School of Medicine, Southeast University, Nanjing, China.
The Center of Joint and Sports Medicine, Orthopedics Department, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Orthop Surg. 2024 Oct;16(10):2311-2325. doi: 10.1111/os.14152. Epub 2024 Jul 23.
In the field of sports medicine, repair surgery for anterior cruciate ligament (ACL) and rotator cuff (RC) injuries are remarkably common. Despite the availability of relatively effective treatment modalities, outcomes often fall short of expectations. This comprehensive review aims to thoroughly examine current strategies employed to promote tendon-bone healing and analyze pertinent preclinical and clinical research. Amidst ongoing investigations, tendon-derived stem cells (TDSCs), which have comparatively limited prior exploration, have garnered increasing attention in the context of tendon-bone healing, emerging as a promising cell type for regenerative therapies. This review article delves into the potential of combining TDSCs with tissue engineering methods, with ACL reconstruction as the main focus. It comprehensively reviews relevant research on ACL and RC healing to address the issues of graft healing and bone tunnel integration. To optimize tendon-bone healing outcomes, our emphasis lies in not only reconstructing the original microstructure of the tendon-bone interface but also achieving proper bone tunnel integration, encompassing both cartilage and bone formation. In this endeavor, we thoroughly analyze the transcriptional and molecular regulatory variables governing TDSCs differentiation, incorporating a retrospective analysis utilizing single-cell sequencing, with the aim of unearthing relevant signaling pathways and processes. By presenting a novel strategy rooted in TDSCs-driven osteogenic and chondrogenic differentiation for tendon-bone healing, this study paves the way for potential future research avenues and promising therapeutic applications. It is anticipated that the findings herein will contribute to advancing the field of tendon-bone healing and foster the exploration of TDSCs as a viable option for regenerative therapies in the future.
在运动医学领域，前交叉韧带（ACL）和肩袖（RC）损伤的修复手术非常常见。尽管有相对有效的治疗方法，但结果往往达不到预期。本综述旨在全面检查目前用于促进肌腱-骨愈合的策略，并分析相关的临床前和临床研究。在正在进行的研究中，肌腱来源的干细胞（TDSCs），由于之前的探索相对较少，在肌腱-骨愈合方面越来越受到关注，成为再生治疗有前途的细胞类型。这篇综述文章探讨了将 TDSCs 与组织工程方法相结合的潜力，以 ACL 重建为主要关注点。它全面回顾了 ACL 和 RC 愈合的相关研究，以解决移植物愈合和骨隧道整合的问题。为了优化肌腱-骨愈合的结果，我们不仅要重建肌腱-骨界面的原始微观结构，还要实现适当的骨隧道整合，包括软骨和骨的形成。在这项研究中，我们深入分析了调节 TDSCs 分化的转录和分子调节变量，包括利用单细胞测序进行的回顾性分析，目的是发现相关的信号通路和过程。通过提出一种基于 TDSCs 驱动的成骨和成软骨分化的新策略来促进肌腱-骨愈合，本研究为未来的研究途径和有前途的治疗应用铺平了道路。预计本文的研究结果将有助于推动肌腱-骨愈合领域的发展，并促进 TDSCs 作为未来再生治疗的可行选择的探索。
