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2023 ISAKOS Biennial Congress Paper

New Bioactive Spatially-Embedded Growth Factor (SEGF) Scaffold Promotes Bone-To-Tendon Interface Healing After Chronic Rotator Cuff Repair

Jian Han, MD, PhD CHINA
Hyeon Jang Jeong, MD, PhD, Seongnam-Si, Gyeonggi-do KOREA, REPUBLIC OF
Joo Han Oh, MD, PhD, Seongnam-Si, Gyeonggi-do KOREA, REPUBLIC OF
Seoul National University Bundang Hospital, Seongnam-Si , Gyeonggi-do, KOREA, REPUBLIC OF

FDA Status Not Applicable

Summary

This new bioactive spatially-embedded growth factor (SEGF) Scaffold effectively accelerated BTI healing in chronic rotator cuff tear model of rabbits.

Abstract

Background

Restoration of the original anatomical bone-to-tendon interface (BTI) after rotator cuff repair (RCR) remains a significant challenge, therefore a multitude of biocompatible biomaterials has been investigated to promote rotator cuff healing after repair.

Purpose

To investigate the efficacy of 3D-printed scaffolds incorporated with spatiotemporal delivery of growth factors (GF) to accelerate BTI healing after RCR.

Methods

Advanced 3D printing was used to fabricate the multilayered scaffolds, spatially embedded with different GFs to guide regional differentiation of endogenous stem/progenitor cells. A sustained, spatially controlled release of GFs was confirmed. The multi-lineage differentiation potential of mesenchymal stem cells (MSCs) in the scaffold was assayed. In vivo, a total of 50 rabbits, with induced chronic rotator cuff injuries, were divided into 4 groups: Normal (N, n = 2), saline control (A, n = 16), scaffold without GF (B, n = 16), and scaffold with GF (C, n = 16). At 6 weeks after the creation of rotator cuff tears, surgical repairs were performed when scaffolds were implanted between the bony footprint and supraspinatus tendon. RT-qPCR analysis was performed at 4 weeks after the repair, and biomechanical and micro-CT analyses were performed at 12 weeks after repair.

Results

In vitro, the scaffolds successfully guided regional differentiation of MSCs, forming multiphase tissues with tendon, cartilage and bone-like regions. In vivo, group C showed higher collagen type Ia1, collagen type IIIa1, and aggrecan expressions than the other groups (P < 0.001, = 0.005 and =0.006, respectively) at 4 weeks after repair. For the biomechanical evaluation, group C showed a significantly higher load-to-failure rate than the other groups (P = 0.003) at 12 weeks after repair. For the micro-CT analysis, group C showed higher bone mineral density and bone volume/total volume rate than the other groups (P = 0.001 and < 0.001, respectively) at 12 weeks after repair.

Conclusion