Journal
ACS BIOMATERIALS SCIENCE & ENGINEERING
Volume 7, Issue 3, Pages 904-915Publisher
AMER CHEMICAL SOC
DOI: 10.1021/acsbiomaterials.0c00193
Keywords
poly(urethane urea)ester; macroporous scaffold; biomechanically matched; bridging model; massive rotator cuff tear; tendon-bone interface
Categories
Funding
- China Postdoctoral Science Foundation [2019M661525]
- National Natural Science Foundation of China [81902186, 81671920, 31972923, 81871753, 81772341]
- National Key Research and Development Program of China [2018YFC1106200, 2018YFC1106201, 2018YFC1106202]
- Technology Support Project of Science and Technology Commission of Shanghai Municipality of China [19441901700, 19441901701, 19441901702, 18441902800]
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The study developed a self-fitting three-dimensional scaffold that promoted regeneration of massive rotator cuff tears, showing potential for application in shoulder cuff repair.
The postoperative retear rate of direct repair of massive rotator cuff tear has risen up to 40% because of the dissatisfied tendon-to-bone healing and poor regenerative potential of remnant rotator cuff tissue. A biological scaffold that connects the remnant rotator cuff tissue and bone might be a promising substitute. In the present study, we have developed a macroporous three-dimensional scaffold poly(ester-urethane)urea (PEUU), with self-fitting capability employing thermally induced phase separation (TIPS) technique. The scaffold provides oriented connected macropores for cells migration, and promoted tendon-to-bone healing on the basis of surgical repair. The scaffolds were characterized by scanning electron microscopy, stress-strain test and cell biocompatibility study. In vitro studies exhibited that PEUU scaffold with suitable elastic mechanical properties can better support proliferation and migration of rabbit bone mesenchymal stem cells (RBMSCs). After three months postreconstruction of massive rotator cuff tear in a rabbit model using PEUU scaffold, there was complete regeneration of rotator cuff with physical tendon-to-bone interface and continuous tendon tissue, as observed from histological analysis. Further, biomechanical testing demonstrated that rotator cuff induced by PEUU scaffold had no significant difference as compared to normal rotator cuff. This macroporous, mechanically matched scaffold is potentially suitable for the application in massive rotator cuff repair. In conclusion, this study demonstrates the high efficiency of the macroporous 3D scaffold with self-fitting capability in facilitating rotator cuff regeneration.
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