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Zou J, Yang W, Cui W, Li C, Ma C, Ji X, Hong J, Qu Z, Chen J, Liu A, Wu H. Therapeutic potential and mechanisms of mesenchymal stem cell-derived exosomes as bioactive materials in tendon-bone healing. J Nanobiotechnology 2023; 21:14. [PMID: 36642728 PMCID: PMC9841717 DOI: 10.1186/s12951-023-01778-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/11/2023] [Indexed: 01/17/2023] Open
Abstract
Tendon-bone insertion (TBI) injuries, such as anterior cruciate ligament injury and rotator cuff injury, are the most common soft tissue injuries. In most situations, surgical tendon/ligament reconstruction is necessary for treating such injuries. However, a significant number of cases failed because healing of the enthesis occurs through scar tissue formation rather than the regeneration of transitional tissue. In recent years, the therapeutic potential of mesenchymal stem cells (MSCs) has been well documented in animal and clinical studies, such as chronic paraplegia, non-ischemic heart failure, and osteoarthritis of the knee. MSCs are multipotent stem cells, which have self-renewability and the ability to differentiate into a wide variety of cells such as chondrocytes, osteoblasts, and adipocytes. Numerous studies have suggested that MSCs could promote angiogenesis and cell proliferation, reduce inflammation, and produce a large number of bioactive molecules involved in the repair. These effects are likely mediated by the paracrine mechanisms of MSCs, particularly through the release of exosomes. Exosomes, nano-sized extracellular vesicles (EVs) with a lipid bilayer and a membrane structure, are naturally released by various cell types. They play an essential role in intercellular communication by transferring bioactive lipids, proteins, and nucleic acids, such as mRNAs and miRNAs, between cells to influence the physiological and pathological processes of recipient cells. Exosomes have been shown to facilitate tissue repair and regeneration. Herein, we discuss the prospective applications of MSC-derived exosomes in TBI injuries. We also review the roles of MSC-EVs and the underlying mechanisms of their effects on promoting tendon-bone healing. At last, we discuss the present challenges and future research directions.
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Affiliation(s)
- Jiaxuan Zou
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Weinan Yang
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Wushi Cui
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Congsun Li
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Chiyuan Ma
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Xiaoxiao Ji
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Jianqiao Hong
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Zihao Qu
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Jing Chen
- grid.27255.370000 0004 1761 1174The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033 People’s Republic of China
| | - An Liu
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
| | - Haobo Wu
- grid.412465.0Department of Orthopedics, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XOrthopedics Research Institute of Zhejiang University, Hangzhou, 310002 People’s Republic of China ,grid.13402.340000 0004 1759 700XKey Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University, Hangzhou, 310002 People’s Republic of China ,Clinical Research Center of Motor System Disease of Zhejiang Province, Hangzhou, 310002 People’s Republic of China
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Zhang M, Deng L, Zhou J, Liu T, Yang Z, Liu J, Jia Y, Jiang J, Yun X. Combination of autologous osteochondral and periosteum transplantation effectively promotes fibrocartilage regeneration at the tendon-bone junction of the rotator cuff in rabbits. Knee Surg Sports Traumatol Arthrosc 2022. [PMID: 36515732 DOI: 10.1007/s00167-022-07250-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Rotator cuff tendon-bone healing often leads to scarring and low biomechanical strength, resulting in a tendency to re-tear. This study examined whether combining autologous osteochondral transplantation and periosteum transplantation increases fibrocartilage transition zone regeneration and improves biomechanical fixation. METHODS A total of 48 New Zealand white rabbits were divided into the periosteum, autologous osteochondral, combination of autologous osteochondral and periosteum, and control groups. The supraspinatus tendon was cut from the greater tuberosity and repaired by different transplants. A total of 12 rabbits were used for histological examination (haematoxylin and eosin staining, Masson's staining and Safranin-O staining) at 4, 8 and 12 weeks after the repair, and 36 rabbits were used for biomechanical tests (maximal failure load and stiffness). RESULTS At 4 weeks following the operation, each group had a large tendon-bone gap with a small number of disordered collagen fibres. At 8 weeks, the tendon-bone gap was smaller than that before the operation, and the tendon-bone gap in each experimental group was smaller with neater and denser collagen fibres and chondrocytes than in the control group, with the osteochondral combined periosteum group having the best results. At 12 weeks, the typical tendon-bone transitional structure was observed in the osteochondral combined periosteum group, and more collagen fibres and chondrocytes were generated in each group. The osteochondral combined periosteum group had the largest staining area and the largest amount of cartilage. The maximum tensile strength and stiffness of each group increased over time. There was no significant difference in each group's maximum tensile strength and stiffness at 4 weeks after the operation. However, the maximum tensile strength and stiffness of the osteochondral combined periosteum group at 8 and 12 weeks after operation were significantly higher than those of other groups (P < 0.05). CONCLUSION Histological and biomechanical results show that autologous osteochondral transplantation combined with periosteum transplantation can effectively promote the regeneration of fibrous cartilage in the tendon-bone junction of the rotator cuff. It is concluded that this technique is a new treatment method to promote tendon-bone healing in the rotator cuff.
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Kang K, Geng Q, Cui L, Wu L, Zhang L, Li T, Zhang Q, Gao S. Upregulation of Runt related transcription factor 1 (RUNX1) contributes to tendon-bone healing after anterior cruciate ligament reconstruction using bone mesenchymal stem cells. J Orthop Surg Res 2022; 17:266. [PMID: 35562802 PMCID: PMC9107123 DOI: 10.1186/s13018-022-03152-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/27/2022] [Indexed: 11/20/2022] Open
Abstract
Background Anterior cruciate ligament (ACL) injury could lead to functional impairment along with disabilities. ACL reconstruction often fails owing to the regeneration failure of tendon–bone interface. Herein, we aimed to investigate the effects of Runt related transcription factor 1 (RUNX1) on tendon–bone healing after ACL reconstruction using bone mesenchymal stem cells (BMSCs). Methods BMSCs were isolated from the marrow cavity of rat femur, followed by the modification of RUNX1 with lentiviral system. Then, an ACL reconstruction model of rats was established with autografts. Results Results of flow cytometry exhibited positive-antigen CD44 and CD90, as well as negative-antigen CD34 and CD45 of the BMSCs. Then, we found that RUNX1-upregulated BMSCs elevated the decreased biomechanical strength of the tendon grafts after ACL reconstruction. Moreover, based on the histological observation, upregulation of RUNX1 was linked with better recovery around the bone tunnel, a tighter tendon–bone interface, and more collagen fibers compared to the group of BMSCs infected with LV-NC. Next, RUNX1-upregulated BMSCs promoted osteogenesis after ACL reconstruction, as evidenced by the mitigation of severe loss and erosion of the cartilage and bone in the tibial and femur area, as well as the increased number of osteoblasts identified by the upregulation of alkaline phosphatase, osteocalcin, and osteopontin in the tendon–bone interface. Conclusion Elevated expression of RUNX1 contributed to tendon–bone healing after ACL reconstruction using BMSCs.
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Affiliation(s)
- Kai Kang
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Qian Geng
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Lukuan Cui
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Lijie Wu
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Lei Zhang
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Tong Li
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Qian Zhang
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Shijun Gao
- The Second Department of Joint Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
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Gong H, Huang B, Zheng Z, Fu L, Chen L. Clinical Use of Platelet-Rich Plasma to Promote Tendon-Bone Healing and Graft Maturation in Anterior Cruciate Ligament Reconstruction-A Randomized Controlled Study. Indian J Orthop 2022; 56:805-11. [PMID: 35103026 DOI: 10.1007/s43465-021-00533-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/17/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND We investigated the effect of platelet-rich plasma (PRP) on tendon-bone healing and intra-articular graft (IAG) maturation after anterior cruciate ligament (ACL) reconstruction. METHODS In this prospective randomized controlled study, 60 patients with ruptured ACLs were divided one-to-one into two groups (study and control). Patients were treated using single-bundle autologous hamstring autografts. Only patients in the study group were administered PRP. Knee function (pre-operative and three-, six-, and 12-month post-operative Lysholm activity, Tegner and International Knee Documentation Committee scores, femoral tunnel (FT) and tibial tunnel (TT) diameters measured with computed tomography (post-operative follow-up at 4 days and at 12 months), and magnetic resonance imaging signal/noise quotients of the IAG and graft in the FT (at 12 months) were used to evaluate tendon-bone healing and graft maturation. RESULTS Patients' knee function scores improved after ACL reconstruction, but there were no significant differences between groups. At 12 months, FT (study, 8.88 ± 1.46 mm; control, 8.42 ± 2.75 mm) and TT (study, 9.50 ± 1.07 mm; control, 9.99 ± 1.91 mm) diameters were larger than FT (study, 6.91 ± 0.74 mm; control, 7.30 ± 1.17 mm) and TT (study, 9.31 ± 0.83 mm; control, 9.36 ± 0.88 mm) diameters at 4 days; however, differences between groups were not significant (FT, P = 0.67; TT, P = 0.52). There were no significant differences between groups for signal/noise quotients of the IAG (study, 1.38 ± 0.70; control, 2.01 ± 0.62; P = 0.06) and FT-portion of the graft (study, 2.39 ± 1.22; control, 2.46 ± 0.83; P = 0.89). CONCLUSION PRP had no significant effect on reducing bone tunnel widening, accelerating tendon-bone healing, or improving knee function; however, PRP may improve IAG maturation. TRIAL REGISTRATION Our study was first registered at Clinicaltrials.gov with registration No. NCT04659447 on 12/09/2020.
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Tie K, Cai J, Qin J, Xiao H, Shangguan Y, Wang H, Chen L. Nanog/NFATc1/Osterix signaling pathway-mediated promotion of bone formation at the tendon-bone interface after ACL reconstruction with De-BMSCs transplantation. Stem Cell Res Ther 2021; 12:576. [PMID: 34775995 PMCID: PMC8591902 DOI: 10.1186/s13287-021-02643-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Bone formation plays an important role in early tendon–bone healing after anterior cruciate ligament reconstruction (ACLR). Dedifferentiated osteogenic bone marrow mesenchymal stem cells (De-BMSCs) have enhanced osteogenic potential. This study aimed to investigate the effect of De-BMSCs transplantation on the promotion of bone formation at the tendon–bone interface after ACLR and to further explore the molecular mechanism of the enhanced osteogenic potential of De-BMSCs. Methods BMSCs from the femurs and tibias of New Zealand white rabbits were subjected to osteogenic induction and then cultured in medium without osteogenic factors; the obtained cell population was termed De-BMSCs. De-BMSCs were induced to undergo osteo-, chondro- and adipo-differentiation in vitro to examine the characteristics of primitive stem cells. An ACLR model with a semitendinosus tendon was established in rabbits, and the animals were divided into a control group, BMSCs group, and De-BMSCs group. At 12 weeks after surgery, the rabbits in each group were sacrificed to evaluate tendon–bone healing by histologic staining, micro-computed tomography (micro-CT) examination, and biomechanical testing. During osteogenic differentiation of De-BMSCs, an siRNA targeting nuclear factor of activated T-cells 1 (NFATc1) was used to verify the molecular mechanism of the enhanced osteogenic potential of De-BMSCs. Results De-BMSCs exhibited some properties similar to BMSCs, including multiple differentiation potential and cell surface markers. Bone formation at the tendon–bone interface in the De-BMSCs group was significantly increased, and biomechanical strength was significantly improved. During the osteogenic differentiation of De-BMSCs, the expression of Nanog and NFATc1 was synergistically increased, which promoted the interaction of NFATc1 and Osterix, resulting in increased expression of osteoblast marker genes such as COL1A, OCN, and OPN. Conclusions De-BMSCs transplantation could promote bone formation at the tendon–bone interface after ACLR and improve the biomechanical strength of the reconstruction. The Nanog/NFATc1/Osterix signaling pathway mediated the enhanced osteogenic differentiation efficiency of De-BMSCs. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02643-9.
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Affiliation(s)
- Kai Tie
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Jinghang Cai
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Jun Qin
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Hao Xiao
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Yangfan Shangguan
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Hui Wang
- Department of Pharmacology, Basic Medical School of Wuhan University, Wuhan, 430071, China.
| | - Liaobin Chen
- Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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Liao H, Yu HP, Song W, Zhang G, Lu B, Zhu YJ, Yu W, He Y. Amorphous calcium phosphate nanoparticles using adenosine triphosphate as an organic phosphorus source for promoting tendon-bone healing. J Nanobiotechnology 2021; 19:270. [PMID: 34493293 PMCID: PMC8425074 DOI: 10.1186/s12951-021-01007-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/19/2021] [Indexed: 11/20/2022] Open
Abstract
Background Rotator cuff tear (RCT) is a common problem of the musculoskeletal system. With the advantage of promoting bone formation, calcium phosphate materials have been widely used to augment tendon-bone healing. However, only enhancing bone regeneration may be not enough for improving tendon–bone healing. Angiogenesis is another fundamental factor required for tendon–bone healing. Therefore, it’s necessary to develop a convenient and reliable method to promote osteogenesis and angiogenesis simultaneously, thereby effectively promoting tendon–bone healing. Methods The amorphous calcium phosphate (ACP) nanoparticles with dual biological activities of osteogenesis and angiogenesis were prepared by a simple low-temperature aqueous solution method using adenosine triphosphate (ATP) as an organic phosphorus source. The activities of osteogenesis and angiogenesis and the effect on the tendon–bone healing of ACP nanoparticles were tested in vitro and in a rat model of acute RCT. Results The ACP nanoparticles with a diameter of tens of nanometers were rich in bioactive adenosine. In vitro, we confirmed that ACP nanoparticles could enhance osteogenesis and angiogenesis. In vivo, radiological and histological evaluations demonstrated that ACP nanoparticles could enhance bone and blood vessels formation at the tendon–bone junction. Biomechanical testing showed that ACP nanoparticles improved the biomechanical strength of the tendon–bone junction and ultimately promoted tendon–bone healing of rotator cuff. Conclusions We successfully confirmed that ACP nanoparticles could promote tendon–bone healing. ACP nanoparticles are a promising biological nanomaterial in augmenting tendon–bone healing. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s12951-021-01007-y.
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Affiliation(s)
- Haoran Liao
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Han-Ping Yu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai, 200050, China
| | - Wei Song
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Guangcheng Zhang
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Bingqiang Lu
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China
| | - Ying-Jie Zhu
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, 1295 Dingxi Road, Shanghai, 200050, China.
| | - Weilin Yu
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
| | - Yaohua He
- Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China. .,Department of Orthopedics, Jinshan Branch of Shanghai Sixth People's Hospital, Affiliated to Shanghai University of Medicine and Health Sciences, 147 Jiankang Road, Shanghai, 201599, China.
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Lu D, Yang C, Zhang Z, Xiao M. Enhanced tendon-bone healing with acidic fibroblast growth factor delivered in collagen in a rabbit anterior cruciate ligament reconstruction model. J Orthop Surg Res 2018; 13:301. [PMID: 30482233 PMCID: PMC6260728 DOI: 10.1186/s13018-018-0984-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/23/2018] [Indexed: 12/21/2022] Open
Abstract
Background The objective of the present study was to investigate the effectiveness of acidic fibroblast growth factor delivered in collagen (aFGF/collagen) for promoting tendon–bone interface healing after anterior cruciate ligament (ACL) reconstruction in rabbits. Methods ACL reconstructions were performed in the right hind limbs of New Zealand rabbits. Each left long digital extensor tendon was harvested as an autograft, and collagen incorporating different concentrations of aFGF or same amount of collagen alone was applied at the tendon–bone interface after ACL reconstruction. The control group underwent ACL reconstruction only. There were high and low aFGF/collagen groups, collagen alone group, and control group (n = 21 rabbits per group). Histological and biomechanical analyses were performed at 4, 8, and 12 weeks postoperatively to evaluate the effect of aFGF/collagen on tendon–bone interface healing. Results Results of biomechanical tests showed that at both 8 and 12 weeks postoperatively, the elastic modulus and stiffness in both the high and low aFGF/collagen treatment groups were significantly higher than those in the control group and collagen alone group, with that in the high aFGF/collagen concentration group being the highest. Histological analysis showed that at 8 weeks, tightly organized Sharpey-like fibers were observed in both aFGF/collagen groups with new bone growth into the tendon in the high concentration group. At 12 weeks postoperatively, a fibrocartilage transition zone was observed in the bone tunnels in both aFGF/collagen groups, especially in the high aFGF/collagen group. Conclusion Application of the aFGF/collagen composite could enhance early healing at the tendon–bone interface after ACL reconstruction, especially with the use of a high aFGF/collagen concentration.
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Affiliation(s)
- Daifeng Lu
- The Fourth Affiliated Hospital of Harbin Medical University, No. 37 Yiyuan street, Harbin, Nangang District, China
| | - Chuandong Yang
- Heilongjiang Provincial Academy of Medical Sciences, No. 157 Care Road, Harbin, Nangang District, China
| | - Zhitao Zhang
- The Fourth Affiliated Hospital of Harbin Medical University, No. 37 Yiyuan street, Harbin, Nangang District, China
| | - Mochao Xiao
- The Fourth Affiliated Hospital of Harbin Medical University, No. 37 Yiyuan street, Harbin, Nangang District, China.
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Sun Z, Wang X, Ling M, Wang W, Chang Y, Yang G, Dong X, Wu S, Wu X, Yang B, Chen M. Acceleration of tendon-bone healing of anterior cruciate ligament graft using intermittent negative pressure in rabbits. J Orthop Surg Res 2017; 12:60. [PMID: 28420425 DOI: 10.1186/s13018-017-0561-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 04/03/2017] [Indexed: 12/14/2022] Open
Abstract
Background The purpose of this study was to test effects of negative pressure on tendon–bone healing after reconstruction of anterior cruciate ligament (ACL) in rabbits. Methods Hind legs of 24 New Zealand White rabbits were randomly selected as negative pressure group and the contralateral hind legs as control. Reconstruction of the ACL was done. Joints of the negative pressure side were placed with drainage tubes connecting the micro-negative pressure aspirator. Control side was placed with ordinary drainage tubes. Drainage tubes on both sides were removed at the same time 5 days after operation. After 6 weeks, joint fluid was drawn to detect the expression levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α); at the same time, femur–ligament–tibia complex was obtained to determine tendon graft tension and to observe the histomorphology, blood vessels of the tendon–bone interface, and expression of vascular endothelial growth factor (VEGF). Results The maximum load breakage of tendon graft was significantly greater in the negative pressure group than in the control group (P < 0.05). Histological studies of the tendon–bone interface found that there was more new bone formation containing chondroid cells and aligned connective tissue in the negative pressure group than in the control group. Expression of VEGF was higher in the negative pressure group than in the control group (P < 0.01). Content of IL-1β and TNF-α in synovial fluid is lower in the negative pressure group than in the control group (P < 0.01). Conclusions Intermittent negative pressure plays an active role in tendon–bone healing and creeping substitution of ACL reconstruction in the rabbits.
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Teng C, Zhou C, Xu D, Bi F. Combination of platelet-rich plasma and bone marrow mesenchymal stem cells enhances tendon-bone healing in a rabbit model of anterior cruciate ligament reconstruction. J Orthop Surg Res 2016; 11:96. [PMID: 27605093 PMCID: PMC5015347 DOI: 10.1186/s13018-016-0433-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 08/28/2016] [Indexed: 02/07/2023] Open
Abstract
Background The objective of this study was to investigate the potency of platelet-rich plasma (PRP) combined with bone marrow mesenchymal stem cells (BMSCs) to promote tendon–bone healing in a rabbit model. Methods In the in vitro study, the effects of PRP on osteogenic induction of BMSCs were analysed. Later, PRP with or without BMSCs was used in the rabbit model of anterior cruciate ligament reconstruction. Specimens were harvested 8 weeks postoperatively to evaluate tendon–bone healing by histology, radiology, and biomechanical testing. Results The in vitro study revealed that collagen I, osteocalcin, and osteopontin expression was higher in BMSCs co-cultured with PRP for 14 days. The in vivo study revealed a more mature tendon–bone interface using light microscopy, a more newly formed bone at the bone tunnel walls detected by micro-computed tomography, and a significantly higher failure load as assessed by biomechanical testing in the BMSC + PRP group than in the control and PRP groups. Conclusions These results indicate that the combination of PRP and BMSCs promotes tendon–bone healing and has potential for clinical use. Electronic supplementary material The online version of this article (doi:10.1186/s13018-016-0433-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chong Teng
- Department of Orthopaedic Surgery, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, 322000, China
| | - Chenhe Zhou
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Danfeng Xu
- Department of Orthopaedic Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Fanggang Bi
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450001, China.
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Tabuchi K, Soejima T, Kanazawa T, Noguchi K, Nagata K. Chronological changes in the collagen-type composition at tendon-bone interface in rabbits. Bone Joint Res 2012; 1:218-24. [PMID: 23610694 PMCID: PMC3626213 DOI: 10.1302/2046-3758.19.2000109] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 07/03/2012] [Indexed: 11/16/2022] Open
Abstract
Objectives The purpose of this study was to evaluate chronological changes
in the collagen-type composition at tendon–bone interface during
tendon–bone healing and to clarify the continuity between Sharpey-like
fibres and inner fibres of the tendon. Methods Male white rabbits were used to create an extra-articular bone–tendon
graft model by grafting the extensor digitorum longus into a bone
tunnel. Three rabbits were killed at two, four, eight, 12 and 26
weeks post-operatively. Elastica van Gieson staining was used to colour
5 µm coronal sections, which were examined under optical and polarised
light microscopy. Immunostaining for type I, II and III collagen
was also performed. Results Sharpey-like fibres comprised of type III collagen in the early
phase were gradually replaced by type I collagen from 12 weeks onwards,
until continuity between the Sharpey-like fibres and inner fibres
of the tendon was achieved by 26 weeks. Conclusions Even in rabbits, which heal faster than humans, an observation
period of at least 12 to 26 weeks is required, because the collagen-type
composition of the Sharpey-like fibre bone–tendon connection may
have insufficient pullout strength during this period. These results suggest
that caution is necessary when permitting post-operative activity
in humans who have undergone intra-bone tunnel grafts.
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Affiliation(s)
- K Tabuchi
- Kurume University, Department of Orthopaedic Surgery, 67 Asahi-machi, Kurume 830-0011, Japan
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