scholarly journals TGF–β3 Loaded Electrospun Polycaprolacton Fibre Scaffolds for Rotator Cuff Tear Repair: An in Vivo Study in Rats

2020 ◽  
Vol 21 (3) ◽  
pp. 1046
Author(s):  
Janin Reifenrath ◽  
Mathias Wellmann ◽  
Merle Kempfert ◽  
Nina Angrisani ◽  
Bastian Welke ◽  
...  
Keyword(s):  
Foreign Body ◽  
Rotator Cuff ◽  
Healing Process ◽  
Tendon Healing ◽  
Biomechanical Analysis ◽  
Rotator Cuff Tears ◽  
Histological Evaluation ◽  
Foreign Body Giant Cell ◽  
Special Focus

Biological factors such as TGF–β3 are possible supporters of the healing process in chronic rotator cuff tears. In the present study, electrospun chitosan coated polycaprolacton (CS–g–PCL) fibre scaffolds were loaded with TGF–β3 and their effect on tendon healing was compared biomechanically and histologically to unloaded fibre scaffolds in a chronic tendon defect rat model. The biomechanical analysis revealed that tendon–bone constructs with unloaded scaffolds had significantly lower values for maximum force compared to native tendons. Tendon-bone constructs with TGF–β3-loaded fibre scaffolds showed only slightly lower values. In histological evaluation minor differences could be observed. Both groups showed advanced fibre scaffold degradation driven partly by foreign body giant cell accumulation and high cellular numbers in the reconstructed area. Normal levels of neutrophils indicate that present mast cells mediated rather phagocytosis than inflammation. Fibrosis as sign of foreign body encapsulation and scar formation was only minorly present. In conclusion, TGF–β3-loading of electrospun PCL fibre scaffolds resulted in more robust constructs without causing significant advantages on a cellular level. A deeper investigation with special focus on macrophages and foreign body giant cells interactions is one of the major foci in further investigations.

scholarly journals Use of Gracile and semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marie Protais ◽  
Maxime Laurent-Perrot ◽  
Mickaël Artuso ◽  
M. Christian Moody ◽  
Alain Sautet ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Donor Site ◽  
Anatomical Study ◽  
Donor Site Morbidity ◽  
Rotator Cuff Tears ◽  
Subacromial Space ◽  
Greater Tuberosity ◽  
Working Zone ◽  
Superior Capsular Reconstruction

Abstract Background Irreparable rotator cuff tears are common and difficult to treat. Techniques for “filling the loss of substance” require fixation to the rotator cuff stump (tendon augmentation) or to the glenoid (superior capsular reconstruction), which are complicated by the narrow working zone of the subacromial space. The main objective of this study was to determine whether a braided graft of gracilis (GR) and semitendinosus (ST) could fill a loss of tendon substance from an irreparable rupture of the supra- and infraspinatus, by fixing the graft to the greater tuberosity and the spine of the scapula. Methods This was a cadaveric study with the use of ten specimens. The GRA and ST tendons were harvested, braided and reinforced with suture. An experimental tear of the supraspinatus (SS) and upper infraspinatus (IS) retracted at the glenoid was made. The GRAST transplant was positioned over the tear. The transplant was attached to the greater tuberosity by two anchors and then attached to the medial third of the scapular spine by trans-osseous stitching. The percentage of filling obtained was then measured and passive mobility of the shoulder was assessed. We proceeded to the same technique under arthroscopy for a 73 years old patient whom we treated for a painful shoulder with irreparable cuff tear. We inserted a GRAST graft using arthroscopy. Results The Braided-GRAST allowed a 100% filling of the loss of tendon substance. Mobility was complete in all cases. Conclusion This technique simplifies the medial fixation and restores the musculo-tendinous chain where current grafting techniques only fill a tendinous defect. The transplant could have a subacromial “spacer” effect and lower the humeral head. The donor site morbidity and the fate of the transplant in-vivo are two limits to be discussed. This anatomical study paves the way for clinical experimentation.

scholarly journals Biceps Detachment Preserves Joint Function in a Chronic Massive Rotator Cuff Tear Rat Model

2018 ◽  
Vol 46 (14) ◽  
pp. 3486-3494 ◽  
Author(s):  
Mengcun Chen ◽  
Snehal S. Shetye ◽  
Julianne Huegel ◽  
Corinne N. Riggin ◽  
Daniel J. Gittings ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Shoulder Joint ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Joint Function ◽  
Massive Rotator Cuff Tears ◽  
Sham Surgery ◽  
Biceps Tenotomy

Background: Lesions of the long head of the biceps tendon are often associated with massive rotator cuff tears (MRCTs), and biceps tenotomy is frequently performed for pain relief and functional reservation. However, the efficacy and safety of biceps tenotomy regarding the effects on the surrounding tissues in chronic MRCT are unclear. Hypothesis: Biceps tenotomy would result in improved mechanical and histological properties of the intact subscapularis tendon and improved in vivo shoulder function while not compromising glenoid cartilage properties. Study Design: Controlled laboratory study. Methods: Right supraspinatus and infraspinatus tendons were detached in 25 male Sprague-Dawley rats, followed by 4 weeks of cage activity to create a chronic MRCT condition. Animals were randomly divided into 2 groups and received either biceps tenotomy (n = 11) or sham surgery (n = 14) and were sacrificed 4 weeks thereafter. Forelimb gait and ground-reaction forces were recorded 1 day before the tendon detachment (baseline), 1 day before the surgical intervention (biceps tenotomy or sham), and 3, 7, 10, 14, 21, and 28 days after the intervention to assess in vivo shoulder joint function. The subscapularis tendon and glenoid cartilage were randomly allocated for mechanical testing or histologic assessment after the sacrifice. Results: Compared with sham surgery, biceps tenotomy partially restored the in vivo shoulder joint function, with several gait and ground-reaction force parameters returning closer to preinjury baseline values at 4 weeks. With biceps tenotomy, mechanical properties of the subscapularis tendons were improved, while mechanical properties and histological Mankin scores of the glenoid cartilage were not diminished when compared with the sham group. Conclusion: Biceps tenotomy in the presence of chronic MRCT partially preserves overall shoulder function and potentially restores subscapularis tendon health without causing detrimental effects to joint cartilage. This laboratory study adds to the growing literature regarding the protective effects of biceps tenotomy on the shoulder joint in a chronic MRCT model. Clinical Relevance: This study provides important basic science evidence supporting the use of biceps tenotomy in patients with massive rotator cuff tears.

Bioactive LbL-assembled multilayer nanofilms upregulate tenogenesis and angiogenesis enabling robust healing of degenerative rotator cuff tendons in vivo

2019 ◽  
Vol 7 (10) ◽  
pp. 4388-4398 ◽  
Author(s):  
Fei Han ◽  
Peng Zhang ◽  
Xuejun Wen ◽  
Chao Lin ◽  
Peng Zhao
Keyword(s):  
Rotator Cuff ◽  
Multilayer Film ◽  
Tendon Healing

The aim of this work was to fabricate LbL-assembled multilayer film-modified aligned scaffolds and investigate their regulation of TSPCs and potential for degenerative tendon healing.

A Biomechanical Comparison of Three Miniature Locking Plate Systems in a Rabbit Radial and Ulnar Fracture Model

2019 ◽  
Vol 32 (04) ◽  
pp. 297-304 ◽  
Author(s):  
Harue Takizawa ◽  
Muneki Honnami ◽  
Takamasa Sakai ◽  
Akari Sasaki ◽  
Ayumi Sakamoto ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Locking Plate ◽  
Healing Process ◽  
Biomechanical Testing ◽  
Histological Evaluation ◽  
Fracture Stabilization ◽  
Significant Difference ◽  
Ulnar Fracture ◽  
Fracture Models

Objective The aim of this study was to evaluate the biomechanical properties of three different miniature locking plate systems used to fixate radial and ulnar fractures in toy breed dogs. Implant size, shape, material and locking systems differ, and their influence on the fracture healing process is unknown. In the present study, we aimed to investigate this matter in vivo using rabbit radial and ulnar fracture models. Study Design Eighteen rabbits were randomly divided into three groups, and the left radius and ulna were osteotomized to create fracture models. The osteotomies were then fixated using either the TITAN LOCK 1.5, Fixin micro or LCP 1.5 system. Radiographs were obtained 2, 3 and 4 weeks after surgery. Four weeks after surgery, the radiuses were collected and used for biomechanical testing or histological examinations. Results During the 4 weeks of observation, no adverse effects due to the implants occurred. The radiographic scores in each group did not differ significantly at any time point. The maximum load in the LCP group was significantly higher than that in the TITAN and Fixin groups. There was no significant difference in bending stiffness or work to failure among the groups. Initial fracture healing via woven bone was evident at histological evaluation. Conclusions All three miniature locking plate systems provided adequate fracture stabilization 4 weeks after surgery, despite their differences, in rabbit models.

Shoulder Tendon Repair Biomechanics Using a Polyurethane Patch in a Chronic Ovine Defect Model

2007 ◽  
Author(s):  
Kirk C. McGilvray ◽  
Amy S. Lyons ◽  
A. Simon Turner ◽  
John D. MacGillivray ◽  
Struan H. Coleman ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Tendon Repair ◽  
Soft Tissue Injuries ◽  
High Rate ◽  
Rotator Cuff Tears ◽  
Defect Model ◽  
Lower Back ◽  
System 1 ◽  
Cuff Repair

Rotator cuff disorders are one of the most common soft tissue injuries of the musculoskeletal system [1], second only to lower back pain presentations in clinical frequency [2]. Surgical repairs of chronic, massive rotator cuff tears are associated with a high rate of complications, typically by full or partial re-rupture of the repair [3,4]. The literature is replete with clinical retrospective studies or evaluation of cadaveric shoulders [5], however these studies do not address the in vivo healing characteristics of a given surgical repair. The purpose of this study was to quantitatively describe the degree of shoulder healing via biomechanical analyses using an ovine chronic infraspinatus model that was repaired with and without a polyurethane scaffold rotator cuff repair (RCR) patch.

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