Growth Factors for Rotator Cuff Repair

Gulotta, Lawrence V.; Rodeo, Scott A.

doi:10.1016/j.csm.2008.09.002

Cited by 167 publications

(140 citation statements)

References 36 publications

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“…22 Soluble factor supplementation is a widely applied scaffold enhancement strategy and has shown considerable functional value for tendon tissue engineering. 23,24 PDGF-BB and IGF-1 have previously been shown to promote dosedependent increases in tenocyte proliferation and collagen synthesis, both individually and in concert. 21,22,[25][26][27] Additionally, both factors have been noted as chemoattractants of tenocytes 21 as well as mesenchymal stem cells (MSCs).…”

Section: Introductionmentioning

confidence: 99%

Composite Growth Factor Supplementation Strategies to Enhance Tenocyte Bioactivity in Aligned Collagen-GAG Scaffolds

Caliari

Harley

2013

Tissue Engineering Part A

103

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Biomolecular environments encountered in vivo are complex and dynamic, with combinations of biomolecules presented in both freely diffusible (liquid-phase) and sequestered (bound to the extracellular matrix) states. Strategies for integrating multiple biomolecular signals into a biomimetic scaffold provide a platform to simultaneously control multiple cell activities, such as motility, proliferation, phenotype, and regenerative potential. Here we describe an investigation elucidating the influence of the dose and mode of presentation (soluble, sequestered) of five biomolecules (stromal cell-derived factor 1a , platelet-derived growth factor BB [PDGF-BB], insulin-like growth factor 1 [IGF-1], basic fibroblast growth factor [bFGF], and growth/ differentiation factor 5 [GDF-5]) on the recruitment, proliferation, collagen synthesis, and genomic stability of equine tenocytes within an anisotropic collagen-GAG scaffold for tendon regeneration applications. Critically, we found that single factors led to a dose-dependent trade-off between driving tenocyte proliferation (PDGF-BB, IGF-1) versus maintenance of a tenocyte phenotype (GDF-5, bFGF). We identified supplementation schemes using factor pairs (IGF-1, GDF-5) to rescue the tenocyte phenotype and gene expression profiles while simultaneously driving proliferation. These results suggest coincident application of multi-biomolecule cocktails has a significant value in regenerative medicine applications where control of cell proliferation and phenotype are required. Finally, we demonstrated an immobilization strategy that allows efficient sequestration of bioactive levels of these factors within the scaffold network. We showed sequestration can lead to a greater sustained bioactivity than soluble supplementation, making this approach particularly amenable to in vivo translation where diffusive loss is a concern and continuous biomolecule supplementation is not feasible.

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Section: Introductionmentioning

confidence: 99%

Composite Growth Factor Supplementation Strategies to Enhance Tenocyte Bioactivity in Aligned Collagen-GAG Scaffolds

Caliari

Harley

2013

Tissue Engineering Part A

103

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“…Throughout this process, healing of the rotator cuff repair should be respected. The healing process is divided into three stages: inflammation (0-7 days), repair (5-14 days), and remodeling (> 14 days) [10]. One primate study showed an almost mature tendon-to-bone healing by 15 weeks after surgery.…”

Section: Rehabilitation Guidelinesmentioning

confidence: 99%

Rotator cuff repair: post-operative rehabilitation concepts

Sgroi

Cilenti

2018

Curr Rev Musculoskelet Med

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Purpose of review With improvements in surgical techniques and increased knowledge of rotator cuff healing, there was a need to identify a safe progression after rotator cuff repair. The rehabilitation specialist plays an integral role in the care of these patients, and by implementing an evidence and criteria-based model, patients may be able to return to their prior levels of function sooner with fewer complications. Recent findings Timing of progression for rotator cuff patients should align not only with healing but also potential strain on the involved tissue. Recent electromyography studies have identified exercises which elicit highest level of muscle activation for individual dynamic stabilizers. The physical therapist should also be aware of potential complications and be prepared to manage appropriately if they should arise. Summary During rehabilitation after rotator cuff repair, there should be constant communication with the surgical team. Awareness of complication management, healing potential of the repaired tendon, and anatomy of the shoulder complex are critical. During the early stages, reducing pain and inflammation should be prioritized followed by progressive restoration of range of motion. When advancing range of motion, progression from passive, active assisted, and active movements allow for gradual introduction of stress to the healing construct. Even though time frames are not used for progression, it is important not to place excessive stress on the shoulder for up to 12 weeks to allow for proper tendonto-bone healing. As exercises are progressed, scapular muscle activation is initiated, followed by isometric and lastly isotonic rotator cuff exercises. When treating overhead athletes, advanced strengthening in the overhead position is performed, followed by plyometric training. Advanced strengthening is initiated when all preceding criteria have been met. It is important that patients are educated early in the rehabilitation process so that they can manage their expectations to realistic time frames.

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“…Also the transforming growth factor beta (TGF-β) acts on the remodeling of the matrix by organizing the structure and density of the collagen fibers, regulating cell behavior in the different healing phases of recovery. 34,35 In the initial part of the repair phase, the derived growth factor of the PDGF platelets also regulates the expression ofinsulin-like growth factor (IGF-1), which in addition to accelerating cell proliferation supports the synthesis of collagen and other ECM components during the remodeling phase. 22,34,35 TGF-β is produced by most of the cells involved in the healing processes, remaining high during inflammation just before the traumatic incident.…”

Section: Growth Factors and Healing Of The Tendonmentioning

confidence: 99%

Oxygen-ozone therapy in the treatment of functional overload syndromes of music professionals

2017

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Musculoskeletal disorders of musicians and entertainment professionals in general have been the subject of studies and research since the nineteenth century.For the physician, they represent a grouping of pathologies that are easy to diagnose but difficult to cure, especially due to the high frequency of relapses. Oxygen-ozone therapy is an effective method for the treatment of these illnesses without the side effects of other drugs.

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Growth Factors for Rotator Cuff Repair

Cited by 167 publications

References 36 publications

Composite Growth Factor Supplementation Strategies to Enhance Tenocyte Bioactivity in Aligned Collagen-GAG Scaffolds

Composite Growth Factor Supplementation Strategies to Enhance Tenocyte Bioactivity in Aligned Collagen-GAG Scaffolds

Rotator cuff repair: post-operative rehabilitation concepts

Oxygen-ozone therapy in the treatment of functional overload syndromes of music professionals

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