Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Republic of Korea.
Institute of Biomaterial and Medical Engineering, Cellumed Co., Ltd, Seoul, Republic of Korea.
J Biomed Mater Res B Appl Biomater. 2017 Oct;105(7):1840-1846. doi: 10.1002/jbm.b.33716. Epub 2016 May 26.
Biologic augmentation for rotator cuff repair is a challenging treatment in patients with chronic large, massive, and irreparable rotator cuff injuries. Particularly, the use of an extracellular matrix (ECM) patch such as dermal tissue offered improved biomechanical properties in previous studies. Cytokines induce cell chemotaxis, proliferation, matrix synthesis, and cell differentiation. Moreover, osteoinductive growth factors such as bone morphogenetic protein-2 (BMP-2) affect the formation of new bone and fibrocartilage in lesions. However, the effects of using a dermal patch in combination with BMP-2 have not been evaluated to date, although many researchers have recognized the importance thereof. In this study, rhBMP-2-coated dermal patch (1 cm × 2 cm) isolated from human cadaveric donor was inserted in a rabbit model of chronic rotator cuff injury for in vivo evaluation. Bone mineral density and biomechanical strength were tested and histological and histomorphometric analyses were performed. The results showed that insertion of an rhBMP-2-coated acellular dermal patch not only significantly ameliorated new bone formation, it also improved biomechanical properties such as ultimate tensile strength. Thus, the use of this combination may improve the chronic rotator cuff injury-healing rate and clinical outcomes after rotator cuff repair. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1840-1846, 2017.
生物增强剂在肩袖修复中是一个具有挑战性的治疗方法，适用于慢性大、巨大和不可修复的肩袖损伤患者。特别是，在以前的研究中，使用细胞外基质（ECM）贴片，如真皮组织，可提供改善的生物力学性能。细胞因子诱导细胞趋化、增殖、基质合成和细胞分化。此外，骨诱导生长因子如骨形态发生蛋白-2（BMP-2）影响病变中新骨和纤维软骨的形成。然而，到目前为止，尚未评估使用真皮贴片与 BMP-2 联合使用的效果，尽管许多研究人员已经认识到其重要性。在这项研究中，从人体尸体供体中分离的 rhBMP-2 包被真皮贴片（1cm×2cm）被插入兔慢性肩袖损伤模型中进行体内评价。测试了骨矿物质密度和生物力学强度，并进行了组织学和组织形态计量学分析。结果表明，插入 rhBMP-2 包被的去细胞真皮贴片不仅显著改善了新骨形成，还改善了最终拉伸强度等生物力学性能。因此，这种联合使用可能会提高慢性肩袖损伤的愈合率和肩袖修复后的临床效果。©2016 Wiley Periodicals, Inc. J 生物医学材料研究部分 B：应用生物材料，105B：1840-1846，2017。
