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
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Biologics for tendon repair.
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Clementine M. Boutry,Yukitoshi Kaizawa,Bob C. Schroeder,Alex Chortos,Anais Legrand,Zhen Wang,James Chang,Paige M. Fox,Zhenan Bao +8 more
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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
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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
Tenocyte proliferation on collagen scaffolds protects against degradation and improves scaffold properties
TL;DR: Comparing the changing properties of collagen scaffolds incubated in culture medium, with and without human tenocytes, indicates that tenocytes proliferation both reduces the degradation and produces scaffolds with improved properties.
Journal Article
Development of a refined tenocyte differentiation culture technique for tendon tissue engineering (vol 197, pg 27, 2013)
TL;DR: In this paper, the authors showed that human tenocytes can differentiate in the absence of exogenous fetal bovine serum (FBS) but in the presence of insulin-like growth factor-1 (IGF-1) and transforming growth factorβ3 (TGF-β3).
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Pulsed Magnetic Field Therapy Increases Tensile Strength in a Rat Achilles' Tendon Repair Model
Distribution of Lubricin in the Ruptured Human Rotator Cuff and Biceps Tendon
TL;DR: The lubricin layer on the torn edges of ruptured human supraspinatus and biceps tendons may interfere with the integrative bonding of the Torn edges necessary for repair.