Selective Serotonin Reuptake Inhibitor Promotes Bone-Tendon Interface Healing in a Rotator Cuff Tear Rat Model

Abstract

Background: Selective serotonin reuptake inhibitor (SSRI) is believed to accelerate wound healing, and thus expected to have a positive effect on rotator cuff repair. We hypothesized that SSRI has a positive effect on the healing of the bone-tendon interface (BTI), and improved rotator cuff tear healing would be confirmed by mechanical strength measurements and histological assessment of the restored tendon. Methods: The study used 40 adult male Sprague-Dawley wild-type rats. The animals were divided into two groups: group-SSRI, the supraspinatus repair with SSRI injection group, and group-C, conventional supraspinatus repair only without SSRI. Biomechanical and histological analyses were performed 8 weeks after index rotator cuff surgery. Results: The ultimate load (N) was significantly higher in group-SSRI than in group-C (54.8 +/- 56.9 Vs 25.1 +/- 11.1, p = .031). In the histological evaluation, the Bonar score confirmed significant differences in collagen fiber density (group-C: 0.6 +/- 0.5, group-SSRI: 1.1 +/- 0.6, p = .024), vascularity (group-C: 0.1 +/- 0.2, group-SSRI: 0.3 +/- 0.4, p = .024) and cellularity (group-C: 1.7 +/- 0.4, group-SSRI: 2.0 +/- 0.0, p = .023) between the groups. Based on the total score, group-SSRI was significantly better compared with group-C (6.3 +/- 2.7 Vs 4.3 +/- 1.9, p = .019). Conclusion: Our study demonstrated that SSRI could facilitate improved biomechanical and histological outcomes 8 weeks after rotator cuff repair in a rat model. Consequently, SSRI may improve healing after rotator cuff repair.