Abstract

Rotator cuff tear is one of the most common shoulder diseases. Rotator cuff augmentation (RCA) is trying to solve the high retear failure percentage after the surgery procedures (20–90%). The ideal augmentation patch must provide a temporal mechanical support during the healing process. In this work, we proposed a simple method for the fabrication of synthetic RCA patches. This method combines the use of electrospraying to produce poly-L-lactic-co-ε-caprolactone (PLC) films in an organogel form and electrospinning to produce poly(lactic) acid (PLA) nanofibers. The device consists in a combination of layers, creating a multilayered construct, enabling the possibility of tuning its mechanical properties and thickness. Besides, both techniques are simple to escalate for industrial production. A complete characterization has been performed to optimize the involved number of layers and production time of PLC films and PLA nanofibers fabrication, obtaining a final optimal configuration for RCA devices. Structural, mechanical and suture properties were evaluated. Also, the possibility of surface functionalization to improve the bioactivity of the scaffold was studied, adding aligned electrospun PLA nanofibers on the surface of the device to mimic the natural tendon topography. Surface modification was characterized by culturing adult normal human dermal fibroblasts. Lack of toxicity was detected for material presented, and cell alignment shape orientation guided by aligned fibers, mimicking tendon structure, was obtained. Cell proliferation and protein production were also evaluated.

Highlights

  • Rotator cuff augmentation (RCA) has become an increasing technique to prevent tendon retear after a surgery repair

  • The fabrication process of patches for RCA is presented. These RCA devices are made of PLC films by electrospraying and poly(lactic) acid (PLA) nanofibers by electrospinning

  • Production of organogel PLC films by electrospraying and PLA fibers addition by electrospinning The inner microstructure of PLC/Ethyl L-lactate (EtLac) organogels films produced by electrospraying after solvent exchange in water was characterized by Field Emission Scanning Electron Microscopy (FE-SEM) [21]

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Summary

Introduction

Rotator cuff augmentation (RCA) has become an increasing technique to prevent tendon retear after a surgery repair. In cases with large, massive and chronic tears, the retear failure incidence ranges from 20% to 90% depending on the case [6,7,8,9]. Different types of patches for RCA have been studied since the 90s [10] in order to improve tendon reattachment and healing process, especially in large tears and chronic failures. Among them, decellularized extracellular matrix (ECM) membranes from different donors (porcine, equine, and human) provide a temporal and suitable support for cells and a source of biochemical signals and proteins that can stimulate the tissue regeneration. Other concern about the use of ECM membranes are their fast body resorption, losing their mechanical supporting resistance at early healing stages [14]

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