Effects of Monofilament Nylon Coated With Basic Fibroblast Growth Factor on Endogenous Intrasynovial Flexor Tendon Healing

Hamada, Yoshitaka; Katoh, Shinsuke; Hibino, Naohito; Kosaka, Hirofumi; Hamada, Daisuke; Yasui, Natsuo

doi:10.1016/j.jhsa.2005.12.003

Cited by 72 publications

(55 citation statements)

References 26 publications

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“…This conclusion is supported by a recent flexor tendon study that demonstrated improved healing due to sustained delivery of bFGF. 32 Other literature suggests that the slowest release kinetics in vitro may not necessarily represent the most desirable release kinetics in vivo. In many in vivo models the combination of an initial bolus followed by controlled release actually stimulates more healing than slower release models.…”

Section: Discussionmentioning

confidence: 99%

PDGF‐BB released in tendon repair using a novel delivery system promotes cell proliferation and collagen remodeling

Thomopoulos¹,

Zaegel²,

Das³

et al. 2007

Journal Orthopaedic Research

141

151

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The purpose of this study was to promote fibroblast proliferation and collagen remodeling in flexor tendon repair through sustained delivery of platelet derived growth factor (PDGF-BB). The release kinetics of PDGF-BB from a novel fibrin matrix delivery system was initially evaluated in vitro. After the in vivo degradation rate of the fibrin matrix was determined using fluorescently tagged fibrin, PDGF-BB was delivered to the site of flexor tendon repair in vivo in a canine model. The effect of PDGF-BB on intrasynovial tendon healing was studied using histology-based assays (cell density, proliferation, and type I collagen expression) and by measuring total DNA levels and reducible collagen crosslink levels. The fibrin matrix delivery system provided sustained release of PDGF-BB in vitro at a rate modulated by the ratio of heparin to growth factor. In vivo, the fibrin matrix remained at the repair site for more than 10 days. Delivery of PDGF-BB led to a qualitative increase in cell density, cell proliferation, and type I collagen mRNA expression. PDGF-BB also led to statistically significant increases in total DNA (20% increase at 7 days, 18% increase at 14 days) and reducible collagen crosslinks (30% increase at 7 days). Sustained delivery of growth factors may be achieved using a novel fibrin-based delivery system. PDGF-BB delivery increased cell proliferation and matrix remodeling and thus may accelerate flexor tendon healing. ß

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Section: Discussionmentioning

confidence: 99%

PDGF‐BB released in tendon repair using a novel delivery system promotes cell proliferation and collagen remodeling

Thomopoulos¹,

Zaegel²,

Das³

et al. 2007

Journal Orthopaedic Research

141

151

View full text Add to dashboard Cite

show abstract

“…Moreover, maximal stress, yield stress, stiffness, ultimate strain, and yield strain were significantly improved relative to controls [51][52][53]. Gel-coated nylon sutures soaked in a 400 μg/mL bFGF solution and used to treat severed rabbit flexor digitorum fibularis tendons (FDFTs) increased epitenon proliferation and epitenocyte infiltration and enhanced ultimate failure load by more than 33 % at 3 weeks, suggesting that bFGF may specifically promote early healing [54]. In accord with this result, Ide et al found that rat supraspinatus tendon ruptures repaired with bFGF-treated fibrin sealant (100 mg/kg) had significantly higher tendon-to-bone insertion maturity scores (15.8 ± 0.8 vs. 10.6 ± 0.5 out of 32) and mechanical strength (6.6 ± 2.0 N vs. 3.2 ± 0.6 N) than tendons repaired with untreated fibrin sealant after 2 weeks, although there were no significant differences between the two groups at 4 or 6 weeks [55].…”

Section: Fibroblast Growth Factormentioning

confidence: 99%

Biologic and Tissue Engineering Strategies for Tendon Repair

Sigal

Grande

Dines

et al. 2016

Regen. Eng. Transl. Med.

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This review summarizes recent developments in biologic treatments-including growth factors, platelet-rich plasma (PRP), stem cells, and cell-seeded scaffolds-for tendon repair. Growth and differentiation faction-5 (GDF-5), insulin-related growth factor-1 (IGF-1), and basic fibroblast growth factor (bFGF) all improved extracellular matrix (ECM) production and tensile strength of treated tendons; however, no clinical trials were done on GDF-5. Platelet-derived growth factor-BB (PDGF-BB) improved proliferation and ECM production, but did not consistently improve mechanical properties. The literature was mixed on the efficacy of PRP for the treatment of chronic and acute tendinopathies. However, PRP did cause any complications, and its benefits may be enhanced once an ideal, standardized composition is developed. Therefore, PRP may be a valid treatment, especially once nonsurgical management options have failed. Mesenchymal stem cells (MSCs) significantly and substantially improved the quality of tendon repairs and demonstrated the ability to regenerate an enthesis. Adipose-derived stem cells (ADSCs) have similar effects and are easier to harvest. The periosteum may also regenerate the tendon-bone attachment. Tenocytes, meanwhile, may be ideal for midsubstance tendon repairs. Cell-seeded scaffolds-especially ECMderived scaffolds-were demonstrated to improve ECM production, enhancing the healing abilities of tenocytes or stem cells while providing early mechanical support to healing tendons.Each of these treatments demonstrated enhanced healing compared to common surgical techniques; moreover, patient outcomes may be enhanced by combining these treatments. Lay SummaryTendon injuries are very prevalent and can be debilitating. Tendon heals poorly, and the scar tissue that forms is weak and susceptible to reinjury. A major focus of orthopedic research is regenerative medicine, encouraging the formation of healthy tendon rather than mechanically inferior scar tissue. This review summarizes the recent scientific literature on biologic treatments for tendon repair, such as growth factors, platelet-rich plasma, and stem cells. The purpose of which is to show which treatments are promising candidates for clinical use and research, helping to guide physicians and to lay out a path for future research.

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“…VEGF, PDGF, FGF, and TGF-b also have been shown to play an important role in ligament and tendon healing [24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Although a body of research evidence exists in animal models [38], the results of late-stage, randomized, controlled clinical studies in humans are as yet unavailable (with the exception of BMPs), and the long-term local and systemic effects of these agents are unknown [39].…”

Section: Increasing Clinical Use Of Growth Factorsmentioning

confidence: 99%

International Olympic Committee Consensus Statement: Molecular Basis of Connective Tissue and Muscle Injuries in Sport

Ljungqvist

Schwellnus

Bachl

et al. 2008

Clinics in Sports Medicine

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Effects of Monofilament Nylon Coated With Basic Fibroblast Growth Factor on Endogenous Intrasynovial Flexor Tendon Healing

Cited by 72 publications

References 26 publications

PDGF‐BB released in tendon repair using a novel delivery system promotes cell proliferation and collagen remodeling

PDGF‐BB released in tendon repair using a novel delivery system promotes cell proliferation and collagen remodeling

Biologic and Tissue Engineering Strategies for Tendon Repair

International Olympic Committee Consensus Statement: Molecular Basis of Connective Tissue and Muscle Injuries in Sport

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