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He X, Li Y, Zou D, Zu H, Li W, Zheng Y. An overview of magnesium-based implants in orthopaedics and a prospect of its application in spine fusion. Bioact Mater 2024; 39:456-478. [PMID: 38873086 PMCID: PMC11170442 DOI: 10.1016/j.bioactmat.2024.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/22/2024] [Accepted: 04/22/2024] [Indexed: 06/15/2024] Open
Abstract
Due to matching biomechanical properties and significant biological activity, Mg-based implants present great potential in orthopedic applications. In recent years, the biocompatibility and therapeutic effect of magnesium-based implants have been widely investigated in trauma repair. In contrast, the R&D work of Mg-based implants in spinal fusion is still limited. This review firstly introduced the general background for Mg-based implants. Secondly, the mechanical properties and degradation behaviors of Mg and its traditional and novel alloys were reviewed. Then, different surface modification techniques of Mg-based implants were described. Thirdly, this review comprehensively summarized the biological pathways of Mg degradation to promote bone formation in neuro-musculoskeletal circuit, angiogenesis with H-type vessel formation, osteogenesis with osteoblasts activation and chondrocyte ossification as an integrated system. Fourthly, this review followed the translation process of Mg-based implants via updating the preclinical studies in fracture fixation, sports trauma repair and reconstruction, and bone distraction for large bone defect. Furthermore, the pilot clinical studies were involved to demonstrate the reliable clinical safety and satisfactory bioactive effects of Mg-based implants in bone formation. Finally, this review introduced the background of spine fusion surgeryand the challenges of biological matching cage development. At last, this review prospected the translation potential of a hybrid Mg-PEEK spine fusion cage design.
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Affiliation(s)
- Xuan He
- Department of Orthopaedics, Peking University Third Hospital, No.49 North Huayuan Road, Haidian, Beijing, PR China
| | - Ye Li
- Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, PR China
| | - Da Zou
- Department of Orthopaedics, Peking University Third Hospital, No.49 North Huayuan Road, Haidian, Beijing, PR China
| | - Haiyue Zu
- Department of Orthopaedics, The First Affiliated Hospital of Suchow University, PR China
| | - Weishi Li
- Department of Orthopaedics, Peking University Third Hospital, No.49 North Huayuan Road, Haidian, Beijing, PR China
| | - Yufeng Zheng
- Department of Materials Science and Engineering, College of Engineering, Peking University, Comprehensive Scientific Research Building, Beijing, PR China
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Lemmon EA, Bonnevie ED, Patel JM, Miller LM, Mauck RL. Transient inhibition of meniscus cell migration following acute inflammatory challenge. J Orthop Res 2023; 41:2055-2064. [PMID: 36866823 PMCID: PMC10750267 DOI: 10.1002/jor.25545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/23/2023] [Accepted: 03/01/2023] [Indexed: 03/04/2023]
Abstract
Meniscus tears represent a common orthopedic injury that often requires surgery to restore pain-free function. The need for surgical intervention is due, in part, to the inflammatory and catabolic environment that inhibits meniscus healing after injury. In other organ systems, healing is dependent on the migration of cells to the site of injury; however, in the meniscus, it is currently unknown how the microenvironment dictates cell migration in the postinjury inflamed setting. Here, we investigated how inflammatory cytokines alter meniscal fibrochondrocyte (MFC) migration and sensation of microenvironmental stiffness. We further tested whether an FDA approved interleukin-1 receptor antagonist (IL-1Ra; Anakinra) could rescue migratory deficits caused by inflammatory challenge. When cultured in the presence of inflammatory cytokines (tumor necrosis factor-α [TNF-α] or interleukin-1β [IL-1β]) for 1 day, MFC migration was inhibited for 3 days before returning to control levels at Day 7. This migratory deficit was clear in three-dimensional as well, where fewer MFCs exposed to inflammatory cytokines migrated from a living meniscal explant compared with control. Notably, addition of IL-1Ra to MFCs previously exposed to IL-1β restored migration to baseline levels. This study demonstrates that joint inflammation can have negative impacts on meniscus cell migration and mechanosensation, affecting their potential for repair, and that resolution of this inflammation with concurrent anti-inflammatories can reverse these deficits. Future work will apply these findings to mitigate the negative consequences of joint inflammation and promote repair in a clinically relevant meniscus injury model.
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Affiliation(s)
- Elisabeth A. Lemmon
- University of Pennsylvania Perelman School of Medicine, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania, USA
| | - Edward D. Bonnevie
- University of Pennsylvania Perelman School of Medicine, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania, USA
| | - Jay M. Patel
- Department of Orthopaedics, Emory University, Decatur, Georgia, USA
| | - Liane M. Miller
- University of Pennsylvania Perelman School of Medicine, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania, USA
| | - Robert L. Mauck
- University of Pennsylvania Perelman School of Medicine, Department of Orthopaedic Surgery, Philadelphia, Pennsylvania, USA
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Qin H, Weng J, Zhou B, Zhang W, Li G, Chen Y, Qi T, Zhu Y, Yu F, Zeng H. Magnesium Ions Promote In Vitro Rat Bone Marrow Stromal Cell Angiogenesis Through Notch Signaling. Biol Trace Elem Res 2023; 201:2823-2842. [PMID: 35870071 DOI: 10.1007/s12011-022-03364-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/15/2022] [Indexed: 11/02/2022]
Abstract
Bone defects are often caused by trauma or surgery and can lead to delayed healing or even bone nonunion, thereby resulting in impaired function of the damaged site. Magnesium ions and related metallic materials play a crucial role in repairing bone defects, but the mechanism remains unclear. In this study, we induced the angiogenic differentiation of bone marrow stromal cells (BMSCs) with different concentrations of magnesium ions. The mechanism was investigated using γ-secretase inhibitor (DAPT) at different time points (7 and 14 days). Angiogenesis, differentiation, migration, and chemotaxis were detected using the tube formation assay, wound-healing assay, and Transwell assay. Besides, we analyzed mRNA expression and the angiogenesis-related protein levels of genes by RT-qPCR and western blot. We discovered that compared with other concentrations, the 5 mM magnesium ion concentration was more conducive to forming tubes. Additionally, hypoxia-inducible factor 1 alpha (Hif-1α) and endothelial nitric oxide (eNOS) expression both increased (p < 0.05). After 7 and 14 days of induction, 5 mM magnesium ion group tube formation, migration, and chemotaxis were enhanced, and the expression of Notch pathway genes increased. Moreover, expression of the Notch target genes hairy and enhancer of split 1 (Hes1) and Hes5 (hairy and enhancer of split 5), as well as the angiogenesis-related genes Hif-1α and eNOS, were enhanced (p < 0.05). However, these trends did not occur when DAPT was applied. This indicates that 5 mM magnesium ion is the optimal concentration for promoting the angiogenesis and differentiation of BMSCs in vitro. By activating the Notch signaling pathway, magnesium ions up-regulate the downstream genes Hes1 and Hes5 and the angiogenesis-related genes Hif-1α and eNOS, thereby promoting the angiogenesis differentiation of BMSCs. Additionally, magnesium ion-induced differentiation enhances the migration and chemotaxis of BMSCs. Thus, we can conclude that magnesium ions and related metallic materials promote angiogenesis to repair bone defects. This provides the rationale for developing artificial magnesium-containing bone materials through tissue engineering.
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Affiliation(s)
- Haotian Qin
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Jian Weng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Bo Zhou
- Department of Hand & Microsurgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Weifei Zhang
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Guoqing Li
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Yingqi Chen
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Tiantian Qi
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Yuanchao Zhu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China
| | - Fei Yu
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
| | - Hui Zeng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
- National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
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Chen Z, Deng XH, Jiang C, Wang JS, Li WP, Zhu KL, Li YH, Song B, Zhang ZZ. Repairing Avascular Meniscal Lesions by Recruiting Endogenous Targeted Cells Through Bispecific Synovial-Meniscal Aptamers. Am J Sports Med 2023; 51:1177-1193. [PMID: 36917829 DOI: 10.1177/03635465231159668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Tissue engineering is a promising treatment option for meniscal lesions in the avascular area, but a favorable cell source and its utilization in tissue-engineered menisci remain uncertain. Therefore, a more controllable and convenient method for cell recruitment is required. HYPOTHESIS Circular bispecific synovial-meniscal (S-M) aptamers with a gelatin methacryloyl (GelMA) hydrogel can recruit endogenous synovial and meniscal cells to the site of the defect, thereby promoting in situ meniscal regeneration and chondroprotection. STUDY DESIGN Controlled laboratory study. METHODS Synovial and meniscal aptamers were filtered through systematic evolution of ligands by exponential enrichment (SELEX) and cross-linked to synthesize the S-M aptamer. A GelMA-aptamer system was constructed. An in vitro analysis of the bi-recruitment of synovial and meniscal cells was performed, and the migration and proliferation of the GelMA-aptamer hydrogel were also tested. For the in vivo assay, rabbits (n = 90) with meniscal defects in the avascular zone were divided into 3 groups: repair with the GelMA-aptamer hydrogel (GelMA-aptamer group), repair with the GelMA hydrogel (GelMA group), and no repair (blank group). Regeneration of the repaired meniscus and degeneration of the cartilage were assessed by gross and histological evaluations at 4, 8, and 12 weeks postoperatively. The mechanical properties of repaired menisci were also evaluated. RESULTS In vitro synovial and meniscal cells were recruited simultaneously by the S-M aptamer with high affiliation and specificity. The GelMA-aptamer hydrogel promoted the migration of targeted cells. Compared with the other groups, the GelMA-aptamer group showed enhanced fibrocartilaginous regeneration, lower cartilage degeneration, and better mechanical strength at 12 weeks after meniscal repair. CONCLUSION/CLINICAL RELEVANCE Bispecific S-M aptamers could be used for avascular meniscal repair by recruiting endogenous synovial and meniscal cells and promoting fibrocartilaginous regeneration.
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Affiliation(s)
- Zhong Chen
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xing-Hao Deng
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chuan Jiang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing-Song Wang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wei-Ping Li
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ke-Long Zhu
- School of Chemistry, Sun Yat-sen University, Guangzhou, China
| | - Yu-Heng Li
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Song
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zheng-Zheng Zhang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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Kimura M, Nakase J, Takata Y, Shimozaki K, Asai K, Yoshimizu R, Kanayama T, Yanatori Y, Tsuchiya H. Regeneration Using Adipose-Derived Stem Cell Sheets in a Rabbit Meniscal Defect Model Improves Tensile Strength and Load Distribution Function of the Meniscus at 12 Weeks. Arthroscopy 2023; 39:360-370. [PMID: 35995333 DOI: 10.1016/j.arthro.2022.07.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 02/02/2023]
Abstract
PURPOSE The purpose of this study was to evaluate the mechanical properties, such as the tensile strength and load distribution function, of the meniscus tissue regenerated using adipose-derived stem cell (ADSC) sheets in a rabbit meniscal defect model. METHODS ADSC sheets were prepared from adipose tissue of rabbits. The anterior half of the medial meniscus was removed from both knees. One knee was transplanted with an ADSC sheet; the contralateral knee was closed without transplantation. Mechanical tests were performed at 4 and 12 weeks posttransplantation. In the tensile test, tensile force was applied to the entire medial meniscus, including the normal area (n = 10/group). Compression tests were performed on the entire knee, with soft tissues other than the ligament removed. A pressure-sensitive film was inserted under the medial meniscus and a 40-N load was applied (n = 5/group). RESULTS In the tensile test, the elastic modulus in ADSC-treated knees was higher at 12 weeks (ADSC: 70.30 ± 18.50 MPa, control: 43.71 ± 7.11 MPa, P = .009). The ultimate tensile strength (UTS) in ADSC-treated knees at 12 weeks was also higher (ADSC: 22.69 ± 5.87 N, control: 15.45 ± 4.08 N, P = .038). In the compression test, the contact area was larger in the ADSC group at 4 weeks (ADSC: 31.60 ± 8.17 mm2, control: 20.33 ± 2.86 mm2, P = .024) and 12 weeks (ADSC: 41.07 ± 6.09 mm2, control: 30.53 ± 5.47 mm2, P = .04). Peak pressure was significantly lower in ADSC-treated knees at 12 weeks (ADSC: 11.91 ± 1.03 MPa, control: 15.53 ± 2.3 MPa, P = .002). CONCLUSIONS The regenerated meniscus tissue, 12 weeks after transplantation of the ADSC sheets into the meniscal defect area, had high elastic modulus and UTS. In the meniscus-tibia compartment, the contact area was large and the peak pressure was low. CLINICAL RELEVANCE ADSC sheets promoted regeneration of meniscus. ADSC sheet transplantation for meniscal defects could be an effective regenerative therapy.
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Affiliation(s)
- Mitsuhiro Kimura
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Junsuke Nakase
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
| | - Yasushi Takata
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Kengo Shimozaki
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Kazuki Asai
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Rikuto Yoshimizu
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Tomoyuki Kanayama
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Yusuke Yanatori
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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Li Z, Lin H, Shi S, Su K, Zheng G, Gao S, Zeng X, Ning H, Yu M, Li X, Liao G. Controlled and Sequential Delivery of Stromal Derived Factor-1 α (SDF-1α) and Magnesium Ions from Bifunctional Hydrogel for Bone Regeneration. Polymers (Basel) 2022; 14:polym14142872. [PMID: 35890649 PMCID: PMC9315491 DOI: 10.3390/polym14142872] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/09/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
Bone healing is a complex process that requires the participation of cells and bioactive factors. Stromal derived factor-1 α (SDF-1α) and magnesium ions (Mg2+) both are significant bioactive factors for cell recruitment and osteogenesis during bone regeneration. Thus, a bifunctional hydrogel containing a sequential delivery system is fabricated to improve osteogenesis. During sequential delivery of the hydrogel, SDF-1α is predominantly released at the early stage of bone mesenchymal stem cells (BMSCs) recruitment, while Mg2+ are constantly delivered at a later stage to improve osteogenic differentiation of recruited cells. In addition, due to the early release of SDF-1α, the hydrogel showed strong BMSCs recruitment and proliferation activity. Mg2+ can not only induce up-regulation of osteogenic gene expression in vitro, but also promote bone tissue and angiogenesis in vivo. Taken together, the injection of xanthan gum-polydopamine crosslinked hydrogel co-loading SDF-1α and Mg2+ (XPMS hydrogel) provides a novel strategy to repair bone defects.
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Affiliation(s)
- Zhengshi Li
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (Z.L.); (S.S.); (K.S.); (G.Z.); (S.G.)
| | - Huimin Lin
- Guangdong Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China;
| | - Shanwei Shi
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (Z.L.); (S.S.); (K.S.); (G.Z.); (S.G.)
| | - Kai Su
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (Z.L.); (S.S.); (K.S.); (G.Z.); (S.G.)
| | - Guangsen Zheng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (Z.L.); (S.S.); (K.S.); (G.Z.); (S.G.)
| | - Siyong Gao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (Z.L.); (S.S.); (K.S.); (G.Z.); (S.G.)
| | - Xuan Zeng
- Institute of Polymer Optoelectronic Materials and Devices, State Key Laboratory of Luminescent Materials and Devices, South China University of Technology, Guangzhou 510640, China; (X.Z.); (H.N.)
| | - Honglong Ning
- Institute of Polymer Optoelectronic Materials and Devices, State Key Laboratory of Luminescent Materials and Devices, South China University of Technology, Guangzhou 510640, China; (X.Z.); (H.N.)
| | - Meng Yu
- Guangdong Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou 510515, China;
- Correspondence: (M.Y.); (X.L.); (G.L.); Tel.: +86-15332176225 (M.Y.); +86-18675951079 (X.L.); +86-13500020072 (G.L.)
| | - Xiang Li
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (Z.L.); (S.S.); (K.S.); (G.Z.); (S.G.)
- Correspondence: (M.Y.); (X.L.); (G.L.); Tel.: +86-15332176225 (M.Y.); +86-18675951079 (X.L.); +86-13500020072 (G.L.)
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China; (Z.L.); (S.S.); (K.S.); (G.Z.); (S.G.)
- Correspondence: (M.Y.); (X.L.); (G.L.); Tel.: +86-15332176225 (M.Y.); +86-18675951079 (X.L.); +86-13500020072 (G.L.)
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Xu Z, Fang Y, Chen Y, Zhao Y, Wei W, Teng C. Hydrogel Development for Rotator Cuff Repair. Front Bioeng Biotechnol 2022; 10:851660. [PMID: 35782490 PMCID: PMC9240348 DOI: 10.3389/fbioe.2022.851660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Rotator cuff tears (RCTs) are common in shoulder disease and disability. Despite significant advances in surgical repair techniques, 20–70% of patients still have postoperative rotator cuff dysfunction. These functional defects may be related to retear or rotator cuff quality deterioration due to tendon retraction and scar tissue at the repair site. As an effective delivery system, hydrogel scaffolds may improve the healing of RCTs and be a useful treatment for irreparable rotator cuff injuries. Although many studies have tested this hypothesis, most are limited to laboratory animal experiments. This review summarizes differences in hydrogel scaffold construction, active ingredients, and application methods in recent research. Efforts to determine the indications of hydrogel scaffolds (with different constructions and cargos) for various types of RCTs, as well as the effectiveness and reliability of application methods and devices, are also discussed.
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Affiliation(s)
- Zhengyu Xu
- Department of Orthopaedics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Yifei Fang
- Department of Orthopaedics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Yao Chen
- Department of Orthopaedics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Yushuang Zhao
- Department of Orthopaedics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
| | - Wei Wei
- Department of Orthopaedics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
- Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Wei Wei, ; Chong Teng,
| | - Chong Teng
- Department of Orthopaedics, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, China
- *Correspondence: Wei Wei, ; Chong Teng,
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Chu YS, Wong PC, Jang JSC, Chen CH, Wu SH. Combining Mg–Zn–Ca Bulk Metallic Glass with a Mesoporous Silica Nanocomposite for Bone Tissue Engineering. Pharmaceutics 2022; 14:pharmaceutics14051078. [PMID: 35631664 PMCID: PMC9145403 DOI: 10.3390/pharmaceutics14051078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023] Open
Abstract
Mg–Zn–Ca bulk metallic glass (BMG) is a promising orthopedic fixation implant because of its biodegradable and biocompatible properties. Structural supporting bone implants with osteoinduction properties for effective bone regeneration have been highly desired in recent years. Osteogenic growth peptide (OGP) can increase the proliferation and differentiation of mesenchymal stem cells and enhance the mineralization of osteoblast cells. However, the short half-life and non-specificity to target areas limit applications of OGP. Mesoporous silica nanoparticles (MSNs) as nanocarriers possess excellent properties, such as easy surface modification, superior targeting efficiency, and high loading capacity of drugs or proteins. Accordingly, we propose a system of combining the OGP-containing MSNs with Mg–Zn–Ca BMG materials to promote bone regeneration. In this work, we conjugated cysteine-containing OGP (cgOGP, 16 a.a.) to interior walls of channels in MSNs and maintained the dispersity of MSNs via PEGylation. An in vitro study showed that metal ions released from Mg–Zn–Ca BMG promoted cell proliferation and migration and elevated alkaline phosphatase (ALP) activity and mineralization. On treating cells with both BMG ion-containing Minimum Essential Medium Eagle-alpha modification (α-MEM) and OGP-conjugated MSNs, enhanced focal adhesion turnover and promoted differentiation were observed. Hematological analyses showed the biocompatible nature of this BMG/nanocomposite system. In addition, in vivo micro-computed tomographic and histological observations revealed that our system stimulated osteogenesis and new bone formation around the implant site.
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Affiliation(s)
- Yun Shin Chu
- Graduate Institute of Biomedical Materials and Tissue Engineering, Taipei Medical University, Taipei 11031, Taiwan;
| | - Pei-Chun Wong
- Department of Orthopedics, Taipei Medical University Hospital, Taipei 11031, Taiwan;
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Orthopedics Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
| | - Jason Shian-Ching Jang
- Graduate Institute of Materials Science and Engineering, National Central University, Taoyuan 32001, Taiwan;
- Department of Mechanical Engineering, National Central University, Taoyuan 32001, Taiwan
| | - Chih-Hwa Chen
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Orthopedics, Taipei Medical University—Shuang Ho Hospital, New Taipei 11031, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Research Center of Biomedical Device, Taipei Medical University, Taipei 11031, Taiwan
| | - Si-Han Wu
- Graduate Institute of Nanomedicine and Medical Engineering, Taipei Medical University, Taipei 11031, Taiwan
- International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence:
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Ding G, Du J, Hu X, Ao Y. Mesenchymal Stem Cells From Different Sources in Meniscus Repair and Regeneration. Front Bioeng Biotechnol 2022; 10:796367. [PMID: 35573249 PMCID: PMC9091333 DOI: 10.3389/fbioe.2022.796367] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 04/11/2022] [Indexed: 01/22/2023] Open
Abstract
Meniscus damage is a common trauma that often arises from sports injuries or menisci tissue degeneration. Current treatment methods focus on the repair, replacement, and regeneration of the meniscus to restore its original function. The advance of tissue engineering provides a novel approach to restore the unique structure of the meniscus. Recently, mesenchymal stem cells found in tissues including bone marrow, peripheral blood, fat, and articular cavity synovium have shown specific advantages in meniscus repair. Although various studies explore the use of stem cells in repairing meniscal injuries from different sources and demonstrate their potential for chondrogenic differentiation, their meniscal cartilage-forming properties are yet to be systematically compared. Therefore, this review aims to summarize and compare different sources of mesenchymal stem cells for meniscal repair and regeneration.
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Affiliation(s)
- Guocheng Ding
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Jianing Du
- School of Basic Medical Sciences, Peking University, Beijing, China
| | - Xiaoqing Hu
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Yingfang Ao
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
- *Correspondence: Yingfang Ao,
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10
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Park DY, Yin XY, Chung JY, Jin YJ, Kwon HJ, Lee GB, Park JH, Min BH. Circumferential Rim Augmentation Suture Around the Perimeniscal Capsule Decreases Meniscal Extrusion and Progression of Osteoarthritis in Rabbit Meniscus Root Tear Model. Am J Sports Med 2022; 50:689-698. [PMID: 35289232 DOI: 10.1177/03635465211064297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND We recently analyzed the joint capsule adjacent to the medial meniscus and found that the perimeniscal joint capsule has collagen fiber orientation similar to that of circumferential meniscal fibers, potentially playing a role in preventing extrusion. PURPOSE To analyze the meniscal extrusion prevention potential of the circumferential rim augmentation suture around the perimeniscal capsule in a rabbit root tear model and analyze the biomechanical function in a porcine cadaveric knee. STUDY DESIGN Controlled laboratory study. METHODS Rabbit medial meniscus root tear models were divided into 3 experimental groups: root tear, root tear and suture repair, and root tear and circumferential rim augmentation suture. As for the circumferential rim augmentation suture procedure, a suture was placed to circumscribe the outer rim of the medial meniscus and passed through bone tunnels located at the tibial insertion of each root. After 4 and 8 weeks, meniscal extrusion was analyzed by micro-computed tomography, gross morphology, and histologic analysis of the medial femoral cartilage. For biomechanical analysis, porcine knees were divided into groups similar to rabbit experiments. Tibiofemoral contact parameters were assessed using a pressure mapping sensor system after applying a load of 200 N on the knee joint. RESULTS The root tear and circumferential rim augmentation suture group showed less meniscal extrusion, less gap within the tear site, and less cartilage degeneration compared with other groups after 4 and 8 weeks of surgery in the rabbit root tear model. Biomechanical analysis showed the root tear and circumferential rim augmentation suture group had larger contact area and lower peak contact pressure compared with root tear and root tear and suture repair groups. CONCLUSION The circumferential rim augmentation suture reduced the degree of meniscal extrusion while restoring meniscal function, potentially preventing progression of arthritis in a rabbit root tear model and porcine knee biomechanical analysis. CLINICAL RELEVANCE The circumferential rim augmentation suture may be a novel augmentation option during root tear treatment.
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Affiliation(s)
- Do Young Park
- Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea.,Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea
| | - Xiang Yun Yin
- Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea.,Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea
| | - Jun Young Chung
- Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Yong Jun Jin
- Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea.,Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea
| | - Hyeon Jae Kwon
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea.,Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Ga Bin Lee
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea.,Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Jin Ho Park
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea.,Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Byoung-Hyun Min
- Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea.,Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea.,Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
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11
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Yan W, Dai W, Cheng J, Fan Y, Zhao F, Li Y, Maimaitimin M, Cao C, Shao Z, Li Q, Liu Z, Hu X, Ao Y. Histologically Confirmed Recellularization is a Key Factor that Affects Meniscal Healing in Immature and Mature Meniscal Tears. Front Cell Dev Biol 2021; 9:793820. [PMID: 34957120 PMCID: PMC8692889 DOI: 10.3389/fcell.2021.793820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/23/2021] [Indexed: 11/24/2022] Open
Abstract
Healing outcomes of meniscal repair are better in younger than in older. However, exact mechanisms underlying superior healing potential in younger remain unclear from a histological perspective. This study included 24 immature rabbits and 24 mature rabbits. Tears were created in the anterior horn of medial meniscus of right knee in each rabbit. Animals were sacrificed at 1, 3, 6, and 12 weeks postoperatively. We performed macroscopic and histological evaluations of post-meniscal repair specimens. Cells were counted within a region of interest to confirm cellularization at tear site in immature menisci. The width of cell death zone was measured to determine the region of cell death in mature menisci. Apoptosis was evaluated by TUNEL assay. Vascularization was assessed by CD31 immunofluorescence. The glycosaminoglycans and the types 1 and 2 collagen content was evaluated by calculating average optical density of corresponding histological specimens. Cartilage degeneration was also evaluated. Healing outcomes following untreated meniscal tears were superior in immature group. Recellularization with meniscus-like cell morphology was observed at tear edge in immature menisci. Superior recellularization was observed at meniscal sites close to joint capsule than at sites distant from the capsule. Recellularization did not occur at tear site in mature group; however, we observed gradual enlargement of cell death zone. Apoptosis was presented at 1, 3, 6, 12 weeks in immature and mature menisci after untreated meniscal tears. Vascularization was investigated along the tear edges in immature menisci. Glycosaminoglycans and type 2 collagen deposition were negatively affected in immature menisci. We observed glycosaminoglycan degradation in mature menisci and cartilage degeneration, specifically in immature cartilage of the femoral condyle. In conclusion, compared with mature rabbits, immature rabbits showed more robust healing response after untreated meniscal tears. Vascularization contributed to the recellularization after meniscal tears in immature menisci. Meniscal injury fundamentally alters extracellular matrix deposition.
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Affiliation(s)
- Wenqiang Yan
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Wenli Dai
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Jin Cheng
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Yifei Fan
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Fengyuan Zhao
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Yuwan Li
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Maihemuti Maimaitimin
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Chenxi Cao
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Zhenxing Shao
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Qi Li
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Zhenlong Liu
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Xiaoqing Hu
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Yingfang Ao
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
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12
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Trivedi J, Betensky D, Desai S, Jayasuriya CT. Post-Traumatic Osteoarthritis Assessment in Emerging and Advanced Pre-Clinical Meniscus Repair Strategies: A Review. Front Bioeng Biotechnol 2021; 9:787330. [PMID: 35004646 PMCID: PMC8733822 DOI: 10.3389/fbioe.2021.787330] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Surgical repair of meniscus injury is intended to help alleviate pain, prevent further exacerbation of the injury, restore normal knee function, and inhibit the accelerated development of post-traumatic osteoarthritis (PTOA). Meniscus injuries that are treated poorly or left untreated are reported to significantly increase the risk of PTOA in patients. Current surgical approaches for the treatment of meniscus injuries do not eliminate the risk of accelerated PTOA development. Through recent efforts by scientists to develop innovative and more effective meniscus repair strategies, the use of biologics, allografts, and scaffolds have come into the forefront in pre-clinical investigations. However, gauging the extent to which these (and other) approaches inhibit the development of PTOA in the knee joint is often overlooked, yet an important consideration for determining the overall efficacy of potential treatments. In this review, we catalog recent advancements in pre-clinical therapies for meniscus injuries and discuss the assessment methodologies that are used for gauging the success of these treatments based on their effect on PTOA severity. Methodologies include histopathological evaluation of cartilage, radiographic evaluation of the knee, analysis of knee function, and quantification of OA predictive biomarkers. Lastly, we analyze the prevalence of these methodologies using a systemic PubMed® search for original scientific journal articles published in the last 3-years. We indexed 37 meniscus repair/replacement studies conducted in live animal models. Overall, our findings show that approximately 75% of these studies have performed at least one assessment for PTOA following meniscus injury repair. Out of this, 84% studies have reported an improvement in PTOA resulting from treatment.
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Affiliation(s)
| | | | | | - Chathuraka T. Jayasuriya
- Department of Orthopaedics, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, United States
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13
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Muench LN, Kriscenski D, Tamburini L, Berthold DP, Rupp MC, Mancini MR, Cote MP, McCarthy MB, Mazzocca AD. Augmenting Suture Tape Used in Rotator Cuff Surgery With Magnesium Increases in Vitro Cellular Adhesion of Human Subacromial Bursal Tissue. Arthrosc Sports Med Rehabil 2021; 3:e1975-e1980. [PMID: 34977656 PMCID: PMC8689267 DOI: 10.1016/j.asmr.2021.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Lukas N. Muench
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Germany
- Address correspondence to Lukas N. Muench, M.D., Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany.
| | - Danielle Kriscenski
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
| | - Lisa Tamburini
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
| | - Daniel P. Berthold
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
- Department of Orthopaedic Sports Medicine, Technical University of Munich, Germany
| | | | - Michael R. Mancini
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
| | - Mark P. Cote
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
| | - Mary Beth McCarthy
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
| | - Augustus D. Mazzocca
- Department of Orthopedic Surgery, UConn Health Center, Farmington, Connecticut, U.S.A
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14
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Yan W, Dai W, Cheng J, Fan Y, Wu T, Zhao F, Zhang J, Hu X, Ao Y. Advances in the Mechanisms Affecting Meniscal Avascular Zone Repair and Therapies. Front Cell Dev Biol 2021; 9:758217. [PMID: 34778268 PMCID: PMC8581462 DOI: 10.3389/fcell.2021.758217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Injuries to menisci are the most common disease among knee joint-related morbidities and cover a widespread population ranging from children and the general population to the old and athletes. Repair of the injuries in the meniscal avascular zone remains a significant challenge due to the limited intrinsic healing capacity compared to the peripheral vascularized zone. The current surgical strategies for avascular zone injuries remain insufficient to prevent the development of cartilage degeneration and the ultimate emergence of osteoarthritis (OA). Due to the drawbacks of current surgical methods, the research interest has been transferred toward facilitating meniscal avascular zone repair, where it is expected to maintain meniscal tissue integrity, prevent secondary cartilage degeneration and improve knee joint function, which is consistent with the current prevailing management idea to maintain the integrity of meniscal tissue whenever possible. Biological augmentations have emerged as an alternative to current surgical methods for meniscal avascular zone repair. However, understanding the specific biological mechanisms that affect meniscal avascular zone repair is critical for the development of novel and comprehensive biological augmentations. For this reason, this review firstly summarized the current surgical techniques, including meniscectomies and meniscal substitution. We then discuss the state-of-the-art biological mechanisms, including vascularization, inflammation, extracellular matrix degradation and cellular component that were associated with meniscal avascular zone healing and the advances in therapeutic strategies. Finally, perspectives for the future biological augmentations for meniscal avascular zone injuries will be given.
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Affiliation(s)
- Wenqiang Yan
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Wenli Dai
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Jin Cheng
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Yifei Fan
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Tong Wu
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Fengyuan Zhao
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Jiahao Zhang
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Xiaoqing Hu
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
| | - Yingfang Ao
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China.,Institute of Sports Medicine of Peking University, Beijing, China.,Beijing Key Laboratory of Sports Injuries, Beijing, China
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15
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Wang X, Ding Y, Li H, Mo X, Wu J. Advances in electrospun scaffolds for meniscus tissue engineering and regeneration. J Biomed Mater Res B Appl Biomater 2021; 110:923-949. [PMID: 34619021 DOI: 10.1002/jbm.b.34952] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/14/2021] [Accepted: 09/22/2021] [Indexed: 01/14/2023]
Abstract
The meniscus plays a critical role in maintaining the homeostasis, biomechanics, and structural stability of the knee joint. Unfortunately, it is predisposed to damages either from sports-related trauma or age-related degeneration. The meniscus has an inherently limited capacity for tissue regeneration. Self-healing of injured adult menisci only occurs in the peripheral vascularized portion, while the spontaneous repair of the inner avascular region seems never happens. Repair, replacement, and regeneration of menisci through tissue engineering strategies are promising to address this problem. Recently, many scaffolds for meniscus tissue engineering have been proposed for both experimental and preclinical investigations. Electrospinning is a feasible and versatile technique to produce nano- to micro-scale fibers that mimic the microarchitecture of native extracellular matrix and is an effective approach to prepare nanofibrous scaffolds for constructing engineered meniscus. Electrospun scaffolds are reported to be capable of inducing colonization of meniscus cells by modulating local extracellular density and stimulating endogenous regeneration by driving reprogramming of meniscus wound microenvironment. Electrospun nanofibrous scaffolds with tunable mechanical properties, controllable anisotropy, and various porosities have shown promises for meniscus repair and regeneration and will undoubtedly inspire more efforts in exploring effective therapeutic approaches towards clinical applications. In this article, we review the current advances in the use of electrospun nanofibrous scaffolds for meniscus tissue engineering and repair and discuss prospects for future studies.
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Affiliation(s)
- Xiaoyu Wang
- Key Laboratory of Science and Technology of Eco-Textile & Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Yangfan Ding
- Key Laboratory of Science and Technology of Eco-Textile & Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Haiyan Li
- Key Laboratory of Science and Technology of Eco-Textile & Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Xiumei Mo
- Key Laboratory of Science and Technology of Eco-Textile & Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Jinglei Wu
- Key Laboratory of Science and Technology of Eco-Textile & Shanghai Engineering Research Center of Nano-Biomaterials and Regenerative Medicine, College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China.,Department of Plastic and Reconstructive Surgery, Shanghai Key Laboratory of Tissue Engineering, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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16
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Chen B, Liang Y, Zhang J, Bai L, Xu M, Han Q, Han X, Xiu J, Li M, Zhou X, Guo B, Yin Z. Synergistic enhancement of tendon-to-bone healing via anti-inflammatory and pro-differentiation effects caused by sustained release of Mg 2+/curcumin from injectable self-healing hydrogels. Am J Cancer Res 2021; 11:5911-5925. [PMID: 33897889 PMCID: PMC8058719 DOI: 10.7150/thno.56266] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 03/18/2021] [Indexed: 12/18/2022] Open
Abstract
Poor healing response after rotator cuff reconstruction is multifactorial, with the inflammatory microenvironment and deficiency of stem cell differentiation factors at the lesion site being most relevant. However, there is a lack of effective tissue engineering strategies that can simultaneously exert anti-inflammatory and pro-differentiation effects to promote rotator cuff healing. Methods: In this study, we synthesized and characterized a novel active drug delivery vector that successfully overcame the challenge of simultaneous high-efficiency loading and controlled release of Mg2+ and curcumin. The anti-inflammatory and pro-differentiation effects of the composite hydrogel were evaluated in vitro and in vivo. Moreover, healing of the rotator cuff tendon-to-bone interface was studied by histology, immunofluorescence, and biomechanical tests. Results: The composite hydrogel exhibited excellent biocompatibility and injectability, good adhesiveness, and rapid self-healing. The released curcumin showed obvious anti-inflammatory and antioxidation effects, which protected stem cells and tendon matrix. Furthermore, released Mg2+ promoted stem cell aggregation and chondrogenesis. Moreover, biomechanical tests and histological results of a rat rotator cuff tear model at 8 weeks after surgery indicated that the composite hydrogel significantly enhanced tendon-to-bone healing. Conclusions: The composite hydrogel mediated sustained in situ release of curcumin and Mg2+ to effectively promote rotator cuff tendon-to-bone healing via anti-inflammatory and pro-differentiation effects. Therefore, this composite hydrogel offers significant promise for rotator cuff repair.
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17
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Shi L, Zhu H, Ma J, Shi LL, Gao F, Sun W. Intra-articular magnesium to alleviate postoperative pain after arthroscopic knee surgery: a meta-analysis of randomized controlled trials. J Orthop Surg Res 2021; 16:111. [PMID: 33546717 PMCID: PMC7863353 DOI: 10.1186/s13018-021-02264-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/25/2021] [Indexed: 12/16/2022] Open
Abstract
Objective We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 h after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery. Protocol registration at PROSPERO: CRD42020156403.
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Affiliation(s)
- Lijun Shi
- Department of Orthopedic, Surgery Graduate School of Peking Union Medical College, China-Japan Friendship institute of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, 100029, Beijing, China
| | - Haiyun Zhu
- Department of Intensive Care Unit, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, 354 North Road, Hongqiao District, Tianjin, 300120, China
| | - Jinhui Ma
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Li-Li Shi
- Department of Gastroenterology, Henan Provincial People's Hospital, Weiwu road No 7, Jinshui district, Zhengzhou City, 450003, Henan province, China
| | - Fuqiang Gao
- Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Wei Sun
- Department of Orthopedic, Surgery Graduate School of Peking Union Medical College, China-Japan Friendship institute of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, 100029, Beijing, China. .,Department of Orthopaedic Surgery, China-Japan Friendship Hospital, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China.
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18
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Sun H, Wen X, Li H, Wu P, Gu M, Zhao X, Zhang Z, Hu S, Mao G, Ma R, Liao W, Zhang Z. Single-cell RNA-seq analysis identifies meniscus progenitors and reveals the progression of meniscus degeneration. Ann Rheum Dis 2019; 79:408-417. [PMID: 31871141 PMCID: PMC7034356 DOI: 10.1136/annrheumdis-2019-215926] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/21/2019] [Accepted: 12/07/2019] [Indexed: 12/26/2022]
Abstract
Objectives The heterogeneity of meniscus cells and the mechanism of meniscus degeneration is not well understood. Here, single-cell RNA sequencing (scRNA-seq) was used to identify various meniscus cell subsets and investigate the mechanism of meniscus degeneration. Methods scRNA-seq was used to identify cell subsets and their gene signatures in healthy human and degenerated meniscus cells to determine their differentiation relationships and characterise the diversity within specific cell types. Colony-forming, multi-differentiation assays and a mice meniscus injury model were used to identify meniscus progenitor cells. We investigated the role of degenerated meniscus progenitor (DegP) cell clusters during meniscus degeneration using computational analysis and experimental verification. Results We identified seven clusters in healthy human meniscus, including five empirically defined populations and two novel populations. Pseudotime analysis showed endothelial cells and fibrochondrocyte progenitors (FCP) existed at the pseudospace trajectory start. Melanoma cell adhesion molecule ((MCAM)/CD146) was highly expressed in two clusters. CD146+ meniscus cells differentiated into osteoblasts and adipocytes and formed colonies. We identified changes in the proportions of degenerated meniscus cell clusters and found a cluster specific to degenerative meniscus with progenitor cell characteristics. The reconstruction of four progenitor cell clusters indicated that FCP differentiation into DegP was an aberrant process. Interleukin 1β stimulation in healthy human meniscus cells increased CD318+ cells, while TGFβ1 attenuated the increase in CD318+ cells in degenerated meniscus cells. Conclusions The identification of meniscus progenitor cells provided new insights into cell-based meniscus tissue engineering, demonstrating a novel mechanism of meniscus degeneration, which contributes to the development of a novel therapeutic strategy.
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Affiliation(s)
- Hao Sun
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Guangzhou, China.,Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Xingzhao Wen
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Hongyi Li
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Peihui Wu
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Minghui Gu
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Xiaoyi Zhao
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Ziji Zhang
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Shu Hu
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Guping Mao
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Ruofan Ma
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital, Guangzhou, China
| | - Weiming Liao
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Zhiqi Zhang
- Department of Joint Surgery, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
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19
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Chen M, Feng Z, Guo W, Yang D, Gao S, Li Y, Shen S, Yuan Z, Huang B, Zhang Y, Wang M, Li X, Hao L, Peng J, Liu S, Zhou Y, Guo Q. PCL-MECM-Based Hydrogel Hybrid Scaffolds and Meniscal Fibrochondrocytes Promote Whole Meniscus Regeneration in a Rabbit Meniscectomy Model. ACS APPLIED MATERIALS & INTERFACES 2019; 11:41626-41639. [PMID: 31596568 DOI: 10.1021/acsami.9b13611] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Regeneration of an injured meniscus continues to be a scientific challenge due to its poor self-healing potential. Tissue engineering provides an avenue for regenerating a severely damaged meniscus. In this study, we first investigated the superiority of five concentrations (0%, 0.5%, 1%, 2%, and 4%) of meniscus extracellular matrix (MECM)-based hydrogel in promoting cell proliferation and the matrix-forming phenotype of meniscal fibrochondrocytes (MFCs). We found that the 2% group strongly enhanced chondrogenic marker mRNA expression and cell proliferation compared to the other groups. Moreover, the 2% group showed the highest glycosaminoglycan (GAG) and collagen production by day 14. We then constructed a hybrid scaffold by 3D printing a wedge-shaped poly(ε-caprolactone) (PCL) scaffold as a backbone, followed by injection with the optimized MECM-based hydrogel (2%), which served as a cell delivery system. The hybrid scaffold (PCL-hydrogel) clearly yielded favorable biomechanical properties close to those of the native meniscus. Finally, PCL scaffold, PCL-hydrogel, and MFCs-loaded hybrid scaffold (PCL-hydrogel-MFCs) were implanted into the knee joints of New Zealand rabbits that underwent total medial meniscectomy. Six months postimplantation we found that the PCL-hydrogel-MFCs group exhibited markedly better gross appearance and cartilage protection than the PCL scaffold and PCL-hydrogel groups. Moreover, the regenerated menisci in the PCL-hydrogel-MFCs group had similar histological structures, biochemical contents, and biomechanical properties as the native menisci in the sham operation group. In conclusion, PCL-MECM-based hydrogel hybrid scaffold seeded with MFCs can successfully promote whole meniscus regeneration, and cell-loaded PCL-MECM-based hydrogel hybrid scaffold may be a promising strategy for meniscus regeneration in the future.
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Affiliation(s)
- Mingxue Chen
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital , Peking University Fourth School of Clinical Medicine , No. 31 Xinjiekou East Street, Xicheng District , Beijing 100035 , People's Republic of China
| | - Zhaoxuan Feng
- School of Material Science and Engineering , University of Science and Technology Beijing , No. 30 Xueyuan Road, Haidian District , Beijing 100083 , People's Republic of China
| | - Weimin Guo
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
- Department of Orthopaedic Surgery, First Affiliated Hospital , Sun Yat-sen University , No. 58 Zhongshan Second Road, Yuexiu District , Guangzhou , Guangdong 510080 , People's Republic of China
| | - Dejin Yang
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital , Peking University Fourth School of Clinical Medicine , No. 31 Xinjiekou East Street, Xicheng District , Beijing 100035 , People's Republic of China
| | - Shuang Gao
- Academy for Advanced Interdisciplinary Studies , Peking University , No. 5 Yiheyuan Road, Haidian District , Beijing 100871 , People's Republic of China
| | - Yangyang Li
- Academy for Advanced Interdisciplinary Studies , Peking University , No. 5 Yiheyuan Road, Haidian District , Beijing 100871 , People's Republic of China
| | - Shi Shen
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
- Department of Bone and Joint Surgery , The Affiliated Hospital of Southwest Medical University , No. 25 Taiping Road , Luzhou 646000 , People's Republic of China
| | - Zhiguo Yuan
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
| | - Bo Huang
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
- Department of Bone and Joint Surgery , The Affiliated Hospital of Southwest Medical University , No. 25 Taiping Road , Luzhou 646000 , People's Republic of China
| | - Yu Zhang
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
| | - Mingjie Wang
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
| | - Xu Li
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
| | - Libo Hao
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
| | - Jiang Peng
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
| | - Shuyun Liu
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
| | - Yixin Zhou
- Department of Orthopedic Surgery, Beijing Jishuitan Hospital , Peking University Fourth School of Clinical Medicine , No. 31 Xinjiekou East Street, Xicheng District , Beijing 100035 , People's Republic of China
| | - Quanyi Guo
- Chinese PLA General Hospital, Beijing Key Lab of Regenerative Medicine in Orthopedics, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA , Institute of Orthopedics , No. 28 Fuxing Road, Haidian District , Beijing 100853 , People's Republic of China
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