The Role of Nanomaterials and Biological Agents on Rotator Cuff Regeneration

Washington, Kenyatta S.; Shemshaki, Nikoo Saveh; Laurencin, Cato T.

doi:10.1007/s40883-020-00171-1

Cited by 10 publications

(6 citation statements)

References 99 publications

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“…Massive full-thickness RCTs, as described in our chronic RC model, are associated with atrophy and fat accumulation of muscles. − The healing of RCTs and the surgical outcomes are directly affected by muscle degeneration including fat accumulation, muscle atrophy, and fibrosis formation. ,,,, We previously demonstrated the potential of electroactive biomaterials along with topographical cues (PEDOT:PSS matrix) in healing muscle atrophy by using rat acute and subacute models . However, these short-term models were not enough to develop muscle degeneration, which led us to evaluate the efficacy of the material in a chronic injury model.…”

Section: Discussionmentioning

confidence: 99%

“…Rotator cuff tears (RCTs) are a common source of pain and disability in the adult population. , The delay between the time of injury and the time of repair is one of the most commonly observed challenges and is described as the chronic rotator cuff (RC) model. Despite the successful repair of the torn tendon, chronic RCTs lead to fat accumulation and muscle atrophy. , In chronic RCTs, tendon/muscle retraction causes fat accumulation in the RC muscles, muscle atrophy, fibrosis, and shoulder instability. ,, One of the challenges with RC repair is the high retear rate after surgery (up to 94%) . Full-thickness RCTs which involve the entire thickness of one or more tendons comprise about 80% of retears. − The rate of retear is affected by several factors such as fat accumulation of muscle, muscle atrophy, patient age, tear size, and repair strategies. − …”

Section: Introductionmentioning

confidence: 99%

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Efficacy of a Novel Electroconductive Matrix To Treat Muscle Atrophy and Fat Accumulation in Chronic Massive Rotator Cuff Tears of the Shoulder

Shemshaki,

Kan,

Barajaa

et al. 2023

ACS Biomater. Sci. Eng.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of a Novel Electroconductive Matrix To Treat Muscle Atrophy and Fat Accumulation in Chronic Massive Rotator Cuff Tears of the Shoulder

Shemshaki,

Kan,

Barajaa

et al. 2023

ACS Biomater. Sci. Eng.

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“…Muscle degeneration following massive rotator cuff tendon tears is described by fat accumulation, muscle atrophy, and fibrosis formation in the RC muscles ( 17 , 33 , 67 – 71 ). In this study, we confirmed a significant increase in fat accumulation, muscle atrophy, and fibrosis formation at 16 wk (NR-16) compared with normal muscles (N-16) ( SI Appendix , Fig.…”

Section: Discussionmentioning

confidence: 99%

Muscle degeneration in chronic massive rotator cuff tears of the shoulder: Addressing the real problem using a graphene matrix

Shemshaki

Kan

Barajaa

et al. 2022

Proc. Natl. Acad. Sci. U.S.A.

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Massive rotator cuff tears (MRCTs) of the shoulder cause disability and pain among the adult population. In chronic injuries, the tendon retraction and subsequently the loss of mechanical load lead to muscle atrophy, fat accumulation, and fibrosis formation over time. The intrinsic repair mechanism of muscle and the successful repair of the torn tendon cannot reverse the muscle degeneration following MRCTs. To address these limitations, we developed an electroconductive matrix by incorporating graphene nanoplatelets (GnPs) into aligned poly(l-lactic acid) (PLLA) nanofibers. This study aimed to understand 1) the effects of GnP matrices on muscle regeneration and inhibition of fat formation in vitro and 2) the ability of GnP matrices to reverse muscle degenerative changes in vivo following an MRCT. The GnP matrix significantly increased myotube formation, which can be attributed to enhanced intracellular calcium ions in myoblasts. Moreover, the GnP matrix suppressed adipogenesis in adipose-derived stem cells. These results supported the clinical effects of the GnP matrix on reducing fat accumulation and muscle atrophy. The histological evaluation showed the potential of the GnP matrix to reverse muscle atrophy, fat accumulation, and fibrosis in both supraspinatus and infraspinatus muscles at 24 and 32 wk after the chronic MRCTs of the rat shoulder. The pathological evaluation of internal organs confirmed the long-term biocompatibility of the GnP matrix. We found that reversing muscle degenerative changes improved the morphology and tensile properties of the tendon compared with current surgical techniques. The long-term biocompatibility and the ability of the GnP matrix to treat muscle degeneration are promising for the realization of MRCT healing and regeneration.

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“…The study of biomaterials that re-create the bone-tendon interface and can augment tendon repair have also been of interest recently and should continue to be explored [140]. Finally, nanotechnology has only been recently explored as a possible adjunct in aiding RCR success and can continue to be a topic of exploration [141]…”

Section: Future Directionsmentioning

confidence: 99%

Review of Ortho-Biologics in Rotator Cuff Repair

Konopitski¹,

Malige²

2022

Shoulder Surgery for RC Pathology, Arthropathy and Tumors

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Rotator cuff repair is one of the most commonly performed surgeries in orthopedics, yet rates of postoperative failure and retear remain relatively high. Poor biology and limited healing potential at the cuff insertion are frequently cited as potential confounders to otherwise technically successful surgeries. Over the past several years, ortho-biologics have been developed in an attempt to augment rotator cuff repairs. The following review will briefly cover normal biomechanics and histology of the rotator cuff and how this is altered in cuff tears, provide an in-depth summary of the available literature on various ortho-biologic agents, outline the limitations of each agent and give an idea on the future of ortho-biologics in rotator cuff.

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The Role of Nanomaterials and Biological Agents on Rotator Cuff Regeneration

Cited by 10 publications

References 99 publications

Efficacy of a Novel Electroconductive Matrix To Treat Muscle Atrophy and Fat Accumulation in Chronic Massive Rotator Cuff Tears of the Shoulder

Efficacy of a Novel Electroconductive Matrix To Treat Muscle Atrophy and Fat Accumulation in Chronic Massive Rotator Cuff Tears of the Shoulder

Muscle degeneration in chronic massive rotator cuff tears of the shoulder: Addressing the real problem using a graphene matrix

Review of Ortho-Biologics in Rotator Cuff Repair

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