Biologics and stem cell‐based therapies for rotator cuff repair

Abstract

The rotator cuff is composed of several distinct muscles and tendons that function in concert to coordinate shoulder motion. Injuries to these tendons frequently result in permanent dysfunction and persistent pain. Despite considerable advances in operation techniques, surgical repair alone still does not fully restore rotator cuff function. This review focuses on recent research in the use of biologics and stem cell-based therapies to augment repair, highlighting promising avenues for future work and remaining challenges. While a number of animal models are used for rotator cuff studies, the anatomy of the rotator cuff varies dramatically between species. Since the rodent rotator cuff shares the most anatomical features with the human, this review will focus primarily on rodent models to enable consistent interpretation of outcome measures.

Effect of Fatty Acid–Binding Protein 4 Inhibition on Rotator Cuff Muscle Quality: Histological, Biomechanical, and Biomolecular Analysis

“…11,24,38,39 Thus, several stem cell–based therapies for rotator cuff repair have recently been attempted. 2,35,37 However, because of an insufficient population and decline in function of stem cells, especially in older patients, 7,15,16,30 we cannot rule out other possible regulators involved in muscle fatty infiltration. Therefore, an in-depth study on the mechanism of muscle fatty infiltration that leads to muscle weakness, pain, and limited shoulder motion is important.…”

Regeneration of a full-thickness defect of rotator cuff tendon with freshly thawed umbilical cord-derived mesenchymal stem cells in a rat model

“…Recently, several studies have shown that the healing effect of MSCs comes from the paracrine effect, which secrete cytokines and growth factors to recruit, proliferate, and differentiate tissue-specific progenitor cells to synthesis-specific matrix [ 43 ]. Moreover, MSCs have the ability to modulate local inflammatory environment by regulating inflammatory cell function by inducing macrophage recruitment and polarization to alternatively activated macrophage suppressing inflammation and the inflammatory-related cells [ 44 , 45 ]. Thus, the injected UC MSCs disappeared over time, but the local environment influenced by UC MSCs has a positive effect on the regeneration of the structure of the injured tendon.…”

Application of Autogenous Urine-Derived Stem Cell Sheet Enhances Rotator Cuff Healing in a Canine Model

“…So far, stem cells have been isolated from various tissues, including bone marrow, adipose tissue, umbilical cord blood, synovium, tendon, dental pulp, and endometrium, as reported in numerous studies. 6,16,19,24,28,41 Stem cells derived from bone marrow, adipose tissue, umbilical cord blood, synovium, and tendon could promote enthesis regeneration at the bone-tendon healing site. 6,28,47 A group of urine cells fitting MSC characteristics was recently discovered.…”

“…In the field of RC healing, the most commonly used stem cells have been isolated from bone marrow (BMSCs) or adipose tissue (ASCs). 6,19,31,36,45 A type of stem cell with superior chondrogenic lineage that has been isolated from synovial tissue was introduced in the enhancement of enthesis regeneration and proved to have prohealing efficacy. 33 More recently, several studies revealed that there were abundant stem cells with self-renewal capacity, clonogenicity, and multilineage potential in the tendon tissue.…”