Novel Implications of Tissue Engineering in the Treatment and Management of Rotator Cuff Tendinopathy

Sanchez Tc, Diaz Cg, T. George
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Abstract

Tendinopathy encompasses one of the most common and debilitating group of injuries in persons of all age. Current treatments range from rest and ice to more invasive mechanisms such as surgical repair or artificial tendon recreation. In recent years, there has been a push to study minimally invasive treatments to aid in the regeneration and repair of damaged tendons. These treatments are yet to show reproducible clinically significant improvement over placebo treatments. Years of research has been put into synthesizing different materials to create scaffolds including metals, bioactive glasses, natural and synthetic polymers. These scaffolds are constructed through one of a variety or complex processes from 3D printing to solvent leaching. These different mechanisms of creation and materials used allow the scaffolds to embody different properties including pore size, thermal stability, strength and pliability. This allows for the utilization of tissue engineering in a multitude of in vivo environments. Many different cell types are used to seed scaffolds including tenocytes, multipotent stem cells and induced pluripotent stem cells. Scaffolds show promise as a delivery system for drugs as well as cytokines and growth factors. Tissue engineering is a novel field of study that shows promise not only for tendon repair but the field of orthopedics as a whole. This paper focuses on systematic review of the principles of tissue engineering and the implications in tendinopathy.
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组织工程在肩袖肌腱病治疗和管理中的新意义
腱鞘病是所有年龄人群中最常见和使人衰弱的一种损伤。目前的治疗方法从休息和冰敷到更具侵入性的机制,如手术修复或人工肌腱重建。近年来,人们一直在努力研究微创治疗,以帮助受损肌腱的再生和修复。与安慰剂治疗相比,这些治疗尚未显示出可重复的临床显著改善。多年来,人们一直在研究如何合成不同的材料来制造支架,包括金属、生物活性玻璃、天然聚合物和合成聚合物。这些支架是通过从3D打印到溶剂浸出的各种复杂过程之一构建的。这些不同的制造机制和使用的材料使支架具有不同的性能,包括孔径、热稳定性、强度和柔韧性。这使得组织工程在大量体内环境中的应用成为可能。许多不同类型的细胞被用于植入支架,包括腱细胞、多能干细胞和诱导多能干细胞。支架作为药物、细胞因子和生长因子的输送系统显示出很大的前景。组织工程是一个新兴的研究领域,不仅对肌腱修复,而且对整个骨科领域都有很大的前景。本文着重对组织工程原理及其在肌腱病变中的应用进行系统综述。
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