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Enthesis Healing Is Dependent on Scaffold Interphase Morphology—Results from a Rodent Patellar Model. Cells 2022; 11:cells11111752. [PMID: 35681447 PMCID: PMC9179925 DOI: 10.3390/cells11111752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 01/27/2023] Open
Abstract
The use of multiphasic scaffolds to treat injured tendon-to-bone entheses has shown promising results in vitro. Here, we used two versions of a biphasic silk fibroin scaffold to treat an enthesis defect created in a rat patellar model in vivo. One version presented a mixed transition between the bony and the tendon end of the construct (S-MT) while this transition was abrupt in the second version (S-AT). At 12 weeks after surgery, the S-MT scaffold promoted better healing of the injured enthesis, with minimal undesired ossification of the insertion area. The expression of tenogenic and chondrogenic markers was sustained for longer in the S-MT-treated group and the tangent modulus of the S-MT-treated samples was similar to the native tissue at 12 weeks while that of the S-AT-treated enthesis was lower. Our study highlights the important role of the transition zone of multiphasic scaffolds in the treatment of complex interphase tissues such as the tendon-to-bone enthesis.
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Seow D, Yasui Y, Hutchinson ID, Hurley ET, Shimozono Y, Kennedy JG. The Subchondral Bone Is Affected by Bone Marrow Stimulation: A Systematic Review of Preclinical Animal Studies. Cartilage 2019; 10:70-81. [PMID: 28573889 PMCID: PMC6376565 DOI: 10.1177/1947603517711220] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Despite the mechanical and biological roles of subchondral bone (SCB) in articular cartilage health, there remains no consensus on the postoperative morphological status of SCB following bone marrow stimulation (BMS). The purpose of this systematic review was to clarify the morphology of SCB following BMS in preclinical, translational animal models. DESIGN The MEDLINE and EMBASE databases were systematically reviewed using specific search terms on April 19, 2016 based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The morphology of the SCB was assessed using of microcomputed tomography (bone density) and histology (microscopic architecture). RESULTS Seventeen animal studies with 520 chondral lesions were included. The morphology of SCB did not recover following BMS. Compared with untreated chondral defects, BMS resulted in superior morphology of superficial SCB and cartilage but inferior morphology (specifically bone density, P < 0.05) of the deep SCB. Overall, the use of biological adjuvants during BMS resulted in the superior postoperative morphology of SCB. CONCLUSIONS Alterations in the SCB following BMS were confirmed. Biologics adjuvants may improve the postoperative morphology of both SCB and articular cartilage. Refinements of BMS techniques should incorporate consideration of SCB damage and restoration. Investigations to optimize BMS techniques incorporating both minimally invasive approaches and biologically augmented platforms are further warranted.
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Affiliation(s)
- Dexter Seow
- Hospital for Special Surgery, New York, NY, USA,Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Youichi Yasui
- Hospital for Special Surgery, New York, NY, USA,Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Ian D. Hutchinson
- Hospital for Special Surgery, New York, NY, USA,Department of Orthopaedic Surgery, Albany Medical Center, Albany, NY, USA
| | - Eoghan T. Hurley
- Hospital for Special Surgery, New York, NY, USA,Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Yoshiharu Shimozono
- Hospital for Special Surgery, New York, NY, USA,Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan,Department of Orthopaedic Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - John G. Kennedy
- Hospital for Special Surgery, New York, NY, USA,John G. Kennedy, Hospital for Special Surgery, 523 East 72nd Street, Suite 507, New York, NY 10021, USA.
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Ultrasound-guided percutaneous bone drilling for the treatment of lateral epicondylitis. Eur Radiol 2017; 28:390-397. [PMID: 28677063 DOI: 10.1007/s00330-017-4932-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 05/17/2017] [Accepted: 06/07/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the clinical efficacy of sonographically-guided percutaneous bone drilling of the lateral epicondyle (LE) for the treatment of patients with LE. METHODS We included 24 patients with LE who reported pain in this study. All patients underwent sonographically-guided percutaneous bone drilling of the lateral epicondyle. Follow-up sonography and physical examinations were performed 1, 3 and 6 months after the procedure. The outcome measures included sonographic findings, visual analogue scale (VAS) score, maximum voluntary grip strength (MVGS) and patient-related tennis elbow evaluation (PRTEE) score. RESULTS None of the patients had immediate complications during the procedure. The area of the extensor carpi radialis brevis (ECRB) tears decreased significantly at 1 month and declined gradually over the remaining 5 months of the study (p < 0.001). The mean pain VAS score was significantly lower at 6 months than preoperatively (respectively; p < 0.001). The mean MVGS increased significantly between pretreatment and 6 months post-treatment (p < 0.001), whereas the PRTEE score decreased significantly during the same period (p < 0.001). CONCLUSION Sonographically-guided percutaneous drilling is a quick and safe treatment option for LE that can be performed in an outpatient setting. KEY POINTS • Percutaneous drilling of the lateral condyle is effective for the treatment of LE. • The area of ECRB tears can be measured by US-guided saline injection. • US-guided percutaneous drilling is a quick and safe treatment option for LE.
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Kabuto Y, Morihara T, Sukenari T, Kida Y, Oda R, Arai Y, Sawada K, Matsuda KI, Kawata M, Tabata Y, Fujiwara H, Kubo T. Stimulation of Rotator Cuff Repair by Sustained Release of Bone Morphogenetic Protein-7 Using a Gelatin Hydrogel Sheet. Tissue Eng Part A 2015; 21:2025-33. [PMID: 25819324 DOI: 10.1089/ten.tea.2014.0541] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bone morphogenetic protein-7 (BMP-7) promotes not only osteogenesis but also matrix production in chondrocytes and tenocytes. However, because of its short half-life, maintaining local concentrations of BMP-7 is difficult. We examined the use of a gelatin hydrogel sheet (GHS) for the sustained release of BMP-7 in stimulating rotator cuff repair at the tendon-to-bone insertion. Twelve-week-old male Sprague-Dawley rats were used. Radiolabeled BMP-7 ((125)I-BMP-7) was injected into the subacromial bursa in the (125)I-BMP-7 group, whereas a GHS impregnated with (125)I-BMP-7 was implanted on the tendon attached to the tendon-to-bone insertion in the (125)I-BMP-7+GHS group. Levels of (125)I-BMP-7 in the tendon-to-bone insertion were assessed at 1, 3, 7, 14, and 21 postoperative days. The BMP-7 concentrations were significantly higher in the (125)I-BMP-7+GHS group than in the (125)I-BMP-7 group. Next, the bilateral supraspinatus tendons were resected and sutured to the greater tuberosity of the humerus using the Mason-Allen technique. Treatment groups were created as follows: either phosphate-buffered saline (PBS) or BMP-7 was injected into the subacromial bursa in the PBS and BMP-7 groups, whereas a GHS impregnated with either PBS or BMP-7 was implanted on the repaired tendon attached to the tendon-to-bone insertion in the PBS+GHS and BMP-7+GHS groups. The resected specimens were stained at 2, 4, and 8 postoperative weeks with hematoxylin and eosin as well as Safranin O, and tissue repair was evaluated histologically by using the tendon-to-bone maturing score. Tissue repair was assessed biomechanically at 4 and 8 postoperative weeks. The BMP-7+GHS group at 8 postoperative weeks demonstrated a favorable cartilage matrix production and tendon orientation; moreover, the tendon-to-bone maturing score and the ultimate force-to-failure were the highest in this group. The ability of GHS to provide controlled release of various growth factors has been previously reported. We confirmed that the GHS releases BMP-7 in a sustained manner in the rat shoulder joint. At 8 postoperative weeks, the repaired tissue was mostly restored, both histologically and biomechanically, in the BMP-7+GHS group. We therefore conclude that the sustained release of BMP-7 from a GHS can stimulate rotator cuff repair.
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Affiliation(s)
- Yukichi Kabuto
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Toru Morihara
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Tsuyoshi Sukenari
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Yoshikazu Kida
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Ryo Oda
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Yuji Arai
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Koshiro Sawada
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Ken-Ichi Matsuda
- 2 Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Mitsuhiro Kawata
- 2 Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Yasuhiko Tabata
- 3 Department of Biomaterials, Institute for Frontier Medical Sciences, Kyoto University , Kyoto, Japan
| | - Hiroyoshi Fujiwara
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
| | - Toshikazu Kubo
- 1 Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto, Japan
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