Posterior Shoulder Stability Can Be Restored by Posterior Acromial Bone Grafting (Scapinelli) in a Cadaveric Biomechanical Model With Normal Glenoid Anatomy.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. 9. J Tissue Eng Regen Med. 2018 Jul;12(7):1690-1701. doi: 10.1002/term.2696. Epub 2018 Jun 3. Novel engineered tendon-fibrocartilage-bone composite with cyclic tension for rotator cuff repair. Liu Q(1)(2), Hatta T(1), Qi J(1), Liu H(1), Thoreson AR(1), Amadio PC(1), Moran SL(1), Steinmann SP(1), Gingery A(1), Zhao C(1). Author information: (1)Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA. (2)The Second Xiangya Hospital, Central South University, Changsha, P.R. China. Surgical repair of rotator cuff tears presents a significant clinical challenge with high failure rates and inferior functional outcomes. Graft augmentation improves repair outcomes; however, currently available grafting materials have limitations. Although cell-seeded decellularized tendon slices may facilitate cell infiltration, promote tendon incorporation, and preserve original mechanical strength, the unique fibrocartilage zone is yet to be successfully reestablished. In this study, we investigated the biological and mechanical properties of an engineered tendon-fibrocartilage-bone composite (TFBC) with cyclic tension (3% strain; 0.2 Hz). Decellularized TFBCs seeded with bone marrow-derived mesenchymal stem cell (BMSCs) sheets and subjected to mechanical stimulation for up to 7 days were characterised by histology, immunohistochemistry, scanning electron microscopy, mechanical testing, and transcriptional regulation. The decellularized TFBC maintained native enthesis structure and properties. Mechanically stimulated TFBC-BMSC constructs displayed increased cell migration after 7 days of culture compared with static groups. The seeded cell sheet not only integrated well with tendon scaffold but also distributed homogeneously and aligned to the direction of stretch under dynamic culture. Developmental genes were regulated including scleraxis, which was significantly upregulated with mechanical stimulation. The Young's modulus of the cell-seeded constructs was significantly higher compared with the noncell-seeded controls. In conclusion, the results of this study reveal that the TFBC-BMSC composite provides an ideal multilayer construct for cell seeding and growth, with mechanical preconditioning further enhances cell penetration and differentiation. The BMSC cell sheet revitalised TFBC in conjunction with mechanical stimulation could serve as a novel and primed biological patch to improve rotator cuff repair. Copyright © 2018 John Wiley & Sons, Ltd. DOI: 10.1002/term.2696