Poly-N-Acetyl Glucosamine (sNAG) Enhances Early Rotator Cuff Tendon Healing in a Rat Model

Abstract

Rotator cuff injuries frequently require surgical repairs which have a high failure rate. Biological augmentation has been utilized in an attempt to improve tendon repair. Poly-N-acetyl glucosamine (sNAG) polymer containing nanofibers has been shown to increase the rate for healing of venous leg ulcers. The purpose of this study was to investigate the healing and analgesic properties of sNAG in a rat rotator cuff injury and repair model. 144 adult male Sprague Dawley rats underwent a transection and repair of their left supraspinatus tendons. Half of the animals received a sNAG membrane on the tendon-to-bone insertion site. Animals were further subdivided, receiving 1 or 3 days of analgesics. Animals were sacrificed 2, 4, or 8 weeks post-injury. Animals sacrificed at 4 and 8 weeks underwent longitudinal in vivo ambulatory assessment. Histological properties were assessed at 2, 4, and 8 weeks, and mechanical properties at 4 and 8 weeks. In the presence of analgesics, tendons receiving the sNAG polymer had significantly increased max load and max stress. Ambulatory improvements were observed at 14 days in stride length and speed. Therefore, sNAG improves tendon-to-bone healing in a rat rotator cuff detachment and repair model.

Evaluation of patches for rotator cuff repair: A systematic review and meta-analysis based on animal studies

“…Funakoshi, T [ 86 ] found the chitin source patches had better results than simple suture. Nuss, C. A [ 89 ] found that the results of Poly-N-acetyl Glucosamine (sNAG) were superior to those of simple suture. One study [ 73 ] demonstrated that alginate scaffolds had better results than simple suture.…”

Comparative Evaluation of the Book‐Type Acellular Bone Scaffold and Fibrocartilage Scaffold for Bone‐Tendon Healing

“…Among the above three factors, the scaffolds play the most critical role, which can give structural support, mimic the in vivo microenvironment and biologically influence the local cells, so as to regenerate the injured tissue with high‐efficiency . Currently, to precisely control the stiffness, alignment and surface topology of the scaffold, lots of artificial polymer materials have been designed to fabricate the scaffold for B‐T healing, such as poly lactic‐co‐glycolic acid, poly‐ N ‐acetyl glucosamine and electrospun scaffolds . However, these scaffolds composed of polymer materials remain uncertain in biosafety and insufficient in bioactivity, thus partly limiting their application .…”

Review of Ortho-Biologics in Rotator Cuff Repair

“…They have had promising in vitro, animal, and clinical studies showing the potential to be used regularly to improve results due to their ability to be a platform for nanotopography-mediated cell response, the incorporation of stem cells, and the housing and delivery of active growth factors [119][120][121][122][123]. Based on the structure and biomolecular basis of these scaffolds, they have been shown to aid in cell proliferation [124], osteogenic differentiation [125], osteogenesis [126], and improving the biomechanical strength [127] of the healing tendon.…”