{"id":{"repo_id":"auckland-ms","oai_identifier":"oai:researchspace.auckland.ac.nz:2292/64443"},"canonical_url":"https://search.dev.ndltd.org/etd/auckland-ms/oai:researchspace.auckland.ac.nz:2292/64443","repository":{"repo_id":"auckland-ms","name":"University of Auckland","base_url":"https://researchspace.auckland.ac.nz/server/oai/request"},"display":{"title":"Understanding factors affecting tendon healing: Characterising the role of obesity on tendon healing and homeostasis and augmenting its effects with growth factors","abstract":"Background: The burden of tendon disease is rising globally with an increasingly ageing and active population. Tears of rotator cuff tendons are common and result in substantial morbidity and healthcare costs. Recently, obesity has emerged as a key and potentially modifiable risk factor for impaired tendon healing. Aims: This thesis aimed to understand epidemiological trends in rotator cuff injuries in Aotearoa/New Zealand; characterise the contribution of obesity on tendon homeostasis and healing; and evaluate the efficacy of a novel growth factor treatment to improve tendon healing. Methods: A nationwide injury database was used to determine the epidemiological and economic impact of rotator cuff tears. Diet-induced obesity (DIO) in rodent models were used to investigate obesity’s effects on tendon homeostasis and healing after surgery and understand the impact of maternal diet on adult offspring tendon properties. The influence of body mass index (BMI) on tendon cell function was examined in vitro using cells isolated from patients undergoing rotator cuff surgery. Rat and ovine chronic rotator cuff tear models were used to evaluate the efficacy of a combination growth factor hydrogel to improve healing outcomes. Results: The costs of rotator cuff injuries are growing rapidly in Aotearoa/New Zealand, and disparities based on ethnicity, sex, and socio-economic status exist in treatment access. In pre-clinical models, DIO had negative effects on tendon cell and tissue properties, and on tendon healing. Dietary intervention failed to reverse these effects and circulating leptin levels correlated with poor healing outcomes. Growth factor treatments were effective at improving human tenocyte function independent of patient BMI in vitro. The combination growth factor hydrogel improved the quality of tendon healing in the rat model but had no effect in the ovine model. Conclusions: This thesis has better characterised the detrimental effects of obesity on tendon health and healing. The novel growth factor treatment holds promise for improving tendon healing however further optimisation is still required. Epidemiological trends identified here can be used to inform future healthcare strategies and promote more equitable care. Collectively, findings from this thesis have improved our understanding of several clinically relevant factors that affect tendon healing.","abstract_html":"Background: The burden of tendon disease is rising globally with an increasingly ageing and active population. Tears of rotator cuff tendons are common and result in substantial morbidity and healthcare costs. Recently, obesity has emerged as a key and potentially modifiable risk factor for impaired tendon healing. Aims: This thesis aimed to understand epidemiological trends in rotator cuff injuries in Aotearoa/New Zealand; characterise the contribution of obesity on tendon homeostasis and healing; and evaluate the efficacy of a novel growth factor treatment to improve tendon healing. Methods: A nationwide injury database was used to determine the epidemiological and economic impact of rotator cuff tears. Diet-induced obesity (DIO) in rodent models were used to investigate obesity’s effects on tendon homeostasis and healing after surgery and understand the impact of maternal diet on adult offspring tendon properties. The influence of body mass index (BMI) on tendon cell function was examined in vitro using cells isolated from patients undergoing rotator cuff surgery. Rat and ovine chronic rotator cuff tear models were used to evaluate the efficacy of a combination growth factor hydrogel to improve healing outcomes. Results: The costs of rotator cuff injuries are growing rapidly in Aotearoa/New Zealand, and disparities based on ethnicity, sex, and socio-economic status exist in treatment access. In pre-clinical models, DIO had negative effects on tendon cell and tissue properties, and on tendon healing. Dietary intervention failed to reverse these effects and circulating leptin levels correlated with poor healing outcomes. Growth factor treatments were effective at improving human tenocyte function independent of patient BMI in vitro. The combination growth factor hydrogel improved the quality of tendon healing in the rat model but had no effect in the ovine model. Conclusions: This thesis has better characterised the detrimental effects of obesity on tendon health and healing. The novel growth factor treatment holds promise for improving tendon healing however further optimisation is still required. Epidemiological trends identified here can be used to inform future healthcare strategies and promote more equitable care. Collectively, findings from this thesis have improved our understanding of several clinically relevant factors that affect tendon healing.","abstract_has_math":false,"creators":["Bolam, Scott Matthew"],"institution":"ResearchSpace@Auckland","degree_name":"PhD","degree_level":"Doctoral","degree_discipline":"Surgery.","degree_department":null,"school":null,"contributors":[],"advisors":["Munro, Jacob","Musson, David","Cornish, Jillian","Monk, Paul"],"committee_chairs":[],"committee_members":[],"year":2022,"date_issued":"2022","date_published":"2022","updated_at":"2026-07-24T01:03:37Z","subjects":[],"languages":[],"rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"rights_urls":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/2292/64443","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Munro, Jacob","Musson, David","Cornish, Jillian","Monk, Paul"]},{"key":"dc:creator","label":"Author","values":["Bolam, Scott Matthew"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2023-06-29T22:04:28Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2023-06-29T22:04:28Z"]},{"key":"dc:date.issued","label":"Date","values":["2022"]},{"key":"dc:publisher","label":"Institution","values":["ResearchSpace@Auckland"]},{"key":"dc:relation.isreferencedby","label":"Dc Relation Isreferencedby","values":["UoA"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Surgery."]},{"key":"thesis:degree_level","label":"Degree Level","values":["Doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["The University of Auckland"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."]},{"key":"dc:rights.uri","label":"Rights URI","values":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/2292/64443"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: The burden of tendon disease is rising globally with an increasingly ageing and active population. Tears of rotator cuff tendons are common and result in substantial morbidity and healthcare costs. Recently, obesity has emerged as a key and potentially modifiable risk factor for impaired tendon healing. Aims: This thesis aimed to understand epidemiological trends in rotator cuff injuries in Aotearoa/New Zealand; characterise the contribution of obesity on tendon homeostasis and healing; and evaluate the efficacy of a novel growth factor treatment to improve tendon healing. Methods: A nationwide injury database was used to determine the epidemiological and economic impact of rotator cuff tears. Diet-induced obesity (DIO) in rodent models were used to investigate obesity’s effects on tendon homeostasis and healing after surgery and understand the impact of maternal diet on adult offspring tendon properties. The influence of body mass index (BMI) on tendon cell function was examined in vitro using cells isolated from patients undergoing rotator cuff surgery. Rat and ovine chronic rotator cuff tear models were used to evaluate the efficacy of a combination growth factor hydrogel to improve healing outcomes. Results: The costs of rotator cuff injuries are growing rapidly in Aotearoa/New Zealand, and disparities based on ethnicity, sex, and socio-economic status exist in treatment access. In pre-clinical models, DIO had negative effects on tendon cell and tissue properties, and on tendon healing. Dietary intervention failed to reverse these effects and circulating leptin levels correlated with poor healing outcomes. Growth factor treatments were effective at improving human tenocyte function independent of patient BMI in vitro. The combination growth factor hydrogel improved the quality of tendon healing in the rat model but had no effect in the ovine model. Conclusions: This thesis has better characterised the detrimental effects of obesity on tendon health and healing. The novel growth factor treatment holds promise for improving tendon healing however further optimisation is still required. Epidemiological trends identified here can be used to inform future healthcare strategies and promote more equitable care. Collectively, findings from this thesis have improved our understanding of several clinically relevant factors that affect tendon healing."]},{"key":"dc:title","label":"Title","values":["Understanding factors affecting tendon healing: Characterising the role of obesity on tendon healing and homeostasis and augmenting its effects with growth factors"]}]}],"canonical_facts":{"dc:contributor.advisor":["Munro, Jacob","Musson, David","Cornish, Jillian","Monk, Paul"],"dc:creator":["Bolam, Scott Matthew"],"dc:date.accessioned":["2023-06-29T22:04:28Z"],"dc:date.available":["2023-06-29T22:04:28Z"],"dc:date.issued":["2022"],"dc:description.abstract":["Background: The burden of tendon disease is rising globally with an increasingly ageing and active population. Tears of rotator cuff tendons are common and result in substantial morbidity and healthcare costs. Recently, obesity has emerged as a key and potentially modifiable risk factor for impaired tendon healing. Aims: This thesis aimed to understand epidemiological trends in rotator cuff injuries in Aotearoa/New Zealand; characterise the contribution of obesity on tendon homeostasis and healing; and evaluate the efficacy of a novel growth factor treatment to improve tendon healing. Methods: A nationwide injury database was used to determine the epidemiological and economic impact of rotator cuff tears. Diet-induced obesity (DIO) in rodent models were used to investigate obesity’s effects on tendon homeostasis and healing after surgery and understand the impact of maternal diet on adult offspring tendon properties. The influence of body mass index (BMI) on tendon cell function was examined in vitro using cells isolated from patients undergoing rotator cuff surgery. Rat and ovine chronic rotator cuff tear models were used to evaluate the efficacy of a combination growth factor hydrogel to improve healing outcomes. Results: The costs of rotator cuff injuries are growing rapidly in Aotearoa/New Zealand, and disparities based on ethnicity, sex, and socio-economic status exist in treatment access. In pre-clinical models, DIO had negative effects on tendon cell and tissue properties, and on tendon healing. Dietary intervention failed to reverse these effects and circulating leptin levels correlated with poor healing outcomes. Growth factor treatments were effective at improving human tenocyte function independent of patient BMI in vitro. The combination growth factor hydrogel improved the quality of tendon healing in the rat model but had no effect in the ovine model. Conclusions: This thesis has better characterised the detrimental effects of obesity on tendon health and healing. The novel growth factor treatment holds promise for improving tendon healing however further optimisation is still required. Epidemiological trends identified here can be used to inform future healthcare strategies and promote more equitable care. Collectively, findings from this thesis have improved our understanding of several clinically relevant factors that affect tendon healing."],"dc:identifier.uri":["https://hdl.handle.net/2292/64443"],"dc:publisher":["ResearchSpace@Auckland"],"dc:relation.isreferencedby":["UoA"],"dc:rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"dc:rights.uri":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"dc:title":["Understanding factors affecting tendon healing: Characterising the role of obesity on tendon healing and homeostasis and augmenting its effects with growth factors"],"dc:type":["Thesis"],"thesis:degree_discipline":["Surgery."],"thesis:degree_level":["Doctoral"],"thesis:degree_name":["PhD"],"thesis:institution_name":["The University of Auckland"]},"updated_at":"2026-07-24T01:03:37Z"}