Implantation of a porcine acellular dermal graft in a primate model of rotator cuff repair

Scaffold devices for rotator cuff repair

“…47 Recently, xenogeneic porcine dermis processed enzymatically to remove/reduce the a-Gal epitope (Conexa, Tornier Inc, Beverly, MA, USA) was used to repair the excised central third of the supraspinatus tendon in an African Green monkey model. 80 At 6 months, the Conexa graft grossly appeared to be integrated with the host tissue, and the grafts showed histologic evidence of tendon-like remodeling, cellular infiltration, and a mild inflammatory response, believed to be consistent with normal wound healing and remodeling. Abundant vasculature was observed in the graft materials at 3 months, which diminished to native tendon levels by 6 months.…”

“…For example, scaffolds derived from non-cross-linked SIS are rapidly remodeled and replaced by new host tissue, 27 whereas scaffolds derived from dermis appear to undergo slower remodeling and may be incorporated by the host to some extent rather than completely replaced. 80 It is likely that during the process of partial or complete ECM scaffold degradation, growth factors (eg, vascular endothelial growth factor, fibroblast growth factor-2, transforming growth factor-b-1) and other bioactive molecules that have not been destroyed by processing methods are released into the surrounding tissue and affect processes such as angiogenesis, cell recruitment, cell division, and even potential antimicrobial activity. 19,40,41,50,56,77 Considered from this perspective, ECM scaffold degradation may be associated with constructive remodeling events.…”

Xenogeneic acellular dermal matrix in combination with pectoralis major myocutaneous flap reconstructs hypopharynx and cervical esophagus

“…Therefore, basement membrane and dermal surface are well preserved in ADM; this allows ADM to better undergo metaplasia and rapid vascularization. Based on these characteristics, ADM can also guide tissue regeneration and attenuate postoperative scar formation [17,18]. There are clinical data demonstrating that ADM can fuse with host cells with no consequences, which explains its wide clinical research and application.…”

The role of animal models in tendon research

“…Nevertheless, a variety of other valuable animal models also continue to be used to replicate aspects of rotator cuff injury and repair, including murine, 26-28 rabbit, 29,30 ovine, 31-37 canine, 38,39 bovine, 40-43 and primate. 44,45 …”

“…These studies simulated an acute rupture of the rotator cuff tendon(s) of rats, 69 rabbits, 30 canines, 39 or primates 45 and regenerative agent(s) were subsequently applied directly to the injury site, 30 injected into the joint space, 59 delivered via subcutaneous injection, 61 osmotic pump, 58 or scaffolds/ grafts. 40,45,60,63,64,70 Scaffold designs are not limited to the purpose of delivering agents in a controlled manner, as some have also been proven to improve mechanical strength at the repair site 39 and remodel to tendon-like architecture while integrating bone and tendon. 45 The scope of this review does not permit a full exploration of the effects of all of the regenerative agents used in tendon research, so we will only briefly review a few studies examining the use of PRP and stem cells, which have recently garnered considerable interest as potential therapy modalities.…”