Research progress of graft application in promoting rotator cuff tendon-bone healing

Abstract

The incidence of re-tearing after rotator cuff repair is very high. The main reason is that the tendon-osseous junction after the operation is scar healed. In response to this problem, research in recent years has focused on the application of grafts, including cell transplantation, periosteum transplantation, cartilage transplantation, and biosynthetic transplantation. Cell transplantation is mainly a variety of stem cells from different sources. The current research has confirmed that it can achieve better results. The combined application of exosomes and stem cells may be the future development direction. Periosteum transplantation is a promising intervention method, but few clinical applications at present, and there are problems such as limited sources of materials and secondary trauma from the materials. Tissue engineered periostium and artificial bionic periostium may be alternatives to periosteal;cartilage transplantation can promote the regeneration of cartilage at the tendon-osseous junction and facilitate tendon-bone healing. However, there are also limited materials and secondary damage. There is no better solution to this problem. The slow degradation of inorganic composites and the poor effect of single use limit its application; biological derivatives have immunogenicity, poor biomechanics and other issues, there is currently no proper solution; organic synthetic grafts pay more attention to simulating the structure of the physiological tendon-osseointegration zone, and show good results in tendon-bone healing, and have good application prospects. In addition, most of the above-mentioned application research of different grafts stays at the cellular and animal level, and more research is needed in clinical application. This article briefly reviews the application status, advantages, disadvantages and development trends of the above-mentioned different grafts, in order to provide certain guidance for the clinical treatment of rotator cuff tears.