Effect of Recombinant Human Parathyroid Hormone on Rotator Cuff Healing After Arthroscopic Repair

Abstract

To assess the effect of teriparatide, a recombinant human parathyroid hormone, on rotator cuff healing after arthroscopic repair compared with patients who were not treated with teriparatide. This was a prospective propensity-matched study. Thirty-one patients who underwent arthroscopic rotator cuff repair for tears >2cm in size between January 2015 and June 2016 were recruited (group I). Daily subcutaneous injections of teriparatide 20μg were administered for 3months following surgery. In the same period, propensity score matching (1-to-4) was performed to generate an untreated control group undergoing rotator cuff repair alone (group II) with the same tear size. Magnetic resonance imaging evaluation of tendon healing was performed at least 1year postoperatively, as well as the range ofshoulder motion, American Shoulder and Elbow Surgeons score, Constant score, and simple shoulder test. There was no significant difference of the retraction size, the anterior to posterior dimension of torn rotator cuff, or the preoperative bone mineral density in groups I and II (P= .78, .87, and .96, respectively). The rate of retear was significantly lower in group I than in group II (16% vs 33.9%; P= .04). Range of motion and functional scores were not significantly different between the 2 groups (P > .05). Teriparatide, a recombinant human parathyroid hormone, can be a systemic treatment option that significantly enhances the tendon-to-bone healing after arthroscopic rotator cuff repair for patients with rotator cuff tears >2cm. Level III, case-control study.