JOURNAL ARTICLE

Application of tissue engineering techniques for rotator cuff regeneration using a chitosan-based hyaluronan hybrid fiber scaffold

Tadanao Funakoshi, Tokifumi Majima, Norimasa Iwasaki, Naoki Suenaga, Naohiro Sawaguchi, Kazumi Shimode, Akio Minami, Kazuo Harada, Shin-ichiro Nishimura
American Journal of Sports Medicine 2005, 33 (8): 1193-201
16000663

BACKGROUND: The current surgical procedures for irreparable rotator cuff tears have considerable limitations. Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing these conditions.

HYPOTHESIS: A chitosan-based hyaluronan hybrid scaffold could enhance type I collagen products with seeded fibroblasts and thereby increase the mechanical strength of regenerated tendon in vivo.

STUDY DESIGN: Controlled laboratory study.

METHODS: The scaffolds were created from chitosan-based hyaluronan hybrid polymer fibers. Forty-eight rabbit infraspinatus tendons and their humeral insertions were removed to create defects. Each defect was covered with a fibroblast-seeded scaffold (n = 16) or a non-fibroblast-seeded scaffold (n = 16). In the other 16 shoulders, the rotator cuff defect was left free as the control. At 4 and 12 weeks after surgery, the engineered tendons were assessed by histological, immunohistochemical (n = 2), and biomechanical (n = 6) analyses.

RESULTS: Type I collagen was only seen in the fibroblast-seeded scaffold and increased in the regenerated tissue. The tensile strength and tangent modulus in the fibroblast-seeded scaffold were significantly improved from 4 to 12 weeks postoperatively. The fibroblast-seeded scaffold had a significantly greater tangent modulus than did the non-fibroblast-seeded scaffold and the control at 12 weeks.

CONCLUSION: This scaffold material enhanced the production of type I collagen and led to improved mechanical strength in the regenerated tissues of the rotator cuff in vivo.

CLINICAL RELEVANCE: Rotator cuff regeneration is feasible using this tissue engineering technique.

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