Department of Molecular and Integrative Physiology, The University of Michigan, Ann Arbor, Michigan, USA.
Department of Mechanical Engineering, The University of Michigan, Ann Arbor, Michigan, USA.
Tissue Eng Part A. 2023 Sep;29(17-18):471-480. doi: 10.1089/ten.TEA.2022.0196. Epub 2023 Aug 31.
Rotator cuff tears constitute a vast majority of shoulder-related injuries, occurring in a wide population range and increasing in incidence with age. Current treatments for full thickness tears use suture to secure the ruptured tendon back to its native attachment site and often retear due to improper enthesis regeneration. To reduce the occurrence of retear, our laboratory developed an engineered tendon graft for rotator cuff repair (ETG-RC) to serve as an underlayment to traditional suture repair. We hypothesize the ETG-RC will aid in the repair of the torn rotator cuff tendon by promoting the regeneration of a functional enthesis. This devitalized graft fabricated from ovine-derived bone marrow stromal cells was evaluated for biomechanical and histomorphology properties in an ovine infraspinatus rotator cuff repair model. Compared with a current standard practice Suture-Only model, the ETG-RC repair showed comparable high strain-to-failure forces, greater fibrocartilage deposition, regeneration of zonal gradients, and Shapey's fibers formation, indicative of enthesis regeneration. Enthesis regeneration after rotator cuff repair should repair mechanical properties and alleviate the need for subsequent surgeries required due to retear. The ETG-RC could potentially be used for repairing other tendon injuries throughout the body.
肩袖撕裂构成了绝大多数与肩部相关的损伤,其发生在广泛的人群范围内,并随着年龄的增长而增加。目前,全层撕裂的治疗方法是使用缝线将破裂的肌腱固定回其原有的附着部位,但由于腱-骨结合处再生不当,常常会再次撕裂。为了减少再次撕裂的发生,我们的实验室开发了一种用于肩袖修复的工程化肌腱移植物(ETG-RC),作为传统缝线修复的底层。我们假设 ETG-RC 通过促进功能性腱-骨结合处的再生,有助于修复撕裂的肩袖肌腱。这种源自绵羊骨髓基质细胞的去细胞移植物在绵羊冈下肌肩袖修复模型中评估了其生物力学和组织形态学特性。与目前的标准缝线修复模型相比,ETG-RC 修复显示出相当高的失效力应变、更多的纤维软骨沉积、区域梯度的再生和 Shapey 纤维的形成,表明腱-骨结合处的再生。肩袖修复后的腱-骨结合处再生应该可以修复机械性能,并减轻由于再次撕裂而需要进行后续手术的需求。ETG-RC 可能有潜力用于修复全身其他肌腱损伤。