Biologic approaches to enhance rotator cuff healing after injury

Isaac, Christian; Gharaibeh, Burhan; Witt, Michelle R.; Wright, Vonda J.; Huard, Johnny

doi:10.1016/j.jse.2011.10.004

Cited by 119 publications

(94 citation statements)

References 65 publications

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“…By performing in vivo studies using the rabbit subscapularis tendon, histologic analysis coupled with biomechanical testing can be used to elucidate which repair techniques would ultimately result in improved healing of the rotator cuff. Furthermore, there is growing interest in the efficacy of biologic augmentation with platelet-rich plasma, bone marrow aspirate, growth factor supplements, scaffolds, and gene-modified cell therapy for enhancing intrinsic healing potential of repaired tendons [25,30,37], which could also be studied with this model. In conclusion, commonly used rotator cuff repair techniques can be recreated in the rabbit subscapularis with relative Time 0 results similar to human cadaveric data.…”

Section: Discussionmentioning

confidence: 99%

Relative Fixation Strength of Rabbit Subscapularis Repair Is Comparable to Human Supraspinatus Repair at Time 0

Otarodifard

Wong

Preston

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Recent evidence suggests that the rabbit subscapularis tendon may be anatomically, biomechanically, and histologically suitable to study rotator cuff pathology and repair. However, biomechanical comparisons of rotator cuff repairs in this model have not been evaluated and compared to those in human cadaveric specimens. Questions/purposes We quantified the biomechanical properties of the repaired rabbit subscapularis tendon after (1) single-row, (2) double-row, and (3) transosseousequivalent rotator cuff repair techniques and compared the ratios of repairs to previously published data for human repairs.Methods Tensile testing was performed on 21 New Zealand White rabbit subscapularis tendon-humerus complexes for single-row repair, double-row repair, and transosseous-equivalent repair (n = 7 for each group). Video digitizing software was used to quantify deformation. Load elongation data were then used to quantify structural properties. We compared the ratios of rotator cuff repairs for the rabbit data to data from human supraspinatus repair studies previously performed in our laboratory. For our primary end points (linear stiffness, yield load, ultimate load, and energy absorbed to failure), with the numbers available, our statistical power to detect a clinically important difference (defined as 15%) was 85%. Results The ratios of single-row/double-row repair were 0.72, 0.73, 0.71, and 0.66 for human supraspinatus and 0.77, 0.74, 0.79, and 0.89 for rabbit subscapularis repair for linear stiffness, yield load, ultimate load, and energy absorbed to failure, respectively. The ratios of double-row/transosseousequivalent repair were 1.0, 0.86, 0.70, and 0.41 for human supraspinatus and 1.22, 0.85, 0.76, and 0.60 for rabbit subscapularis for linear stiffness, yield load, ultimate load, and energy absorbed to failure, respectively. There were no differences comparing rabbit to human repair ratios for any parameter (p [ 0.09 for all comparisons). Conclusions Subscapularis repairs in the rabbit at Time 0 result in comparable ratios to human supraspinatus repairs. Clinical Relevance The biomechanical similarities between the different types of rotator cuff repair in the rabbit subscapularis and human supraspinatus at Time 0 provide more evidence that the rabbit subscapularis may be an appropriate model to study rotator cuff repairs.

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Section: Discussionmentioning

confidence: 99%

Relative Fixation Strength of Rabbit Subscapularis Repair Is Comparable to Human Supraspinatus Repair at Time 0

Otarodifard

Wong

Preston

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Preclinical evidence from gene therapy and stem cell studies are being used to move therapy from the experimental phase to clinical translation in other reconstructive surgical specialties. 29,30 About flaps and grafts Flaps and interposition grafts are believed to improve blood flow to the fistula closure and may also be used to facilitate skin covering when the vaginal skin is inadequate. The use of flaps and grafts waxes and wanes, with the Martius graft, used to be popular and believed to reduce recurrence in past years.…”

Section: Wound Healing Optimization -Potential Frontiersmentioning

confidence: 99%

Obstetric Fistula in the Developing World: An Agonising Tragedy

Dangal

Thapa²,

Yangzom

et al. 2014

Nepal j. obstet. gynaecol.

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Obstetric fistulae is the most tragic of preventable childbirth complications in the developing world, as affected women are often abandoned by their husbands and family, and forced to live in shame. They occur almost entirely in the developing world and their incidence is poorly studied. Their management requires accurate diagnosis, sufficient pre-operative workup, fine surgery following standard surgical repair steps and principles by skilled surgeons, specialised post-op care, and follow-up. As obstetric fistula is a serious preventable public health issue in developing countries, national and international organizations should launch a campaign to end fistula by increasing the resources and skilled staff available locally to treat obstetric fistula for improving the lives of women currently living with this condition. Moreover, effective preventive strategies for obstetric fistula such as better education to women and provision of improved obstetric care and searching for the best approaches to both prevention and treatment should be the priority. The materials published in PubMed, Lancet, Medline, WHO and Google Scholar web pages from 1990 to 2013 have been utilized to prepare this paper.

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“…These include gene therapy, scaffolds, microspheres, microcapsules or nanocapsules as vehicles as well as coated sutures or dissolution in fibrin sealant [36]. Using appropriate measures, this will also allow for a controlled spatiotemporal release of factors and improve the long-term stability and storage of these factors in tailored systems.…”

Section: Pathology and Natural Healingmentioning

confidence: 99%

“…Bone marrow is the most popular source of MCSs due to its relative ease of access; alternatively, amniotic fluid, umbilical cord blood, adipose tissue, synovium and other tissues can serve as sources for the isolation of MSCs. Bone marrow-derived MSCs may have valid clinical utility, and various strategies have been used to coax these cells down a tenogenic lineage, including the application of growth factors, the ectopic expression of transcription factors, exposure to tensile loads and high-density coculture with tenocytes [36]. It is worth mentioning that tendon-derived stem/progenitor cells have been isolated and cultured from human, mouse, rabbit and rat tendons [48,49,50,51].…”

Section: Pathology and Natural Healingmentioning

confidence: 99%

Therapeutic Strategies for Tendon Healing Based on Novel Biomaterials, Factors and Cells

2013

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The repair of tendon injuries still presents a major clinical challenge to orthopedic medicine. Tendons, like some other tissues, are poorly vascularized and heal slowly. In addition, healing often leads to the formation of fibrous tissue and scar tissue which lack flexibility and biomechanical properties. So the treatment of tendon injuries is challenging. We give an overview of the structure and composition of tendons, pathological states of tendon and natural healing, as well as therapeutic options. We focus in particular on biomaterials that have been specifically developed or suggested for the successful repair of tendon injuries. In addition, we also review factor- and cell-dependent strategies to heal tendon and ligament disorders. Although brief, we hope that this review will be helpful, particularly for those readers who are new to the field of tendon tissue engineering.

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Biologic approaches to enhance rotator cuff healing after injury

Cited by 119 publications

References 65 publications

Relative Fixation Strength of Rabbit Subscapularis Repair Is Comparable to Human Supraspinatus Repair at Time 0

Relative Fixation Strength of Rabbit Subscapularis Repair Is Comparable to Human Supraspinatus Repair at Time 0

Obstetric Fistula in the Developing World: An Agonising Tragedy

Therapeutic Strategies for Tendon Healing Based on Novel Biomaterials, Factors and Cells

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