Biologically Enhanced Healing of the Rotator Cuff

Gordon, Nicole M.; Maxson, Scott; Hoffman, James K.

doi:10.3928/01477447-20120525-06

Cited by 13 publications

(13 citation statements)

References 54 publications

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“…At 10 year follow up, re-tear of rotator cuff was found in only 13% of the MSC-treated group, versus 56% re-tear rate of the control group, indicating enhancement of healing from MSCs and durability of the clinical outcome [159]. Finally, two separate case reports that describe the treatment of rotator cuff tear with the use of a dermal allograft with the addition of MSCs and PRP also report favored outcome [160, 161]. …”

Section: Stem Cellsmentioning

confidence: 99%

Effectiveness of Biologic Factors in Shoulder Disorders

Giotis¹,

Aryaei²,

Vasilakakos³

et al. 2017

TOORTHJ

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Background:Shoulder pathology can cause significant pain, discomfort, and loss of function that all interfere with activities of daily living and may lead to poor quality of life. Primary osteoarthritis and rotator cuff diseases with its sequalae are the main culprits. Management of shoulder disorders using biological factors gained an increasing interest over the last years. This interest reveals the need of effective treatments for shoulder degenerative disorders, and highlights the importance of a comprehensive and detailed understanding of the rapidly increasing knowledge in the field.Methods:This study will describe most of the available biology-based strategies that have been recently developed, focusing on their effectiveness in animal and clinical studies.Results:Data from in vitro work will also be briefly presented; in order to further elucidate newly acquired knowledge regarding mechanisms of tissue degeneration and repair that would probably drive translational work in the next decade. The role of platelet rich-plasma, growth factors, stem cells and other alternative treatments will be described in an evidence-based approach, in an attempt to provide guidelines for their clinical application. Finally, certain challenges that biologic treatments face today will be described as an initiative for future strategies.Conclusion:The application of different growth factors and mesenchymal stem cells appears as promising approaches for enhancing biologic repair. However, data from clinical studies are still limited, and future studies need to improve understanding of the repair process in cellular and molecular level and evaluate the effectiveness of biologic factors in the management of shoulder disorders.

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Section: Stem Cellsmentioning

confidence: 99%

Effectiveness of Biologic Factors in Shoulder Disorders

Giotis¹,

Aryaei²,

Vasilakakos³

et al. 2017

TOORTHJ

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“…109,110 Both patients had a history of recurrent tears and underwent repair with MSCs, platelet-rich plasma (PRP), and allograft human dermal matrix. 109,110 Both patients had a history of recurrent tears and underwent repair with MSCs, platelet-rich plasma (PRP), and allograft human dermal matrix.…”

Section: Animal and Clinical Studiesmentioning

confidence: 99%

Rotator cuff healing and repair

Zhu

Young

Garver³

et al. 2014

Current Orthopaedic Practice

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Despite the frequency of rotator cuff tendinopathies, rotator cuff repair procedures still have high failure rates. Thus, new treatment strategies that accelerate healing and improve regeneration are needed. Tissue engineering approaches, which include the implantation of extracellular matrix scaffolds, cells, and/or growth factors, can be applied to modulate the healing process, improving biomechanical properties and functional outcomes of the repaired tendon. In particular, the microstructural properties of extracellular matrix scaffolds can influence cell migration, protein synthesis, and fiber organization in healing tendon. Through manufacturing techniques, such as three-dimensional printing, the properties of these scaffolds can be optimized for rotator cuff regeneration. In addition to scaffolds, implantation of stem cells and tenocytes has been shown to increase healing rates and reduce inflammation in animal models but has not been tested clinically. Many growth factors also are present at the wound site during healing, but studies attempting to recreate these conditions during healing with platelet-rich plasma have found little evidence supporting its use. Systematic treatments, including anti-inflammatory medication and metalloproteinase inhibitors, are commonly used in rotator cuff tendinopathies but have adverse effects that inhibit tendon healing. A variety of tissue engineering and biologic treatments for rotator cuff tendinopathy are currently being developed, but challenges still remain before they can be applied clinically.

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“…Some authors have reported on their early experience combining biologic factors, such as platelet-rich plasma and mesenchymal stem cells, with rotator cuff grafts in an attempt to maximize tissue regeneration [ 33 ]. Further research is needed on this topic, but it is certainly an appealing option, as these collagen-based scaffolds can serve as carriers for a multitude of biologic factors, especially when the native biologic environment is compromised in chronic, dysvascular cuff tears.…”

Section: Introductionmentioning

confidence: 99%