Department of Joint and Trauma Surgery, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China; Department of Orthopaedic Surgery, The Lingnan Hospital of Sun Yat-sen University, Guangzhou 510630, China.
Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig 04103, Germany.
Int J Biol Macromol. 2023 Aug 1;245:125522. doi: 10.1016/j.ijbiomac.2023.125522. Epub 2023 Jun 21.
Biodegradable subacromial spacer implantation has become practicable for the treatment of irreparable rotator cuff tears (IRCT). However, the relative high degradation rate and inferior tissue regeneration properties of current subacromial spacer may lead to failure regards to long-term survival. It is reported that satisfactory clinical results lie in the surrounding extracellular matrix (ECM) deposition after implantation. This study aims to develop a biological subacromial spacer that would enhance tissue regeneration properties and results in better ECM deposition. Physicochemical properties were characterized on both poly-l-lactide-co-ε-caprolactone (PLCL) dip-coating spacer (monolayer spacer, MS) and PLCL dip-coating + Poly-l-Lactic Acid (PLLA)/Gelatin electrospun spacer (Bilayer Spacer, BS). Cytocompatibility, angiogenesis, and collagen inducibility were evaluated with tendon fibroblasts and endothelial cells. Ultrasonography and histomorphology were used to analyze biodegradability and surrounding ECM deposition after the implantation in vivo. BS was successfully fabricated with the dip-coating and electrospinning technique, based on the human humeral head data. In vitro studies demonstrated that BS showed a greater cytocompatibility, and increased secretion of ECM proteins comparing to MS. In vivo studies indicated that BS promoted ECM deposition and angiogenesis in the surrounding tissue. Our research highlights that BS exhibits better ECM deposition and reveals a potential candidate for the treatment of IRCT in future.
可生物降解的肩峰下间隔物植入术已成为治疗不可修复性肩袖撕裂（IRCT）的可行方法。然而，目前肩峰下间隔物相对较高的降解率和较差的组织再生性能可能导致长期生存失败。据报道，令人满意的临床结果在于植入物后周围细胞外基质（ECM）的沉积。本研究旨在开发一种生物性肩峰下间隔物，以增强组织再生性能并导致更好的 ECM 沉积。对聚-l-乳酸-co-ε-己内酯（PLCL）浸涂间隔物（单层间隔物，MS）和 PLCL 浸涂+聚-l-乳酸（PLLA）/明胶静电纺丝间隔物（双层间隔物，BS）进行了理化性质的表征。采用肌腱成纤维细胞和内皮细胞评估细胞相容性、血管生成和胶原诱导性。超声检查和组织形态学用于分析体内植入后的生物降解性和周围 ECM 沉积。根据人体肱骨头数据，成功地采用浸涂和静电纺丝技术制备了 BS。体外研究表明，BS 表现出更好的细胞相容性，并增加了 ECM 蛋白的分泌。体内研究表明，BS 促进了周围组织的 ECM 沉积和血管生成。我们的研究强调，BS 表现出更好的 ECM 沉积，并为未来治疗 IRCT 提供了一种有潜力的候选方法。
