Postoperative Exercise Modulating Gut Microbiota and Associated Metabolites to Facilitate Bone-Tendon Healing in Rotator Cuff Tears

ABSTRACT:

Background: Rotator cuff tear (RCT) is a prevalent shoulder injury, and postoperative exercise is considered to facilitate RCT healing. However, the effect of postoperative exercise on RCT healing through gut microbiota and metabolites remains unclear.

Method: The control (con) group (n=10) underwent sham surgeries, while the model (mod) and postoperative exercise (sport) groups (each n=10) underwent supraspinatus tendon repair surgeries, and the supraspinatus tendon-humerus complex, fecal, and serum samples were collected.

Results: Synchrotron radiation micro-CT and histological studies indicated that postoperative exercise markedly reduced bone loss and promoted new bone formation at tendon-bone sites. Gut microbiome profiling revealed that exercise significantly reshaped microbial composition, with increased p__Parabacteroides and g__Dubosiella, and decreased g__Lachnoclostridium and g__Allobaculum in the sport group compared with the model group. PICRUSt prediction showed that the HIF-1 signaling pathway and β-Alanine metabolism were notably enriched following exercise. Network correlation analysis suggested that g__Dubosiella functioned as a central taxon within the microbial community. Metabolomics suggested that exercise altered metabolite abundances like Val-Pro-Asp-Pro-Arg, impacting pathways like Gap junction. Moreover, metabolomics further identified β-Alanine metabolism as the key overlapping pathway connecting microbial alterations with serum metabolic changes, with β-alanyl-L-arginine as a representative metabolite. Seven microbe–metabolite pairs showed significant correlations. Among them, g__Parabacteroides exhibited strong associations with multiple metabolites, including cycloheptyl derivatives, and demonstrated predictive value for tendon–bone healing (AUC = 0.88).

Conclusion: Postoperative exercise following RCT repair surgery modulates gut microbiota and metabolites, potentially enhancing RCT healing. This finding provides insights into integrating postoperative exercise into RCT recovery strategies.

INSTRUMENT(S): Liquid Chromatography MS - negative - reverse-phase, Liquid Chromatography MS - positive - reverse-phase

PROVIDER: MTBLS13894 | MetaboLights | 2026-03-03

REPOSITORIES: MetaboLights