Abstract

Rotator cuff tear is the most frequent tendon injury in the adult population. Despite current improvements in surgical techniques and the development of grafts, failure rates following tendon reconstruction remain high. New therapies, which aim to restore the topology and functionality of the interface between muscle, tendon and bone, are essentially required. One of the key factors for a successful incorporation of tissue engineered constructs is a rapid ingrowth of cells and tissues, which is dependent on a fast vascularization. The dorsal skinfold chamber model in female BALB/cJZtm mice allows the observation of microhemodynamic parameters in repeated measurements in vivo and therefore the description of the vascularization of different implant materials. In order to promote vascularization of implant material, we compared a porous polymer patch (a commercially available porous polyurethane based scaffold from Biomerix™) with electrospun polycaprolactone (PCL) fiber mats and chitosan-graft-PCL coated electrospun PCL (CS-g-PCL) fiber mats in vivo. Using intravital fluorescence microscopy microcirculatory parameters were analyzed repetitively over 14 days. Vascularization was significantly increased in CS-g-PCL fiber mats at day 14 compared to the porous polymer patch and uncoated PCL fiber mats. Furthermore CS-g-PCL fiber mats showed also a reduced activation of immune cells. Clinically, these are important findings as they indicate that the CS-g-PCL improves the formation of vascularized tissue and the ingrowth of cells into electrospun PCL scaffolds. Especially the combination of enhanced vascularization and the reduction in immune cell activation at the later time points of our study points to an improved clinical outcome after rotator cuff tear repair.

Highlights

  • IntroductionDegenerative processes in elderly people account for a large number of injuries, so that about 50% of people over their seventies are affected by a rotator cuff tear [1]

  • Rotator cuff tears are common injuries in human shoulders

  • A lack or delay of angiogenesis and supply of nutrients is a common reason for inadequate healing after surgery

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Summary

Introduction

Degenerative processes in elderly people account for a large number of injuries, so that about 50% of people over their seventies are affected by a rotator cuff tear [1]. As a result tendon retraction arises, as well as loss of elasticity in the musculotendinous unit [5]. These changes complicate or in some cases hinder surgical fixation of the tendon to the osseous attachment. The main problem after surgery is the healing process after tendon reconstruction, because instead of a regenerated tendon-bone-junction [6] the formation of scar tissues, which show reduced tensile strength compared to the intact tendon, can be observed [7]. The high incidence of failure related to existing implant materials and repair techniques emphasize the importance of functional solutions for tendon repair [9]

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