{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:40:38Z","timestamp":1785426038172,"version":"3.56.0"},"reference-count":41,"publisher":"Open Medical Publishing","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"introduction\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>As rotator cuff repairs (RCRs) are among the most common procedures in upper extremity orthopedics, healing augmentation using pharmacologic enhancement of the repaired rotator cuff muscle is of particular interest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The purpose of this study is to review the current understanding of Matrix Metalloproteinases (MMPs), Doxycycline, Testosterone, Estrogen, Growth hormone\/ IGF-1, Vitamin D, and Vitamin C as a means to mitigate deleterious effects and propagate factors that support healing following RCR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A review of English language articles in PubMed and Medline was conducted in December of 2020. All articles describing the current understanding of the aforementioned therapies were reviewed. Studies were excluded if they were non-English or reported incomplete results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Matrix metalloproteinases (MMP\u2019s) are fundamental to the healing process after rotator cuff tears through a delicate balance of various proteases that can be modulated by doxycycline through inhibition. While testosterone has shown to induce replication and differentiation of the tendon stem-cells, estrogen agonists have been shown to decrease inflammation and muscle atrophy. Though growth hormone being associated with elevated collagen synthesis and decreased anoxic damage when present, clinical studies have shown inconclusive and adverse effects on rotator cuff healing. Patients with Vitamin D deficiency have shown to have increased fatty infiltration in rotator cuff muscle while Vitamin C functions as an antioxidant that increases collagen and fibroblast proliferation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As manipulation of pharmacologic factors shows potential for enhancing healing following RCRs, future studies are needed to establish a viable augmentation strategy to improve patient outcomes<\/jats:p>\n                  <\/jats:sec>","DOI":"10.52965\/001c.37782","type":"journal-article","created":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T23:43:11Z","timestamp":1662248591000},"source":"Crossref","is-referenced-by-count":11,"title":["Pharmacologic Enhancement of Rotator Cuff Repair: A Narrative Review"],"prefix":"10.52965","volume":"14","author":[{"given":"Maksim","family":"Vaysman","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03cc0mm23","id-type":"ROR","asserted-by":"publisher"}],"name":"Nassau University Medical Center","department":["Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Alben","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Nassau University Medical Center; Osteopathic Medicine, New York Institute of Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Todd","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Nassau University Medical Center; Osteopathic Medicine, Des Moines College of Osteopathic Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Ruotolo","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03cc0mm23","id-type":"ROR","asserted-by":"publisher"}],"name":"Nassau University Medical Center","department":["Orthopedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"30777","published-online":{"date-parts":[[2022,9,4]]},"reference":[{"issue":"5","key":"ref1","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1177\/0363546503262200","article-title":"Matrix metalloproteinase and tissue inhibitor of matrix metalloproteinase mRNA levels are specifically altered in torn rotator cuff tendons","volume":"32","author":"Ian K. 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