Tendon and ligament regeneration and repair: clinical relevance and developmental paradigm.
TLDR
A greater understanding of the molecular mechanisms involved in T/L development and natural healing, coupled with the capability of producing complex biomaterials to deliver multiple biofactors with high spatiotemporal resolution and specificity, should lead to regenerative procedures that more closely recapitulate T/l morphogenesis.Abstract:
Tendon and ligament (T/L) are dense connective tissues connecting bone to muscle and bone to bone, respectively. Similar to other musculoskeletal tissues, T/L arise from the somitic mesoderm, but they are derived from a recently discovered somitic compartment, the syndetome. The adjacent sclerotome and myotome provide inductive signals to the interposing syndetome, thereby upregulating the expression of the transcription factor Scleraxis, which in turn leads to further tenogenic and ligamentogenic differentiation. These advances in the understanding of T/L development have been sought to provide a knowledge base for improving the healing of T/L injuries, a common clinical challenge due to the intrinsically poor natural healing response. Specifically, the three most common tendon injuries involve tearing of the rotator cuff of the shoulder, the flexor tendon of the hand, and the Achilles tendon. At present, injuries to these tissues are treated by surgical repair and/or conservative approaches, including biophysical modalities such as physical rehabilitation and cryotherapy. Unfortunately, the healing tissue forms fibrovascular scar and possesses inferior mechanical and biochemical properties as compared to native T/L. Therefore, tissue engineers have sought to improve upon the natural healing response by augmenting the injured tissue with cells, scaffolds, bioactive agents, and mechanical stimulation. These strategies show promise, both in vitro and in vivo, for improving T/L healing. However, several challenges remain in restoring full T/L function following injury, including uncertainties over the optimal combination of these biological agents as well how to best deliver tissue engineered elements to the injury site. A greater understanding of the molecular mechanisms involved in T/L development and natural healing, coupled with the capability of producing complex biomaterials to deliver multiple growth factors with high spatiotemporal resolution and specificity, will allow tissue engineers to more closely recapitulate T/L morphogenesis, thereby offering future patients the prospect of T/L regeneration, as opposed to simple tissue repair.read more
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Skeletal Tissue Mechanics
TL;DR: This poster presents a probabilistic procedure for estimating the mechanical properties of bone based on known mechanisms, including compressive forces, compressive strength, and the compressive properties of Bone.
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Biologics for tendon repair.
TL;DR: This review describes and critically assess the current strategies for enhancing tendon repair by biological means, mainly of applying growth factors, stem cells, natural biomaterials and genes, alone or in combination, to the site of tendon damage.
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A stretchable and biodegradable strain and pressure sensor for orthopaedic application
Clementine M. Boutry,Yukitoshi Kaizawa,Bob C. Schroeder,Alex Chortos,Anais Legrand,Zhen Wang,James Chang,Paige M. Fox,Zhenan Bao +8 more
TL;DR: An implantable pressure and strain sensor made entirely of biodegradable materials designed to degrade after its useful lifetime is reported, eliminating the need for a second surgery to remove the device.
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Electrospinning: An enabling nanotechnology platform for drug delivery and regenerative medicine.
TL;DR: How the 3D printing technology can contribute to the improvement of traditional electrospinning technology for the fabrication of 3D electrospun nanofiber materials as drug delivery devices/implants, scaffolds or living tissue constructs is emphasized.
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Tendon injury and repair – A perspective on the basic mechanisms of tendon disease and future clinical therapy
Jess G. Snedeker,Jasper Foolen +1 more
TL;DR: A novel framework to understand tendon physiology and pathophysiology is described that may be useful in pushing the field forward and represents a perspective on the important role that biomaterials will play in translating research discoveries to the patient.
References
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Journal ArticleDOI
Rotator cuff: biology and current arthroscopic techniques
Olaf Lorbach,Marc Tompkins +1 more
TL;DR: Current trends in arthroscopic rotators cuff repairs focusing on the used repair technique, potential influencing factors on the results, and long-term outcome after reconstruction of the rotator cuff are summarized.
Journal ArticleDOI
Development of a Refined Tenocyte Differentiation Culture Technique for Tendon Tissue Engineering
Yiwei Qiu,Xiao Wang,Yaonan Zhang,R Rout,Andrew Carr,Liwei Zhu,Zhidao Xia,Zhidao Xia,Afsie Sabokbar +8 more
TL;DR: It is shown for the first time that human tenocytes can be maintained in long-term culture, in serum-free conditions, making this approach a suitable one for the purpose of tendon tissue engineering.
Journal ArticleDOI
In situ guided tissue regeneration in musculoskeletal diseases and aging
Franz Jakob,Regina Ebert,Maximilian Rudert,Ulrich Nöth,Heike Walles,Denitsa Docheva,Matthias Schieker,Lorenz Meinel,Jürgen Groll,Jürgen Groll +9 more
TL;DR: In metabolic bone diseases like osteoporosis, it is already known that antagonists for inhibitors such as activin and sclerostin enhance bone formation, so implementing such strategies into applications for in situ guided tissue regeneration should greatly enhance the efficacy of tailored procedures in the future.
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Bioreactor optimization of tissue engineered rabbit flexor tendons in vivo
TL;DR: Tissue-engineered rabbit flexor tendons reseeded with cells are stronger in vitro after culture in a bioreactor after they are exposed to cyclic strain, and cellularity was increased in theBioreactor tendons.
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Preliminary report of in vitro reconstruction of a vascularized tendonlike structure: a novel application for adipose-derived stem cells.
Vincenzo Vindigni,C Tonello,Luca Lancerotto,Giovanni Abatangelo,Roberta Cortivo,Barbara Zavan,Franco Bassetto +6 more
TL;DR: The biologic performance of biodegradable hyaluronic acid–based (HYAFF-11) scaffolds, which were shown to be suitable for deposition of the autologous extracellular matrix critical for ADSCs differentiation, are highlighted.