Cellular therapy in bone-tendon interface regeneration

Abstract

The intrasynovial bone-tendon interface is a gradual transition from soft tissue to bone, with two intervening zones of uncalcified and calcified fibrocartilage. Following injury, the native anatomy is not restored, resulting in inferior mechanical properties and an increased risk of re-injury. Recent in vivo studies provide evidence of improved healing when surgical repair of the bone-tendon interface is augmented with cells capable of undergoing chondrogenesis. In particular, cellular therapy in bone-tendon healing can promote fibrocartilage formation and associated improvements in mechanical properties. Despite these promising results in animal models, cellular therapy in human patients remains largely unexplored. This review highlights the development and structure-function relationship of normal bone-tendon insertions. The natural healing response to injury is discussed, with subsequent review of recent research on cellular approaches for improved healing. Finally, opportunities for translating in vivo findings into clinical practice are identified.

Strategies to engineer tendon/ligament-to-bone interface: Biomaterials, cells and growth factors

“…Cells bioactive molecules that provide a regenerative microenvironment [88]. Therefore, MSCs placed in a graded scaffold with appropriate biochemical and mechanical stimuli have the potential to differentiate into the various cell types present at the enthesis.…”

Enhanced osteogenic potential of mesenchymal stem cells from cortical bone: a comparative analysis

“…Historically, surgical reconstruction has been predominated by the use of synthetic implants and bone grafts. Over the past 15 years, there has been an explosion in the use of cell-based therapies in orthopedics [38][39][40]. Although BM-MSCs are the most commonly used for this purpose, groups have described different compartments of the bone, mainly the trabecular [16,[41][42][43] and cortical [17,44] portions, as reservoirs of multipotent cells with a greater osteogenic commitment [15,44,45].…”

Gene expression profiling of progenitor cells isolated from rat rotator cuff musculotendinous junction

“…It has been postulated that engineered tendon tissue has the potential to recapitulate the structural organization of the rotator cuff enthesis but this regeneration will require concerted interplay of multiple players including progenitor cells, growth factors, mechanical fixation, and vascular supply [30,35,40]. Progenitor cells have been isolated from healthy tendon (TPC) but factors regulating extracellular matrix production and its regulation are poorly understood [3,12,22,28,36,37].…”