Calcium-Phosphate Matrix With or Without TGF-β₃ Improves Tendon-Bone Healing After Rotator Cuff Repair

Abstract

The delivery of TGF-β(3) with an injectable Ca-P matrix at the supraspinatus tendon footprint has promise to improve healing after soft tissue repair.

Biological augmentation of rotator cuff repair using bFGF-loaded electrospun poly(lactide-co-glycolide) fibrous membranes

“…Given the inadequate healing response, biological methods offer the possibility to augment RC repair and may be critical to improving clinical outcomes. 28 However, acute RCT models, which most prior studies used for evaluation, did not reflect the degenerative, age-related RCTs commonly seen in humans who tend to present with intrinsic degenerative changes in the torn RC tendon. According to Buchmann's approach, 25,26 we established a chronic rat RCT model in this study.…”

“…The total area of metachromasia was then recorded in mm 2 for each specimen. 28 Tissue sections were stained with Picro Sirius red for semiquantitative analysis of collagen deposition and maturation at the repair site. By quantifying the collagen birefringence under polarized light microscopy (Eclipse E800; Nikon, Melville, NY, USA), differences in collagen maturity and organization in the healing tendon could be detected.…”

“…Ten areas (50×50 µm) were randomly selected from the tendon region adjacent to the insertion site and the grayscale values were measured and recorded. 28 …”

Low-intensity pulsed ultrasound therapy: a potential strategy to stimulate tendon-bone junction healing

“…Increasing the integrity of the healing of T-B interface has been attempted by adopting a number of different augmentation strategies ( Fig. 1) with the use of bone mesenchymal stem cells (MSCs) (Soon et al, 2007), calcium phosphate (Mutsuzaki et al, 2011), bone marrow or periosteum (Chen, 2009;Karaoglu et al, 2009), bone morphogenetic protein-2 (Hashimoto et al, 2007), synovial MSCs (Ju et al, 2008), injectable tricalcium phosphate (Huangfu and Zhao, 2007), brushite calcium phosphate cement (Wen et al, 2009), transforming growth factor-β3 (Kovacevic et al, 2011), granulocyte colonystimulating factor (Sasaki et al, 2008), hyperbaric oxygen treatment (Young and Dyson, 1990), magnesium-based bone adhesive (Gulotta et al, 2008), and shock-wave therapy (Wang et al, 2011). However, shock-wave therapy is the only currently reported method of exogenous stimulation to enhance early healing between the grafted tendon and bone tunnel.…”

Άπόπτωσις

“…Proposed biological approaches to enhance rotator cuff healing include matrix metalloproteinase inhibitors, 2 mesenchymal stem cells, 7,24 growth factors, 13 and numerous variations of platelet-rich plasma (PRP). The use of PRP to supplement rotator cuff repair is always sure to ignite controversy, with some studies demonstrating a degree of efficacy 1,20 and many others reporting no value or possibly a deleterious effect.…”