Healing Effect of Subcutaneous Administration of Granulocyte Colony-Stimulating Factor on Acute Rotator Cuff Injury in a Rat Model

Biomechanical properties of various rat rotator cuff repair techniques

While rat models are frequently used to study tendon healing, there is a lack of research comparing various rotator cuff repair methods in this animal model. Determining the most effective method to begin with is pivotal for biological studies focused on healing augmentation. No study to date has shown the superiority of one repair over the other for rotator cuff repair in a rat model. We performed a biomechanic study using a rat model to study the strength of four common grasping techniques. We assessed if the bone tunnel trajectory influenced the early biomechanics of the repair at postoperative day 0 (POD0). Sixty cadaveric rat shoulders were divided equally into 6 groups; 4 groups were allocated for the biomechanical strength testing based on either a (1) modified Mason Allen (MM), (2) modified Kessler loop (MK), (3) horizontal mattress (HM), or a (4) simple interrupted stitch (SS) technique. The remaining 2 groups were used to evaluate two tunneling angles: a transverse tunnel (TT) that was perpendicular to the long humeral axis, or a longitudinal tunnel (LT) that was 30◦ angle to the humerus. MM had the highest mean failure load, followed by MK, HM, and SS. Pairwise comparison revealed that MM was stronger than SS and HM (P = 0.025 and P = 0.026, respectively), although similar to the MK (P = 0.881). MM was stiffer than MK (P < 0.001), HM (P = 0.008), and SS (P < 0.001). The TT and LT had similar loads to failure and stiffness. Our study suggests that the MM technique provides a stronger and stiffer rotator cuff repair than the others.

Allogenic Synovia-Derived Mesenchymal Stem Cells for Treatment of Equine Tendinopathies and Desmopathies-Proof of Concept

Tendon and ligament injuries are frequent in sport horses and humans, and such injuries represent a significant therapeutic challenge. Tissue regeneration and function recovery are the paramount goals of tendon and ligament lesion management. Nowadays, several regenerative treatments are being developed, based on the use of stem cell and stem cell-based therapies. In the present study, the preparation of equine synovial membrane mesenchymal stem cells (eSM-MSCs) is described for clinical use, collection, transport, isolation, differentiation, characterization, and application. These cells are fibroblast-like and grow in clusters. They retain osteogenic, chondrogenic, and adipogenic differentiation potential. We present 16 clinical cases of tendonitis and desmitis, treated with allogenic eSM-MSCs and autologous serum, and we also include their evaluation, treatment, and follow-up. The concerns associated with the use of autologous serum as a vehicle are related to a reduced immunogenic response after the administration of this therapeutic combination, as well as the pro-regenerative effects from the growth factors and immunoglobulins that are part of its constitution. Most of the cases (14/16) healed in 30 days and presented good outcomes. Treatment of tendon and ligament lesions with a mixture of eSM-MSCs and autologous serum appears to be a promising clinical option for this category of lesions in equine patients.

Effects of Platelet-Rich Plasma on Tendon-Bone Healing After Anterior Cruciate Ligament Reconstruction

OBJECTIVE

To investigate the effect of platelet-rich plasma on tendon-bone healing after anterior cruciate ligament reconstruction.

METHODS

This retrospective study included 85 patients (range, 18-50 years; mean age, 33.95 ± 10.53 years; male/female, 49/36) who underwent anterior cruciate ligament reconstruction using autologous hamstring tendons between August 2017 and June 2019 at our institute. The participants in the study group (n = 42) were injected with platelet-rich plasma at both ends of the tendon graft, while those in the control group (n = 43) received an injection of normal saline. Magnetic resonance imaging signal/noise quotient values of the femoral and tibial ends, knee Lysholm scores, and International Knee Documentation Committee scores were compared at 3, 6, and 12 months postoperatively.

RESULTS

The signal/noise quotient values of the femoral and tibial ends in both groups were higher at 6 months than at 3 and 12 months postoperatively. The signal/noise quotient values of the tibial end were significantly lower in the platelet-rich plasma group than in the normal saline group at all follow-up time points (P < 0.05). The signal/noise quotient values of the tibial and femoral ends in both groups were significantly different at 3, 6, and 12 months postoperatively (P < 0.05). Additionally, the signal/noise quotient values of the tibia were significantly lower than those of the femur in both groups (P < 0.05). The Lysholm and International Knee Documentation Committee scores were significantly better in the platelet-rich plasma group than in the normal saline group only at 3 months postoperatively. No complications, such as knee joint infection or vascular and nerve injuries, occurred in any of the 85 patients. The knee flexion of all patients were more than 90°, and the straight degree was 0°. No joint stiffness was observed in all patients.

CONCLUSION

Platelet-rich plasma can promote tendon-bone healing in grafts and can improve early postoperative knee joint function.