Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Functional Materials R&D Group, Korea Dyeing and Finishing Technology Institute, Daegu, Republic of Korea.
Am J Sports Med. 2021 Sep;49(11):3050-3058. doi: 10.1177/03635465211028547. Epub 2021 Jul 21.
The healing failure rate after rotator cuff repair is considerably high.
To evaluate the effect of a porous suture containing transforming growth factor beta 1 (TGF-β1) on the sustained release of TGF-β1 and rotator cuff healing in a rat model.
Controlled laboratory study.
A porous suture was developed, and its tensile strength was measured. TGF-β1 was delivered using the porous suture, and a TGF-β1 release test and human fibroblast proliferation assay were performed. For the animal experiment, 30 rats were randomly allocated into 3 groups (n = 10 each). A bilateral supraspinatus tendon tear was made in all the rats, and repair was performed. Group 1 received repair only; group 2, repair and a single injection of TGF-β1; and group 3, repair using the porous suture containing TGF-β1. Eight weeks after repair, biomechanical and histological analyses were performed.
The porous suture was successfully developed with mechanical properties compatible with the conventional suture, and the sustained release of TGF-β1 from the porous suture was confirmed. In addition, the cell proliferation assay confirmed the biological safety of the porous suture. In the animal experiment, group 3 biomechanically exhibited the largest cross-sectional area and the highest ultimate failure load and ultimate stress (all < .05). Histological examination revealed that group 3 showed significantly better collagen fiber density and tendon-to-bone maturation than did groups 1 and 2 (all < .05).
The porous suture containing TGF-β1 could sustainedly and safely release TGF-β1, and its use during rotator cuff repair could improve rotator cuff healing, as assessed on the basis of the biomechanical and histological changes in the rat model in this study. Considering the effectiveness, safety, and convenience of the porous suture without extra effort in surgery, the findings of the present study will have a far-reaching effect on the treatment of rotator cuff tears.
The porous suture containing TGF-β1 might improve healing after rotator cuff repair.
肩袖修复后的愈合失败率相当高。
评估含有转化生长因子β 1（TGF-β1）的多孔缝线对 TGF-β1持续释放和大鼠模型肩袖愈合的影响。
对照实验室研究。
研制了一种多孔缝线，并测量其拉伸强度。使用多孔缝线递送 TGF-β1，并进行 TGF-β1 释放试验和人成纤维细胞增殖测定。对于动物实验，将 30 只大鼠随机分为 3 组（每组 10 只）。所有大鼠均进行双侧冈上肌腱撕裂修复。第 1 组仅进行修复；第 2 组，修复加单次 TGF-β1 注射；第 3 组，使用含有 TGF-β1 的多孔缝线修复。修复后 8 周，进行生物力学和组织学分析。
成功研制出具有与常规缝线机械性能相匹配的多孔缝线，并证实 TGF-β1 可从多孔缝线中持续释放。此外，细胞增殖测定证实了多孔缝线的生物安全性。在动物实验中，第 3 组在生物力学方面表现出最大的横截面积和最高的最终失效负荷和最终应力（均<0.05）。组织学检查显示，第 3 组的胶原纤维密度和肌腱-骨成熟度明显优于第 1 组和第 2 组（均<0.05）。
含有 TGF-β1 的多孔缝线可以持续、安全地释放 TGF-β1，在本研究的大鼠模型中，使用这种缝线进行肩袖修复可以改善肩袖愈合。考虑到多孔缝线的有效性、安全性和手术过程中的便利性，本研究的发现将对肩袖撕裂的治疗产生深远影响。
含有 TGF-β1 的多孔缝线可能会改善肩袖修复后的愈合。
