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human stem cell use in rotator cuff tear

Gi-Young Park, Dong Rak Kwon, Sang Chul Lee
UNLABELLED: Rotator cuff tendon tear is one of the most common causes of chronic shoulder pain and disability. In this study, we investigated the therapeutic effects of ultrasound-guided human umbilical cord blood (UCB)-derived mesenchymal stem cell (MSC) injection to regenerate a full-thickness subscapularis tendon tear in a rabbit model by evaluating the gross morphology and histology of the injected tendon and motion analysis of the rabbit's activity. At 4 weeks after ultrasound-guided UCB-derived MSC injection, 7 of the 10 full-thickness subscapularis tendon tears were only partial-thickness tears, and 3 remained full-thickness tendon tears...
November 2015: Stem Cells Translational Medicine
V Havlas, J Kotaška, P Koníček, T Trč, Š Konrádová, Z Kočí, E Syková
PURPOSE OF THE STUDY Rotator cuff tears are one of the most frequent shoulder disorders which are often associated with pain and interfere with proper arm function. In order to evaluate the safety and effectiveness of using cultured human autologous mesenchymal stem cells (MSC) applied to the suture site during arthroscopic repair of a rotator cuff tear, a prospective clinical study was designed and started recently at the authors' department. Its primary goal was to evaluate the safety of using cultured human MSCs, the secondary goal then was to study a therapeutic effect of their application...
2015: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Jonathan P Gumucio, Michael D Flood, Stuart M Roche, Kristoffer B Sugg, Adeyiza O Momoh, Paul E Kosnik, Asheesh Bedi, Christopher L Mendias
PURPOSE: Rotator cuff injuries are associated with atrophy and fat infiltration into the muscle, commonly referred to as "fatty degeneration." As the poor function of chronically torn muscles may limit recovery after surgical repair, there is considerable interest in finding therapies to enhance muscle regeneration. Stromal vascular fraction stem cells (SVFCs) can improve muscle regeneration in other chronic injury states, and our objective was to evaluate the ability of SVFCs to reduce fibrosis and fat accumulation, and enhance muscle fibre specific force production after chronic rotator cuff tear...
April 2016: International Orthopaedics
Steven B Orr, Abby Chainani, Kirk J Hippensteel, Alysha Kishan, Christopher Gilchrist, N William Garrigues, David S Ruch, Farshid Guilak, Dianne Little
UNLABELLED: The rotator cuff consists of several tendons and muscles that provide stability and force transmission in the shoulder joint. Whereas most rotator cuff tears are amenable to suture repair, the overall success rate of repair is low, and massive tears are prone to re-tear. Extracellular matrix (ECM) patches are used to augment suture repair, but they have limitations. Tissue-engineered approaches provide a promising solution for massive rotator cuff tears. Previous studies have shown that, compared to nonaligned scaffolds, aligned electrospun polymer scaffolds exhibit greater anisotropy and exert a greater tenogenic effect...
September 2015: Acta Biomaterialia
Maria Valencia Mora, Miguel A Ruiz Ibán, Jorge Díaz Heredia, Raul Barco Laakso, Ricardo Cuéllar, Mariano García Arranz
Rotator cuff tears are frequent shoulder problems that are usually dealt with surgical repair. Despite improved surgical techniques, the tendon-to-bone healing rate is unsatisfactory due to difficulties in restoring the delicate transitional tissue between bone and tendon. It is essential to understand the molecular mechanisms that determine this failure. The study of the molecular environment during embryogenesis and during normal healing after injury is key in devising strategies to get a successful repair...
May 26, 2015: World Journal of Stem Cells
Philippe Hernigou, Guillaume Merouse, Pascal Duffiet, Nathalie Chevalier, Helene Rouard
PURPOSE: While the use of bone marrow concentrate (BMC) has been described in the treatment of rotator cuff tears, the impact of a rotator cuff injury on the mesenchymal stem cells (MSCs) content present in the human shoulder has not been determined, especially with regard to changes in the levels of MSCs at the tendon-bone interface. With the hypothesis that there was a decreased level of MSCs at the tendon-bone interface tuberosity in patients with rotator cuff tear, we assessed the level of MSCs in the tuberosity of the shoulder of patients undergoing a rotator cuff repair...
June 2015: International Orthopaedics
Olaf Lorbach, Mike H Baums, Tanja Kostuj, Stephan Pauly, Markus Scheibel, Andrew Carr, Nasim Zargar, Maristella F Saccomanno, Giuseppe Milano
UNLABELLED: High initial fixation strength, mechanical stability and biological healing of the tendon-to-bone interface are the main goals after rotator cuff repair surgery. Advances in the understanding of rotator cuff biology and biomechanics as well as improvements in surgical techniques have led to the development of new strategies that may allow a tendon-to-bone interface healing process, rather than the formation of a fibrovascular scar tissue. Although single-row repair remains the most cost-effective technique to address a rotator cuff tear, some biological intervention has been recently introduced to improve tissue healing and clinical outcome of rotator cuff repair...
February 2015: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
J Gumucio, M Flood, J Harning, A Phan, S Roche, E Lynch, A Bedi, C Mendias
OBJECTIVES: Rotator cuff tears are among the most common and debilitating upper extremity injuries. Chronic cuff tears result in atrophy and an infiltration of fat into the muscle, a condition commonly referred to as 'fatty degeneration'. While stem cell therapies hold promise for the treatment of cuff tears, a suitable immunodeficient animal model that could be used to study human or other xenograft-based therapies for the treatment of rotator cuff injuries had not previously been identified...
September 2014: Bone & Joint Research
Pietro Randelli, Filippo Randelli, Vincenza Ragone, Alessandra Menon, Riccardo D'Ambrosi, Davide Cucchi, Paolo Cabitza, Giuseppe Banfi
Rotator cuff injuries are a common source of shoulder pathology and result in an important decrease in quality of patient life. Given the frequency of these injuries, as well as the relatively poor result of surgical intervention, it is not surprising that new and innovative strategies like tissue engineering have become more appealing. Tissue-engineering strategies involve the use of cells and/or bioactive factors to promote tendon regeneration via natural processes. The ability of numerous growth factors to affect tendon healing has been extensively analyzed in vitro and in animal models, showing promising results...
2014: BioMed Research International
Philippe Hernigou, Charles Henri Flouzat Lachaniette, Jerome Delambre, Sebastien Zilber, Pascal Duffiet, Nathalie Chevallier, Helene Rouard
PURPOSE: The purpose of this study was to evaluate the efficiency of biologic augmentation of rotator cuff repair with iliac crest bone marrow-derived mesenchymal stem cells (MSCs). The prevalence of healing and prevention of re-tears were correlated with the number of MSCs received at the tendon-to-bone interface. METHODS: Forty-five patients in the study group received concentrated bone marrow-derived MSCs as an adjunct to single-row rotator cuff repair at the time of arthroscopy...
September 2014: International Orthopaedics
Umile Giuseppe Longo, Giacomo Rizzello, Alessandra Berton, Ludovica Maltese, Caterina Fumo, Wasim S Khan, Vincenzo Denaro
Rotator cuff tear causes a high rate of morbidity. After surgical repair, the presence of a scar tissue reduces tendon biomechanical properties. Emerging strategies for enhancing tendon healing are growth factors, cytokines, gene therapy and tissue engineering. However their efficacy has to be proved. Growth factors help the process of tendon healing by aiding cells chemotaxis, differentiation and proliferation. Numerous growth factors, including the bone morphogenetic proteins and platelet-derived growth factor can be found during the early healing process of a rotator cuff repair...
November 2013: Current Stem Cell Research & Therapy
Guillermo Arce, Klaus Bak, Gregory Bain, Emilio Calvo, Benno Ejnisman, Giovanni Di Giacomo, Vicente Gutierrez, Dan Guttmann, Eiji Itoi, W Ben Kibler, Tom Ludvigsen, Augustus Mazzocca, Alberto de Castro Pochini, Felix Savoie, Hiroyuki Sugaya, John Uribe, Francisco Vergara, Jaap Willems, Yon Sik Yoo, John W McNeil, Matthew T Provencher
The goal of this article is to consolidate the International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine (ISAKOS) Upper Extremity Committee's (UEC's) current knowledge on rotator cuff disease and management, as well as highlight key unresolved issues. The rotator cuff is an anatomically complex structure important for providing glenohumeral function and stability as part of a closed chain system. Current consensus suggests rotator cuff injuries are most accurately diagnosed, at levels similar to diagnosis by magnetic resonance imaging, with a combination of cuff- and impingement-specific clinical tests...
November 2013: Arthroscopy: the Journal of Arthroscopic & related Surgery
Zafar Ahmad, Fran Henson, John Wardale, Ali Noorani, Graham Tytherleigh-Strong, Neil Rushton
The failure rate of rotator cuff repair is high. Regenerative techniques using material scaffolds, stem cells, and growth factors help augment repair and regenerate tissue. We reviewed the literature of various regenerative techniques in terms of (1) enhancing the repair process, (2) tissue regeneration, (3) mechanical strength, and (4) clinical outcome.
August 2013: Journal of Orthopaedic Surgery
Chris Hyunchul Jo, Ji Sun Shin, In Woong Park, Hyang Kim, Seung Yeon Lee
BACKGROUND: Multiple channeling is a straightforward additional procedure for rotator cuff repair that creates multiple channels in the greater tuberosity, through which bone marrow of the proximal humerus communicates with the repair site. PURPOSE: To investigate the effect of multiple channeling on clinical and structural outcomes of arthroscopic rotator cuff repair. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A total of 124 patients with a full-thickness rotator cuff tear were included in the study...
November 2013: American Journal of Sports Medicine
Abby Chainani, Kirk J Hippensteel, Alysha Kishan, N William Garrigues, David S Ruch, Farshid Guilak, Dianne Little
Full-thickness rotator cuff tears are one of the most common causes of shoulder pain in people over the age of 65. High retear rates and poor functional outcomes are common after surgical repair, and currently available extracellular matrix scaffold patches have limited abilities to enhance new tendon formation. In this regard, tissue-engineered scaffolds may provide a means to improve repair of rotator cuff tears. Electrospinning provides a versatile method for creating nanofibrous scaffolds with controlled architectures, but several challenges remain in its application to tissue engineering, such as cell infiltration through the full thickness of the scaffold as well as control of cell growth and differentiation...
December 2013: Tissue Engineering. Part A
Pietro Randelli, Erika Conforti, Marco Piccoli, Vincenza Ragone, Pasquale Creo, Federica Cirillo, Pamela Masuzzo, Cristina Tringali, Paolo Cabitza, Guido Tettamanti, Nicoletta Gagliano, Luigi Anastasia
BACKGROUND: Stem cell therapy is expected to offer new alternatives to the traditional therapies of rotator cuff tendon tears. In particular, resident, tissue-specific, adult stem cells seem to have a higher regenerative potential for the tissue where they reside. HYPOTHESIS: Rotator cuff tendon and long head of the biceps tendon possess a resident stem cell population that, when properly stimulated, may be induced to proliferate, thus being potentially usable for tendon regeneration...
July 2013: American Journal of Sports Medicine
Zafar Ahmad, John Wardale, Roger Brooks, Fran Henson, Ali Noorani, Neil Rushton
PURPOSE: To conduct a systematic review of the current evidence for the effects of stem cells on tendon healing in preclinical studies and human studies. METHODS: A systematic search of the PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, and Embase databases was performed for stem cells and tendons with their associated terminology. Data validity was assessed, and data were collected on the outcomes of trials. RESULTS: A total of 27 preclinical studies and 5 clinical studies met the inclusion criteria...
July 2012: Arthroscopy: the Journal of Arthroscopic & related Surgery
Alan J Nixon, Ashlee E Watts, Lauren V Schnabel
Repair of rotator cuff tears in experimental models has been significantly improved by the use of enhanced biologic approaches, including platelet-rich plasma, bone marrow aspirate, growth factor supplements, and cell- and gene-modified cell therapy. Despite added complexity, cell-based therapies form an important part of enhanced repair, and combinations of carrier vehicles, growth factors, and implanted cells provide the best opportunity for robust repair. Bone marrow-derived mesenchymal stem cells provide a stimulus for repair in flexor tendons, but application in rotator cuff repair has not shown universally positive results...
February 2012: Journal of Shoulder and Elbow Surgery
Asheesh Bedi, Travis Maak, Christopher Walsh, Scott A Rodeo, Dan Grande, David M Dines, Joshua S Dines
The pathogenesis of rotator cuff degeneration remains poorly defined, and the incidence of degenerative tears is increasing in the aging population. Rates of recurrent tear and incomplete tendon-to-bone healing after repair remain significant for large and massive tears. Previous studies have documented a disorganized, fibrous junction at the tendon-to-bone interface after rotator cuff healing that does not recapitulate the organization of the native enthesis. Many biologic factors have been implicated in coordinating tendon-to-bone healing and maintenance of the enthesis after rotator cuff repair, including the expression and activation of transforming growth factor-β, basic fibroblast growth factor, platelet-derived growth factor-β, matrix metalloproteinases, and tissue inhibitors of metalloproteinases...
February 2012: Journal of Shoulder and Elbow Surgery
João L Ellera Gomes, Ricardo Canquerini da Silva, Lúcia M R Silla, Marcelo R Abreu, Roberto Pellanda
PURPOSE: To investigate the behavior of rotator cuff tears treated with conventional repair technique with the aid of autologous bone marrow mononuclear cells (BMMC). METHODS: Fourteen consecutive patients (9 women, 5 men, mean age of 59.2 years) with complete rotator cuff tears (mean preoperative UCLA score of 12 ± 3.0) were fixed by transosseous stitches through mini-open incision, with subsequent injection of BMMC into the tendon borders, obtained from the iliac crest just prior to surgery...
February 2012: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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