Biologics in the Management of Rotator Cuff Surgery

Angeline, Michael E.; Rodeo, Scott A.

doi:10.1016/j.csm.2012.07.003

Cited by 64 publications

(63 citation statements)

References 87 publications

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“…In a study on a rat rotator cuff model, Thomopoulos et al 14 reported healing sites with excessive scar formation and a lack of fibrocartilage formation at the tendon-bone enthesis 28 . From what is known at the current time, development of this fibrovascular scar tissue has been reported to occur in three stages: inflammation (0-7 days), repair (5-14 days), and remodeling (>14 days) 9,10,33 . The inflammatory stage begins with platelets depositing fibrin and fibronectin leading to the accumulation of macrophages in response to insulin-like growth factor 1 (IGF-1), platelet-derived growth factor (PDGF), and transforming growth factor β (TGF-β) 9 .…”

Section: Tendon Insertion Healingmentioning

confidence: 99%

“…In contrast to the organized, distinct development of the four zones of the cartilaginous enthesis, tendonbone healing occurs through the formation of fibrovascular scar tissue and does not reestablish the native tendon-bone insertion site formed during embryological development 1,9,14,[21][22][23] . The work done by Thomopoulos et al 24 stresses the importance of understanding the development and morphogeneses of the tendon-bone enthesis in order to more fully understand the healing process of the insertion site.…”

Section: Tendon Insertion Healingmentioning

confidence: 99%

“…Several studies have reported that the gradations developed in native tendon are not regenerated during tendon to bone healing 14,[21][22][23][28][29][30][31][32] . Furthermore, the resulting fibrovascular scar tissue interface has been shown to be mechanically weaker and more prone to failure than that of the natural tendon-bone enthesis created during prenatal development 9,24,28,33 . At the present time, little is known about the natural healing process of the tendon-bone enthesis making it difficult to develop an effective treatment option.…”

Section: Tendon Insertion Healingmentioning

confidence: 99%

“…This is more clearly described as the mechanical boundary between soft and hard tissues 9 . The tidemark is relatively straight which indicates the production of a flat surface during the mineralization process which is important clinically as this surface reduces the risk of damage to soft tissues during joint movement 9 .…”

Section: Tidemarkmentioning

confidence: 99%

“…Entheses are critical as they allow for the proper transmission of contractile forces from the muscle belly to the respective skeletal attachment, while simultaneously dissipating force away from the enthesis itself, from tendon into bone 1,8,9 . Entheses can be further described according to the type of tissue present at the skeletal attachment site, specifically, either dense fibrous connective tissue or fibrocartilage.…”

Section: The Insertion Site or "Enthesis"mentioning

confidence: 99%

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The enthesis: a review of the tendon-to-bone insertion

Apostolakos¹

2014

MLTJ

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SummaryThe integration of tendon into bone occurs at a specialized interface known as the enthesis. The fibrous tendon to bone enthesis is established through a structurally continuous gradient from uncalcified tendon to calcified bone. The enthesis exhibits gradients in tissue organization classified into four distinct zones with varying cellular compositions, mechanical properties, and functions in order to facilitate joint movement. Damage to tendinous insertions is common in the field of orthopaedic medicine and often involves surgical intervention that requires the attempted recreation of the natural organization of tendon into bone. The difficulty associated with recreating the distinct organization may account for the surgical challenges associated with reconstruction of damaged insertion sites. These procedures are often associated with high failure rates and consequently require revision procedures. Management of tendinous injuries and reconstruction of the insertion site is becoming a popular topic in the field of orthopaedic medicine.

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Section: Tendon Insertion Healingmentioning

confidence: 99%

Section: Tendon Insertion Healingmentioning

confidence: 99%

Section: Tendon Insertion Healingmentioning

confidence: 99%

Section: Tidemarkmentioning

confidence: 99%

Section: The Insertion Site or "Enthesis"mentioning

confidence: 99%

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The enthesis: a review of the tendon-to-bone insertion

Apostolakos¹

2014

MLTJ

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Visualizing the Fate of Intra‐Articular Injected Mesenchymal Stem Cells In Vivo in the Second Near‐Infrared Window for the Effective Treatment of Supraspinatus Tendon Tears

et al. 2019

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Mesenchymal stem cells (MSCs) are capable of exerting strong therapeutic potential for the treatment of supraspinatus tendon tear. However, MSC therapy remains underutilized and perhaps underrated due to the limited evidence of dynamic visualization of cellular behavior in vivo. Here, second near‐infrared fluorescence imaging with biocompatible PbS quantum dots (QDs) provides a cellular migration map and information on the biodistribution and clearance processes of three densities of intra‐articularly injected, labeled MSCs to treat supraspinatus tendon tear in mice. Intra‐articular injection avoids entrapment of MSCs by filter organs and reduces the QD‐induced organ toxicity. Notably, the MSCs share a similar migration direction, but the moderate density group is somewhat more efficient, showing the longest residence time and highest cell retention rate around the footprint during the repair stage. Furthermore, quantitative kinetic investigation demonstrates that labeled MSCs are cleared by feces and urine. Histomorphometric analysis demonstrates that the moderate density group achieves maximum therapeutic effect and labeled MSCs do not induce any injury or inflammation to major organs, which suggests that administration of too many or few MSCs may decrease their effectiveness. Such an imaging approach provides spatiotemporal evidence for response to MSC therapy in vivo, facilitating the optimization of MSC therapy.

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Bioactive Patch for Rotator Cuff Repairing via Enhancing Tendon‐to‐Bone Healing: A Large Animal Study and Short‐Term Outcome of a Clinical Trial

Kang,

Wang,

Zhang

et al. 2024

Advanced Science

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Tissue engineering has demonstrated its efficacy in promoting tissue regeneration, and extensive research has explored its application in rotator cuff (RC) tears. However, there remains a paucity of research translating from bench to clinic. A key challenge in RC repair is the healing of tendon–bone interface (TBI), for which bioactive materials suitable for interface repair are still lacking. The umbilical cord (UC), which serves as a vital repository of bioactive components in nature, is emerging as an important source of tissue engineering materials. A minimally manipulated approach is used to fabricate UC scaffolds that retain a wealth of bioactive components and cytokines. The scaffold demonstrates the ability to modulate the TBI healing microenvironment by facilitating cell proliferation, migration, suppressing inflammation, and inducing chondrogenic differentiation. This foundation sets the stage for in vivo validation and clinical translation. Following implantation of UC scaffolds in the canine model, comprehensive assessments, including MRI and histological analysis confirm their efficacy in inducing TBI reconstruction. Encouraging short‐term clinical results further suggest the ability of UC scaffolds to effectively enhance RC repair. This investigation explores the mechanisms underlying the promotion of TBI repair by UC scaffolds, providing key insights for clinical application and translational research.

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Biologics in the Management of Rotator Cuff Surgery

Cited by 64 publications

References 87 publications

The enthesis: a review of the tendon-to-bone insertion

The enthesis: a review of the tendon-to-bone insertion

Visualizing the Fate of Intra‐Articular Injected Mesenchymal Stem Cells In Vivo in the Second Near‐Infrared Window for the Effective Treatment of Supraspinatus Tendon Tears

Bioactive Patch for Rotator Cuff Repairing via Enhancing Tendon‐to‐Bone Healing: A Large Animal Study and Short‐Term Outcome of a Clinical Trial

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