Huang Shuting, Tam Ming Yik, Ho Wai Hon Caleb, Wong Hong Ki, Zhou Meng, Zeng Chun, Xie Denghui, Elmer Ker Dai Fei, Ling Samuel Kk, Tuan Rocky S, Wang Dan Michelle
School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Biol Proced Online. 2024 Oct 4;26(1):31. doi: 10.1186/s12575-024-00256-z.
Shoulder pain and disability from rotator cuff tears remain challenging clinical problem despite advancements in surgical techniques and materials. To advance our understanding of injury progression and develop effective therapeutics using tissue engineering and regenerative medicine approaches, it is crucial to develop and utilize animal models that closely resemble the anatomy and display the pathophysiology of the human rotator cuff. Among various animal models, the rabbit shoulder defect model is particularly favored due to its similarity to human rotator cuff pathology. However, a standardized protocol for creating a massive rotator cuff defect in the rabbits is not well defined. Therefore, the objective of our study was to establish a robust and reproducible model of a rotator cuff defect to evaluate the regenerative efficacy of scaffolds.
In our study, we successfully developed a rabbit model with a massive supraspinatus tendon defect that closely resembles the common rotator cuff injuries observed in humans. This defect involved a complete transection of the tendon, spanning 10 mm in length and encompassing its full thickness and width. To ensure stable scaffolding, we employed an innovative bridging suture technique that utilized a modified Mason-Allen suture as a structural support. Moreover, to assess the therapeutic effectiveness of the model, we utilized different scaffolds, including a bovine tendon extracellular matrix (ECM) scaffold and a commercial acellular dermal matrix (ADM) scaffold. Throughout the observation period, no scaffold damage was observed. Notably, comprehensive histological analysis demonstrated that the regenerative tissue in the tendon ECM scaffold group exhibited an organized and aligned fiber structure, indicating tendon-like tissue regeneration while the tissue in the ADM group showed comparatively less organization.
This study presents a comprehensive description of the implemented procedures for the development of a highly reproducible animal model that induces massive segmental defects in rotator cuff tendons. This protocol can be universally implemented with alternative scaffolds to investigate extensive tendon defects and evaluate the efficacy of regenerative treatments. The application of our animal model offers a standardized and reproducible platform, enabling researchers to systematically evaluate, compare, and optimize scaffold designs. This approach holds significant importance in advancing the development of tissue engineering strategies for effectively repairing extensive tendon defects.
尽管手术技术和材料有所进步，但肩袖撕裂引起的肩部疼痛和功能障碍仍是具有挑战性的临床问题。为了加深我们对损伤进展的理解，并利用组织工程和再生医学方法开发有效的治疗方法，开发和利用与人体肩袖解剖结构相似且能展现其病理生理学的动物模型至关重要。在各种动物模型中，兔肩部缺损模型因其与人类肩袖病理相似而备受青睐。然而，在兔身上创建大面积肩袖缺损的标准化方案尚未明确界定。因此，我们研究的目的是建立一个可靠且可重复的肩袖缺损模型，以评估支架的再生效果。
在我们的研究中，我们成功开发了一种兔模型，该模型具有大面积的冈上肌腱缺损，与人类常见的肩袖损伤极为相似。此缺损涉及肌腱的完全横断，长度为10毫米，涵盖其全层厚度和宽度。为确保支架稳定，我们采用了一种创新的桥接缝合技术，使用改良的梅森 - 艾伦缝合线作为结构支撑。此外，为评估该模型的治疗效果，我们使用了不同的支架，包括牛肌腱细胞外基质（ECM）支架和商用脱细胞真皮基质（ADM）支架。在整个观察期内，未观察到支架损坏。值得注意的是，全面的组织学分析表明，肌腱ECM支架组中的再生组织呈现出有组织且排列整齐的纤维结构，表明有类似肌腱的组织再生，而ADM组中的组织则显示出相对较少的组织化。
本研究全面描述了开发一种高度可重复的动物模型的实施程序，该模型可诱导肩袖肌腱出现大面积节段性缺损。该方案可通过替代支架普遍实施，以研究广泛的肌腱缺损并评估再生治疗的效果。我们的动物模型的应用提供了一个标准化且可重复的平台，使研究人员能够系统地评估、比较和优化支架设计。这种方法对于推进有效修复广泛肌腱缺损的组织工程策略的发展具有重要意义。
