ascorbic-acid and Rotator-Cuff-Injuries

One of the complications after rotator cuff repair is a tendon non-healing. It has already been posited in the literature that vitamin C (VC) promotes tendon healing through its antioxidant properties and its role as a cofactor in collagen synthesis. The aim of this study was to evaluate the effect of postoperative VC supplementation on the tendon healing following repair.. This randomized monocentric prospective study included 98 patients who underwent arthroscopic rotator cuff repair in 1-year period and follow-up ultrasound 6 months postoperatively. The cohort was divided into two groups: the VC+ group (500 mg/day PO for 45 days postoperatively) and the VC- group (no supplementation). The evaluation criterion was tendon healing at 6 months postoperatively according to the Sugaya ultrasound classification. Preoperative and postoperative clinical evaluations were based on active mobilities, the Constant score and the subjective shoulder value.. There was no difference in term of postoperative outcomes between the two groups. At an average follow-up of 6.3 months, the non-healing rate in the overall population was 17%. This rate was higher in VC- compared to VC+, respectively, 23% vs. 11%), p = 0.2.. This study showed a trend to improve tendon healing after rotator cuff repair with VC supplementation. However, a prospective study with a larger patient population should be conducted to confirm this finding.

Topics: Arthroscopy; Ascorbic Acid; Dietary Supplements; Humans; Magnetic Resonance Imaging; Prospective Studies; Rotator Cuff; Rotator Cuff Injuries; Treatment Outcome

Oxidative stress inhibits tendon-to-bone healing after rotator cuff repair. Regulation of oxidative stress has the potential to accelerate this healing, but its mechanism remains unclear.. To investigate the effects of reducing oxidative stress by applying antioxidants, such as. Controlled laboratory study.. A total of 48 Sprague Dawley rats underwent bilateral surgery to repair the infraspinatus tendon to its insertion site 1 week after detachment. Rats were assigned to either the NAC group, the VC group, or a control group. Histological evaluation was performed via hematoxylin-eosin or toluidine blue staining, and oxidative stress was assessed via dihydroethidium intensity and protein carbonyl concentration at 3 and 6 weeks. Superoxide dismutase 1 (SOD1), SOD2, SOD3, peroxiredoxin 5, collagen type I (COL1), COL3, matrix metalloproteinase 1 (MMP-1), MMP-3, and MMP-13 expression and SOD activity were determined at 3 and 6 weeks. Biomechanical tests were performed at 6 and 12 weeks.. Histological evaluation showed that the number of chondrocytes in the NAC group at 6 weeks and in the VC group at 3 and 6 weeks, the area of fibrocartilage at 6 weeks in the VC group, and collagen fibers at 6 weeks in the NAC and VC groups were significantly increased compared with those in the control group. Dihydroethidium intensity at 3 and 6 weeks and protein carbonyls at 6 weeks in the NAC and VC groups were significantly decreased. SOD1 expression and SOD activity at 3 weeks in the VC group and peroxiredoxin 5 expression at 6 weeks in the NAC group were significantly upregulated compared with that in the control group. COL3 expression was significantly upregulated at 6 weeks in the VC group, and MMP-13 expression was significantly decreased at 6 weeks in the NAC and VC groups. The biomechanical strength showed no significant difference.. Antioxidant treatment, via NAC or VC administration, reduced oxidative stress in the rotator cuff repair site and accelerated healing.. These findings provide essential indications to develop clinical strategies for improved healing after rotator cuff surgical repair in patients.

Topics: Acetylcysteine; Animals; Ascorbic Acid; Biomechanical Phenomena; Collagen; Matrix Metalloproteinase 13; Rats; Rats, Sprague-Dawley; Rodentia; Rotator Cuff; Rotator Cuff Injuries; Superoxide Dismutase-1; Tendons; Wound Healing

Topics: Ascorbic Acid; Humans; Rotator Cuff; Rotator Cuff Injuries; Vitamins; Wound Healing

Topics: Arthroscopy; Ascorbic Acid; Dietary Supplements; Humans; Rotator Cuff; Rotator Cuff Injuries; Wound Healing