Effects of Hyaluronic Acid and Steroid on Supraspinatus Tendon Fibroblasts from Patients with Rotator Cuff Tear

Abstract

In clinical settings, intra-articular injections of hyaluroni acid (HA) and steroid are frequently used in conservative treatments in patients with rotator cuff tear. This study was undertaken to examine the effects of HA and steroid on cell toxicity in tendon fibroblasts from patients with rotator cuff tear. Seven patients with full-thickness rotator cuff tear were subjects for this study, with the average age of 56 years. Specimens of the supraspinatus tendon were obtained during arthroscopic surgery. The specimens were cut and cultivated in DMEM, and second and third passage cells were used. The tendon fibroblasts were cultured in the presence of HA (Artz^®,1.0mg/ml) or various concentrations of steroid (Rinderon^®, 2.5-10mg/ml) for 24 hrs. After stimulation, the cell toxicity was examined using Live-Dead Cell Staining Kit^®(Bio Vision), and observed by confocal laser scanning microscopy. As control, the cells were cultured exclusively with 1% DMEM. There appeared to be none/minimal cell toxic effects in HA, while the considerably stronger effects were found in steroid with the dose-dependent manner. Both HA and steroid have anti-inflammatory effects, and are utilized for the treatment of rotator cuff tears. Our data demonstrated that cell toxicity was none/extremely-minimal in the HA-treated fibroblasts, but enormous in the steroid-treated fibroblasts; however the toxic effects were decreased dose-dependently. On the basis of these findings, use of HA/low-concentration steroid may be more favorable for cases in which the intra-articular use of anti-inflammatory agents is needed.