Na Yuyan, Jue Hao, Xia Tian, Li Moxin, Xue Xiaoao, Hua Yinghui
Department of Sports Medicine, Sports Medicine Institute of Fudan University, Huashan Hospital, Fudan University, Shanghai 200040, China.
Regen Biomater. 2024 Jun 19;11:rbae061. doi: 10.1093/rb/rbae061. eCollection 2024.
In recent years, bridging repair has emerged as an effective approach for the treatment of massive rotator cuff tears (MRCTs). The objective of this study was to develop a composite patch that combines superior mechanical strength and biocompatibility and evaluate its potential for enhancing the outcomes of bridging repair for MRCTs. The composite patch, referred to as the PET-matrix patch (PM), was fabricated by immersing a plain-woven PET patch in decellularized matrix gel and utilizing the freeze-drying technique. The results demonstrated that the PM has reliable mechanical properties, with a maximum failure load of up to 480 N. The decellularized matrix sponge (DMS), present on the surface of the PM, displayed a loose and porous structure, with an average pore size of 62.51 μm and a porosity of 95.43%. experiments showed significant elongation of tenocytes on the DMS, with cells spanning across multiple pores and extending multiple protrusions as observed on SEM images. In contrast, tenocytes on the PET patch appeared smaller in size and lacked significant elongation. Additionally, the DMS facilitated the proliferation, migration and differentiation of tenocytes. In a rabbit model of chronic MRCTs, the PM group showed superior outcomes compared to the PET group at 4, 8 and 12 weeks after bridging repair. The PM group displayed significantly higher tendon maturing score, larger collagen diameter in the regenerated tendon and improved tendon-to-bone healing scores compared to the PET group (<0.05). Moreover, the maximum failure load of the tendon-bone complex in the PM group was significantly higher than that in the PET group (<0.05). In summary, the PM possesses reliable mechanical properties and excellent cytocompatibility, which can significantly improve the outcomes of bridging repair for chronic MRCTs in rabbits. Therefore, it holds great potential for clinical applications.
近年来，桥接修复已成为治疗巨大肩袖撕裂（MRCTs）的有效方法。本研究的目的是开发一种兼具优异机械强度和生物相容性的复合补片，并评估其在增强MRCTs桥接修复效果方面的潜力。这种复合补片被称为聚对苯二甲酸乙二酯基质补片（PM），是通过将平纹编织的聚对苯二甲酸乙二酯补片浸入脱细胞基质凝胶中并采用冷冻干燥技术制成的。结果表明，PM具有可靠的机械性能，最大破坏载荷高达480 N。PM表面的脱细胞基质海绵（DMS）呈现出疏松多孔的结构，平均孔径为62.51μm，孔隙率为95.43%。实验显示，DMS上的肌腱细胞显著伸长，如扫描电子显微镜图像所示，细胞跨越多个孔隙并伸出多个突起。相比之下，聚对苯二甲酸乙二酯补片上的肌腱细胞尺寸较小且没有显著伸长。此外，DMS促进了肌腱细胞的增殖、迁移和分化。在慢性MRCTs的兔模型中，桥接修复后4周、8周和12周时，PM组的效果优于聚对苯二甲酸乙二酯组。与聚对苯二甲酸乙二酯组相比，PM组的肌腱成熟评分显著更高，再生肌腱中的胶原直径更大，肌腱-骨愈合评分更高（<0.05）。此外，PM组肌腱-骨复合体的最大破坏载荷显著高于聚对苯二甲酸乙二酯组（<0.05）。总之，PM具有可靠的机械性能和优异的细胞相容性，可显著改善兔慢性MRCTs桥接修复的效果。因此，它在临床应用中具有巨大潜力。
