■由于严重缩回的肩袖肌肌腱组织和肩袖肌腱组织的极端缺陷,无法修复的大量肩袖撕裂(UMRCT)对外科医生来说是具有挑战性的。
■为了制造肌腱干细胞衍生的外泌体负载支架(TSC-Exos-S),并研究其对体外细胞生物活性和体内兔UMRCT模型修复的影响。
■对照实验室研究。
■TSC-Exos-S是通过将TSC-Exos和1型胶原(COL-I)加载到三维生物打印和基于聚己内酯(PCL)的支架中来制造的。扩散,迁移,兔骨髓干细胞(BMSCs)体外培养,基于PCL的支架(S),COL-I装载支架(COL-I-S),和TSC-Exos-S在兔UMRCT模型上进行了体内研究,用S修复了桥接,COL-I-S,TSC-Exos-S,和自体筋膜(FL)。在术后8周和16周进行组织学和生物力学分析。
■TSC-Exos-S表现出可靠的机械强度和皮下降解,这在组织再生之前没有发生。TSC-Exos-S显著促进了扩散,迁移,兔骨髓间充质干细胞的体外分化和张力分化。体内研究表明,用TSC-Exos-S修复的UMRCT在特定的胶原蛋白染色方面在桥接部位表现出明显的肌腱组织再生迹象。此外,与自体FL修复相比,组织学和生物力学特性没有显着差异。
■TSC-Exos-S通过提供机械支持并促进肌腱分化的趋势,在UMRCT中实现了肌腱组织再生。
■本研究提出了一种修复UMRCT的潜在策略,该策略具有严重缩回的肌肌腱组织和大的肌腱组织缺损。
UNASSIGNED: Unrepairable massive rotator cuff tears (UMRCTs) are challenging to surgeons owing to the severely retracted rotator cuff musculotendinous tissues and extreme defects in the rotator cuff tendinous tissues.
UNASSIGNED: To fabricate a tendon stem cell-derived exosomes loaded scaffold (TSC-Exos-S) and investigate its effects on cellular bioactivity in vitro and repair in a rabbit UMRCT model in vivo.
UNASSIGNED: Controlled laboratory study.
UNASSIGNED: TSC-Exos-S was fabricated by loading TSC-Exos and type 1 collagen (COL-I) into a 3-dimensional bioprinted and polycaprolactone (PCL)-based scaffold. The proliferation, migration, and tenogenic differentiation activities of rabbit bone marrow stem cells (BMSCs) were evaluated in vitro by culturing them in saline, PCL-based scaffold (S), COL-I loaded scaffold (COL-I-S), and TSC-Exos-S. In vivo studies were conducted on a rabbit UMRCT model, where bridging was repaired with S, COL-I-S, TSC-Exos-S, and autologous fascia lata (FL). Histological and biomechanical analyses were performed at 8 and 16 weeks postoperatively.
UNASSIGNED: TSC-Exos-S exhibited reliable mechanical strength and subcutaneous degradation, which did not occur before tissue regeneration. TSC-Exos-S significantly promoted the proliferation, migration, and tenogenic differentiation of rabbit BMSCs in vitro. In vivo studies showed that UMRCT repaired with TSC-Exos-S exhibited significant signs of tendinous tissue regeneration at the bridging site with regard to specific collagen staining. Moreover, no significant differences were observed in the histological and biomechanical properties compared with those repaired with autologous FL.
UNASSIGNED: TSC-Exos-S achieved tendinous tissue regeneration in UMRCT by providing mechanical support and promoting the trend toward tenogenic differentiation.
UNASSIGNED: The present study proposes a potential strategy for repairing UMRCT with severely retracted musculotendinous tissues and large tendinous tissue defects.