULDER NEWS: Feature Story

  • Print this Article
  • Email this Article
  • Links/Reprints
  • Steroids and Exercise May Improve Rotator Cuff

    Steroids and Exercise May Improve Recovery of Rotator Cuff Tears


    July 15, 2004

    By Stephanie Riesenman for Shoulder1

    In a novel study, a combination of anabolic steroids and exercise has been shown to speed up and improve recovery of bioengineered rotator cuff tendons, leading researchers to believe the same regimen could improve surgical repair of massive or recurrent rotator cuff tears of the shoulder.

    Such injuries are common in high-performance athletes, but also in the so-called "weekend warriors," particularly older athletes.

    "Give the difficulty attaining uniformly good results in massive or recurrent postsurgical rotator cuff tears, it is reasonable to consider adjunctive methods to enhance the repair and healing process in these difficult clinical problems," wrote the researchers.

    Their study is published in the June issue of the American Journal of Sports Medicine.

    The research was conducted at the University of North Carolina, Chapel Hill and was led by Dr. Spero Karas, assistant professor of orthopedic surgery in UNC’s School of Medicine. Dr. Karas extracted samples of tendon from 6 patients — 5 men and 1 woman — with an average age of 52 years, while surgically repairing tears of their shoulders’ rotator cuff tendons. In a lab, the tissues were ground up to release the cells, which were put in a plate of collagen gel and allowed to grow.

    Next, the bioengineered tendons were tested under 4 different conditions. No steroid was added to the first tissue group, and it was not manipulated to limit exercise. The second group was treated with the steroid, nandrolone decoanate, but again was not allowed to exercise. The thirds group underwent stretch to simulate exercise, but was not treated with the steroid. Finally, the fourth group of artificial tendon was treated with the steroid and was stretched to simulate exercise.

    The bioengineered tendons were examined daily for 7 days to estimate their rate of growth and remodeling. During the first 2 days all samples showed a rapid decrease in width and surface area. By the fourth day the steroid-exercise group showed a much greater decrease in width compared to the other groups. And by the seventh day the steroid-exercise group had the lowest values for surface area and the greatest decrease in width.

    The highest level of actin fiber elongation—which maintains the tendon’s integrity was highest in the steroid-exercise group. This tissue also had a more organized cytoskeleton—which makes up the structure of the tendon and maintains its flexibility.

    MMP-3 is an important enzyme in tissue degradation, re-growth, and repair. High levels of MMP-3 have been associated with cartilage destruction in osteoarthritis. In the study, the steroid-exercise group demonstrated the earliest increase and highest levels of MMP-3, suggesting accelerated tissue repair. However, by the sixth day, levels of MMP-3 in all 4 groups returned to baseline.

    When the researchers ran biomechanical tests on the tendon samples they found that the steroid-exercise group demonstrated significantly greater stress and strain and had higher energy absorption that the other groups.

    Overall, the researchers concluded that the bioartificial tendon, treated with steroids and then mechanical strain, were smaller, stronger, denser, and more elastic and had better biomechanical and remodeling properties than untreated artificial tendon. They also said they formed a more normal looking tendon than the untreated group, which had a more disorganized structure.

    The clinical application of this research is that the synergistic effect of steroids and exercise may improve the characteristics of tendon—particularly in shoulders that have atrophied tendons or rotator cuffs that have been torn for a long time. Dr. Karas also suggested the possibility of using bioengineered tendon when human tissue is deficient following large rotator cuff tears.

    Future studies will examine the long term effects of steroids and exercise on tendon stability, said the researchers.

    "Increasing the time between treatment and analysis, or increasing the time of treatment with anabolic steroid and load (exercise), will be another avenue of study to determine whether the effects will remain significant over a long period of time," wrote the researchers.

    Last updated: 15-Jul-04

    Comments

  • Add Comment
  •    
    Interact on Shoulder1

    Discuss this topic with others.
     
    Feature Archives

    Protein Appears to Protect Against Bone Loss in Arthritis

    Risk Factors Identified for Little League Shoulder

    Orthopedic outcomes affected by activity level

    Understanding the Full Impact of Treatments is Important for Patients with Rotator Cuff Injury

    Joint Replacement Surgery Could Become A Thing Of The Past With New Theory On Genesis Of Osteoarthritis

    Next 5 Features ...

    More Features ...
       
     
    Related Multimedia

    Interview with Dr. Andrews

    The Importance of the Shoulder - Interview with Dr. Andrews

    More Features ...
     
    Related Content
    John Kerry Undergoes Shoulder Surgery

    FDA OKs New Rheumatoid Arthritis Drug

    Jeter Dislocates Shoulder on Opening Day

    Swimmers and Their Shoulders

    Arthritis Cases in Missouri Up Dramatically

    More Features ...
     
    Home About Us Press Jobs Advertise With Us Contact Us
    advertisement
    © 2021 Body1 All rights reserved.
    Disclaimer: The information provided within this website is for educational purposes only and is not a substitute for consultation with your physician or healthcare provider. The opinions expressed herein are not necessarily those of the Owners and Sponsors of this site. By using this site you agree to indemnify, and hold the Owners and Sponsors harmless, from any disputes arising from content posted here-in.