The Rotator Cuff Organ: Integrating Developmental Biology, Tissue Engineering, and Surgical Considerations to Treat Chronic Massive Rotator Cuff Tears

Rothrauff, Benjamin B.; Pauyo, Thierry; Debski, Richard E.; Rodosky, Mark W.; Tuan, Rocky S.; Musahl, Volker

doi:10.1089/ten.teb.2016.0446

Cited by 29 publications

(15 citation statements)

References 253 publications

(300 reference statements)

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“…Considered to be standard procedure, however positioning of shoulder may be detrimental in osteoporotic bone anchor fixation [12,[28][29][30] Acrominosplasty Removal of acromial spur in response to full thickness tear is commonplace; although optimal timing of acrominoplasty remains unclear [12,[31][32][33][34]] Augmentation Use of patches: material, sizes vary [35][36][37][38][39] Platelet-rich plasma [40][41][42][43] Cell therapy (e.g. mesenchymal stem cells) [44][45][46][47] Post-operative rehabilitation…”

Section: Suture Anchormentioning

confidence: 99%

“…In developmental biology, Indian Hedgehog (Ihh) and parathyroid hormone (PTH)-related peptide (PTHrP) exist as reciprocal mediators in a feedback loop to control both chondrogenesis and mineralisation of the growth plate and enthesis [38,39]. Taking cues from this, Hettrich et al (2012) injected 114 Sprague-Dawley rats subcutaneously with 10 μg/kg of rhPTH on the day of surgery.…”

Section: Smokingmentioning

confidence: 99%

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Rotator Cuff Repair Augmentation Using Osteoinductive Growth Factors

Menon

Wragg

Wilson

2019

SN Compr. Clin. Med.

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Rotator cuff injuries (RCIs) present a major health problem due to high incidences of degenerative tears greater than 3 cm and prevalence of re-tears following surgical procedures. Since healing and functional restoration relies upon bone ingrowth into the tendon, it is hypothesised that sustained delivery of osteoinductive factors including bone morphogenetic proteins (BMPs), specifically BMP2-7, may significantly improve RCI tendon-bone healing. Here, growth factor candidates and delivery mechanisms are reviewed, specifically for improved RCI healing through enhanced bone ingrowth. In addition to BMPs, other potentially osteogenic factors including platelet-derived growth factors (PDGF), fibroblast growth factor (FGF), transforming growth beta isoforms (TGF-β1 and TGF-3) and parathyroid hormone (PTH) are evaluated since they can induce bone formation at the healing tendon attachment site. Several challenges must be addressed prior to clinical translation. The majority of published studies utilise in vivo animal models. In general, BMP-7 demonstrates a stronger stimulating effect when compared to BMP-2; the reported effectiveness of BMP-2 is often conflicting. Alternative factors, including PDGF and PTH, also demonstrate potential for assisting bone growth in enthesis healing. The use of sustained and biomimetic delivery systems appears to have the greatest positive effects. Some studies have demonstrated a dose-dependent effect, in conjunction with varying age, indicating that stratified therapies could be a viable solution for RCI healing. To adequately resolve potential treatments for RCI, further expanded and correlated animal trials must be undertaken, and indicative human trials are required with consideration of surgical and patient-specific influences.

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Section: Suture Anchormentioning

confidence: 99%

Section: Smokingmentioning

confidence: 99%

Rotator Cuff Repair Augmentation Using Osteoinductive Growth Factors

Menon

Wragg

Wilson

2019

SN Compr. Clin. Med.

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“…Despite the continuous advancement of rotator cuff repair surgery, non-operative physiotherapy to keep range of movement, rotator cuff and deltoid strength, as well as scapula-stabilizing which utilizes surgical methods to repair the tendon [2], there continues to be increased risk of re-tearing of the tendons after surgical reconstruction [3]. Pathological studies have shown that highly specialized fibro-cartilaginous transition layers between the rotator cuff and the bone cannot regenerate after repair, which leads to patients who cannot be restored to normal function after surgical reconstruction [4,5].…”

Section: Introductionmentioning

confidence: 99%

A New Insight of Kartogenin Induced the Mesenchymal Stem Cells (MSCs) Selectively Differentiate into Chondrocytes by Activating the Bone Morphogenetic Protein 7 (BMP-7)/Smad5 Pathway

et al. 2019

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Background Rotator cuff injury is the most common cause of shoulder disability, and although the repair technique has improved, the rate of rotator cuff reduction after repair is still high. The fibrocartilage region, which appears to be histologically inserted, cannot be regenerated. In recent years, studies have reported that mesenchymal stem cells (MSCs) have enhanced cartilage regeneration in the tendon and bone interface after rotator cuff repair, which has become a hot topic of research. Material/Methods Two mesenchymal stem cell types, SMSC (synovial-derived mesenchymal stem cells) and BMSC (bone marrow-derived mesenchymal stem cells) were intervened using kartogenin (KGN). The cytotoxicity was evaluated and the proliferation of the 2 cells was observed. Four commonly used cartilage phenotype genes were detected by quantitative real-time polymerase chain reaction, and the cartilage differentiation of MSCs induced by KGN was explored. The bidirectional regulation of the expression of BMP-7 and the downstream gene Smad5 was observed by constructing a lentiviral overexpression vector containing the target gene BMP-7. To explore whether BMP-7/Smad5 pathway activation promotes differentiation of SMSCs into chondrocytes. Results KGN can induce the selective differentiation of endogenous MSCs into chondrocytes by activating the BMP-7/Smad5 pathway, which promotes the regeneration of interfacial cartilage, and improves the quality of tendon healing of the tendon after rotator cuff repair. Conclusions This study found a new biological intervention method to promote the effect of tendon on bone healing after rotator cuff repair.

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“…Novel techniques are looking at enhancing the tendon tissue regeneration. Such techniques include the use of platelet-rich plasma (PRP), a substance that when injected releases various growth factors that play a role in tissue repair; the use of stem cells, usually mesenchymal stem cells (MSCs), which have the ability to self-renew and differentiate to various tissues [3]; and the use of tissue-engineered approaches which use various scaffolds and patches to augment repair [4,5]. The aim of this review is to critically analyse the new regenerative therapies that have been used recently to facilitate healing following rotator cuff injuries.…”

Section: Introductionmentioning

confidence: 99%

A Critical Review of Regenerative Therapies for Shoulder Rotator Cuff Injuries

Dickinson

Wilson

2018

SN Compr. Clin. Med.

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Rotator cuff tears can cause pain and weakness in the shoulder and affects a wide range of individuals. Conventional repair consists of operative surgical techniques or conservative treatments including physiotherapy; however, there is still a big issue in the increased risk of re-tearing of the tendons. Regenerative therapies are looking for new and novel ways of improving the healing of tendon injuries. Platelet-rich plasma (PRP) uses the patient's own blood in a concentrated form, to supply the repair site with various growth factors that promote the healing response; however, research shows conflicting evidence about the efficacy and effectiveness of PRP. Stem cell research is slowly increasing use of human patients in research trials and is showing significant results in improving and reducing the re-tear rate. Tissue engineering encapsulates a range of techniques such as scaffolds and patches to augment repair of the rotator cuff tendon, and research has shown that such techniques can provide protection and assistance to the repairing tendon to improve results. This review aims to critically compare and evaluate recent research and provide possible future directions.

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The Rotator Cuff Organ: Integrating Developmental Biology, Tissue Engineering, and Surgical Considerations to Treat Chronic Massive Rotator Cuff Tears

Cited by 29 publications

References 253 publications

Rotator Cuff Repair Augmentation Using Osteoinductive Growth Factors

Rotator Cuff Repair Augmentation Using Osteoinductive Growth Factors

A New Insight of Kartogenin Induced the Mesenchymal Stem Cells (MSCs) Selectively Differentiate into Chondrocytes by Activating the Bone Morphogenetic Protein 7 (BMP-7)/Smad5 Pathway

A Critical Review of Regenerative Therapies for Shoulder Rotator Cuff Injuries

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