Biodegradable Polymer Electrospinning for Tendon Repairment

Mechanical loading on cell-free polymer composite scaffold enhances in situ regeneration of fully functional Achilles tendon in a rabbit model

Traditional tendon engineering using cell-loaded scaffold has limited application potential due to the need of autologous cells. We hypothesize that potent mechanical loading can efficiently induce in situ Achilles tendon regeneration in a rabbit model by using a cell-free porous composite scaffold. In this study, melt-spinning was used to fabricate PGA (polyglycolic acid) and PLA (polylactic acid) filament fibers as well as non-woven PGA fibers. The PLA/PGA (4:2) filament fibers were further braided into a hybrid yarn，which was knitted into a PLA/PGA tubular mesh with potent mechanical property for sustaining natural tendon strain. The results showed that a complete cross-section of Achilles tendon created a model of full mechanical loading on the bridging scaffold, which could efficiently induce in situ tendon regeneration by promoting host cell infiltration, matrix production and tissue remodeling. Histologically, mechanical loading assisted in forming parallel aligned collagen fibers and tenocytes in a fashion similar to those of native tendon. Transmission electron microscope further demonstrated that mechanical strain induced collagen fibril development by increasing fibril diameter and forming bipolar structure, which resulted in enhanced mechanical properties. Interestingly, the synergistic effect between mechanical loading and hyaluronic acid modification was also observed on the induced tenogenic differentiation of infiltrated host fibroblasts. In conclusion, potent mechanical loading is the key inductive microenvironment for in situ tendon regeneration for this polymer-based composite scaffold with proper matrix modification, which may serve as a universal scaffold product for tendon regeneration.

Leveraging artificial intelligence for better translation of fibre-based pharmaceutical systems into real-world benefits

The increasing prominence of biologics in the pharmaceutical market requires more advanced delivery systems to deliver these delicate and complex drug molecules for better therapeutic outcomes. Fibre technology has emerged as a promising approach for creating controlled and targeted drug delivery systems. Fibre-based drug delivery systems offer unprecedented opportunities for improving drug administration, fine-tuning release profiles, and advancing the realm of personalized medicine. These applications range from localized delivery at specific tissue sites to systemic drug administration while safeguarding the stability and integrity of delicate therapeutic compounds. Notwithstanding the promise of fibre-based drug delivery, several challenges such as non-scalability impede cost-effectiveness in the mass production of fibre systems. Biocompatibility and toxicity concerns must also be addressed. Furthermore, issues relating to stability, in-vitro in-vivo correlations, degradation rates, and by-product safety present additional hurdles. Pharmacoinformatics shows the impact of technologies in pharmaceutical processes. Emerging technologies such as Artificial Intelligence (AI) are a transformative force, progressively being applied to enhance various facets of pharmacy, medication development, and clinical healthcare support. However, there is a dearth of studies about the integration of AI in facilitating the translation of predominantly lab-scale pharmaceutical technologies into real-world healthcare interventions. This article explores the application of AI in fibre technology, its potential, challenges, and practical applications within the pharmaceutical field. Through a comprehensive analysis, it presents how the immense capabilities of AI can be leveraged with existing fibre technologies to revolutionize drug delivery and shape the future of therapeutic interventions by enhancing scalability, material integrity, synthesis, and development.

Nanofiber Graft Therapy to Prevent Shoulder Stiffness and Adhesions after Rotator Cuff Tendon Repair: A Comprehensive Review

Stiffness and adhesions following rotator cuff tears (RCTs) are common complications that negatively affect surgical outcomes and impede healing, thereby increasing the risk of morbidity and failure of surgical interventions. Tissue engineering, particularly through the use of nanofiber scaffolds, has emerged as a promising regenerative medicine strategy to address these complications. This review critically assesses the efficacy and limitations of nanofiber-based methods in promoting rotator cuff (RC) regeneration and managing postrepair stiffness and adhesions. It also discusses the need for a multidisciplinary approach to advance this field and highlights important considerations for future clinical trials.

Bletilla striata Polysaccharide-Containing Carboxymethyl Cellulose Bilayer Structure Membrane for Prevention of Postoperative Adhesion and Achilles Tendon Repair

Postoperative tissue adhesion and poor tendon healing are major clinical problems associated with tendon surgery. To avoid postoperative adhesion and promote tendon healing, we developed and synthesized a membrane to wrap the surgical site after tendon suturing. The bilayer-structured porous membrane comprised an outer layer [1,4-butanediol diglycidyl ether cross-linked with carboxymethyl cellulose (CX)] and an inner layer [1,4-butanediol diglycidyl ether cross-linked with Bletilla striata polysaccharides and carboxymethyl cellulose (CXB)]. The morphology, chemical functional groups, and membrane structure were determined. In vitro experiments revealed that the CX/CXB membrane demonstrated good biosafety and biodegradability, promoted tenocyte proliferation and migration, and exhibited low cell attachment and anti-inflammatory effects. Furthermore, in in vivo animal study, the CX/CXB membrane effectively reduced postoperative tendon-peripheral tissue adhesion and improved tendon repair, downregulating inflammatory cytokines in the tendon tissue at the surgical site, which ultimately increased tendon strength by 54% after 4 weeks.

Advances in non-coding RNA in tendon injuries

Tendons serve as important weight-bearing structures that smoothly transfer forces from muscles to skeletal parts, allowing contracted muscle movements to be translated into corresponding joint movements. For body mechanics, tendon tissue plays an important role. If the tendons are damaged to varying degrees, it can lead to disability or pain in patients. That is to say, tendon injuries havea significant impact on quality of life and deserve our high attention. Compared to other musculoskeletal tissues, tendons are hypovascular and hypo-cellular, and therefore have a greater ability to heal, this will lead to a longer recovery period after injury or even disability, which will significantly affect the quality of life. There are many causes of tendon injury, including trauma, genetic factors, inflammation, aging, and long-term overuse, and the study of related mechanisms is of great significance. Currently, tendon there are different treatment modalities, like injection therapy and surgical interventions. However, they have a high failure rate due to different reasons, among which the formation of adhesions severely weakens the tissue strength, affecting the functional recovery and the patient's quality of life. A large amount of data has shown that non coding RNAs can play a huge role in this field, thus attracting widespread attention from researchers from various countries. This review summarizes the relevant research progress on non-coding RNAs in tendon injuries, providing new ideas for a deeper understanding of tendon injuries and exploring new diagnostic and therapeutic approaches.

Enthesis repair - State of play

The fibrocartilaginous enthesis is a highly specialised tissue interface that ensures a smooth mechanical transfer between tendon or ligament and bone through a fibrocartilage area. This tissue is prone to injury and often does not heal, even after surgical intervention. Enthesis augmentation approaches are challenging due to the complexity of the tissue that is characterised by the coexistence of a range of cellular and extracellular components, architectural features and mechanical properties within only hundreds of micrometres. Herein, we discuss enthesis repair and regeneration strategies, with particular focus on elegant interfacial and functionalised scaffold-based designs.

Nanofibrous scaffolds for the healing of the fibrocartilaginous enthesis: advances and prospects

With the current developmental advancements in nanotechnology, nanofibrous scaffolds are being widely used. The healing of fibrocartilaginous enthesis is a slow and complex process, and while existing treatments have a certain effect on promoting their healing, these are associated with some limitations. The nanofibrous scaffold has the advantages of easy preparation, wide source of raw materials, easy adjustment, easy modification, can mimic the natural structure and morphology of the fibrocartilaginous enthesis, and has good biocompatibility, which can compensate for existing treatments and be combined with them to promote the repair of fibrocartilaginous enthesis. The nanofibrous scaffold can promote the healing of fibrocartilaginous enthesis by controlling the morphology and ensuring controlled drug release. Hence, the use of nanofibrous scaffold with stimulative response features in the musculoskeletal system has led us to imagine its potential application in fibrocartilaginous enthesis. Therefore, the healing of fibrocartilaginous enthesis based on a nanofibrous scaffold may be a novel therapeutic approach.

YouTube as a Patient Information Source for Tendon Repair Surgery

Background For tendon rupture, a disabling musculoskeletal injury, surgical management is considered the gold standard. The goal is to reduce complications and enable the patient to regain full mobility and strength. With the rise of modern internet accessibility and social media, YouTube has become a frequently used platform for all ages; however, the accuracy and reliability of the videos and the information therein may be a point of concern. Methodology This cross-sectional, observational study was designed to analyze tendon repair surgery information available on YouTube. Data were collected using a Google Forms questionnaire which included questions analyzing the videos and their content and the professional status of the uploaders. Quality and reliability scores were assessed through the Global Quality Score (GQS), reliability score, and Video Power Index (VPI). Statistical analysis was performed using SPSS software (IBM Corp., Armonk, NY, USA). We included videos one minute to twenty minutes in length that were relevant to the topic of tendon repair surgery and in the English language. Results A total of 82 videos were evaluated, of which 67 videos were chosen. A comparison of GQS, reliability score, and VPI based on the type of uploader was done using the Kruskal-Wallis test. The association between GQS and reliability score with that of the video uploader was found to be statistically significant (p < 0.05). Videos uploaded by hospitals had the highest GQS (4) and reliability score (4). Conclusions On comparing the uploader type, videos uploaded by hospitals had good quality and were useful for patients. The quality and reliability of the videos were almost above average. Only half discussed the signs and symptoms and even fewer discussed pre- and post-procedural care. The most important aspect, i.e., prevention, was mentioned in none of the videos. Due to our limitations, expanding the number of accounts used for search and increasing the number of videos might overcome the search algorithm.