Biologics in Achilles tendon healing and repair: a review

Shapiro, Evan; Grande, Daniel; Drakos, Mark C.

doi:10.1007/s12178-015-9257-z

Cited by 45 publications

(51 citation statements)

References 85 publications

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“…In addition, electrospun nanofibrous scaffolds possess poor suture-retention strength for surgical reconstruction and usually have insufficient mechanical properties to support primary tendon repair. While some post-treatments and modification, like salt leaching/gas foaming technique, ultrasonication, and freeze drying processes were developed to enhance cellular ingrowth into these scaffolds, achieving high cellular density and infiltration and excellent mechanical properties remains challenging [34, 35]. …”

Section: Introductionmentioning

confidence: 99%

Living nanofiber yarn-based woven biotextiles for tendon tissue engineering using cell tri-culture and mechanical stimulation

et al. 2017

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Non-woven nanofibrous scaffolds have been developed for tendon graft application by using electrospinning strategies. However, electrospun nanofibrous scaffolds face some obstacles and limitations, including suboptimal scaffold structure, weak tensile and suture-retention strengths, and compact structure for cell infiltration. In this work, a novel nanofibrous, woven biotextile, fabricated based on electrospun nanofiber yarns, was implemented as a tissue engineered tendon scaffold. Based on our modified electrospinning setup, polycaprolactone (PCL) nanofiber yarns were fabricated with reproducible quality, and were further processed into plain-weaving fabrics interlaced with polylactic acid (PLA) multifilaments. Nonwoven nanofibrous PCL meshes with random or aligned fiber structures were generated using typical electrospinning as comparative counterparts. The woven fabrics contained 3D aligned microstructures with significantly larger pore size and obviously enhanced tensile mechanical properties than their nonwoven counterparts. The biological results revealed that cell proliferation and infiltration, along with the expression of tendon-specific genes by human adipose derived mesenchymal stem cells (HADMSC) and human tenocytes (HT), were significantly enhanced on the woven fabrics compared with those on randomly-oriented or aligned nanofiber meshes. Co-cultures of HADMSC with HT or human umbilical vein endothelial cells (HUVEC) on woven fabrics significantly upregulated the functional expression of most tenogenic markers. HADMSC/HT/HUVEC tri-culture on woven fabrics showed the highest upregulation of most tendon-associated markers than all the other mono- and co-culture groups. Furthermore, we conditioned the tri-cultured constructs with dynamic conditioning and demonstrated that dynamic stretch promoted total collagen secretion and tenogenic differentiation. Our nanofiber yarn-based biotextiles have significant potential to be used as engineered scaffolds to synergize the multiple cell interaction and mechanical stimulation for promoting tendon regeneration.

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Section: Introductionmentioning

confidence: 99%

Living nanofiber yarn-based woven biotextiles for tendon tissue engineering using cell tri-culture and mechanical stimulation

et al. 2017

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“…Despite recent advances in the treatment protocols, their outcomes are still unpredictable due to the decreased mechanical properties of fibrovascular scarring and the degenerative nature of many tendon disorders (Kader et al 2002, Shapiro et al 2015. It has been stated that the calcaneal tendon (Achilles tendon) is one of the most frequently injured tendons in the human musculoskeletal system (Pierre-Jerome et al 2010, Del Buono et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Ultrasonography and Low-field Magnetic Resonance Imaging of the Common Calcanean Tendon in a Rabbit Model for Tendinopathy Research: a Descriptive Study of Normal Anatomy

Skalec¹,

Przyborowska-Zhalniarovich²,

Janus³

et al. 2016

Polish Journal of Veterinary Sciences

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In spite of recent advances in treatment protocols, tendinopathies continue to challenge orthopaedists and surgeons. Due to the complexity of both tendon injuries and the healing processes, animal models are essential for addressing fundamental questions in tendinopathy research. Diagnostic imaging could contribute to the evaluation of animal models, thus providing information, which could be translated to human tendinopathies. The objective of our study was to evaluate in situ appearance of the rabbit common calcanean tendon with ultrasonography and magnetic resonance imaging. Additionally, we sought to assess and compare the feasibility and usefulness of these techniques in a rabbit model while focusing on the imaging of the particular structures involved in calcaneal tendon disorders. Eight California rabbits were used for post-mortem sonographic and low-field magnetic resonance examination. Morphometry was performed on longitudinal sonograms and sagittal MRI scans. The craniocaudal diameter of the tendon was measured at four points of interest. Ultrasonography and magnetic resonance provided good visualisation of the tendon origin, the paratenon and the pre-Achilles fat pad. Magnetic resonance images presented in more detail the structure of the calcaneal insertion. Both modalities failed to visualise the individual components of the common calcanean tendon and the bursa of the calcaneal tendon. Statistical analysis of measurements obtained showed that the craniocaudal diameter of the common calcanean tendon in a rabbit increases significantly with a growing length from the calcaneal tuber. Both magnetic resonance and ultrasonography are feasible, and should be considered complementary, not alternative imaging techniques in a rabbit common calcanean tendon model.

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“…Therapy using the addition of biologics to the wound site is a common method currently being researched to improve the healing of Achilles tendons. These include research into platelet-rich plasma, bone marrow aspirate, bone morphogenetic proteins, stem cells, bioscaffolds, growth factors, and various combinations of these techniques (Shapiro, Grande, & Drakos, 2015).…”

Section: The Achilles Tendonmentioning

confidence: 99%

A Biomechanical Investigation of Collagen, Platelet-Rich Plasma, and Mesenchymal Stromal Cells on the Achilles Tendon in a Rat Model

Austin

Marie

Fagan

et al. 2019

Volume 3: Biomedical and Biotechnology Engineering

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This study aims to biomechanically compare four different treatment methods for repair enhancement in Achilles tendon rupture in rats: collagen, collagen and platelet-rich plasma (PRP), collagen and mesenchymal stromal cells (MSC), and a combination of collagen, platelet-rich plasma and mesenchymal stromal cells (CPM) at one and two week healing periods. This study included ninety Lewis rats weighing approximately 200–300 g. Ten rats were used as donors for MSC and PRP. For the remaining eighty rats, the right leg was completely transected 6 mm proximal to the calcaneus bone, suture repaired, wrapped in CollaTape (CoTa), and then closed. An injection of PRP, MSC, or PRP and MSC was given at the wound site to the applicable groups. After one or two weeks recovery time, the rats were sacrificed and both Achilles tendons were removed. The left tendons were used as virgin tissue controls. It was found that the maximum stress at failure, the total strain energy, the average modulus of elasticity, and the elastic strain energy all increase significantly from one week to two week recovery time. However, there was no statistical difference between treatment groups in any of the mechanical properties.

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Biologics in Achilles tendon healing and repair: a review

Cited by 45 publications

References 85 publications

Living nanofiber yarn-based woven biotextiles for tendon tissue engineering using cell tri-culture and mechanical stimulation

Living nanofiber yarn-based woven biotextiles for tendon tissue engineering using cell tri-culture and mechanical stimulation

Ultrasonography and Low-field Magnetic Resonance Imaging of the Common Calcanean Tendon in a Rabbit Model for Tendinopathy Research: a Descriptive Study of Normal Anatomy

A Biomechanical Investigation of Collagen, Platelet-Rich Plasma, and Mesenchymal Stromal Cells on the Achilles Tendon in a Rat Model

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