Abstract
BackgroundRotator 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.MethodsThe 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.ResultsThe 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.ConclusionsWe successfully confirmed that ACP nanoparticles could promote tendon–bone healing. ACP nanoparticles are a promising biological nanomaterial in augmenting tendon–bone healing.Graphic abstract
Highlights
Rotator cuff tear (RCT) is a common problem of the musculoskeletal system
Our study aims to evaluate the efficacy of amorphous calcium phosphate (ACP) nanoparticles in improving the tendon–bone healing after rotator cuff repair (RCR), and we hypothesized that the ACP nanoparticles can promote tendon–bone healing due to their dual biological activities of osteogenesis and angiogenesis (Scheme 1)
Characterization of ACP nanoparticles The samples were characterized by scanning electron microscopy (SEM, Hitachi S-4800, Japan), transmission electron microscopy (TEM, Tecnai G2 F20), X-ray diffraction (XRD, Rigaku, Ultima IV, Cu Kα radiation, λ = 1.54178 Å), Fourier transform infrared spectroscopy (FTIR, Fourier trans‐ form infrared spectroscopy (FTIR)-7600, Lambda Scientifc, Australia), thermogravimetric (TG) analysis (STA 409/PC, Netzsch, Germany; heating rate 10 °C/min in flowing air) and surface area analyzer (Tristar II 3020, micromeritics, USA)
Summary
Rotator cuff tear (RCT) is a common problem of the musculoskeletal system. Only enhancing bone regeneration may be not enough for improving tendon–bone healing. The arthroscopic rotator cuff repair (RCR) has been determined to be an effective treatment, there is still a high re-tear rate after surgery. Poor tendon–bone healing in the rotator cuff is believed to be the main reason for the high postoperative re-tear rate [5]. After rotator cuff repair, a fibrovascular tissue is formed between tendon and bone, followed by bone grows into the fibrous interface and gradually grows into the tendon, which reconstructs the continuous collagen fibers between tendon and bone. Promoting osteogenesis and angiogenesis is essential to promoting bone growth towards the tendon–bone junction and enhancing tendon–bone healing [7,8,9]
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