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Cited by 15Shoulder Injury and TreatmentTendon Structure and TreatmentBone Tissue Engineering Materials

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Enhancement of tendon-bone healing following rotator cuff repair using hydroxyapatite with TGFβ1

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You, Xiebo, Shen, Yueqin, Yu, Weihan, He, Yaohua·2018·Molecular Medicine Reports
DOI 10.3892/mmr.2018.8499PMC PMC5865958
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Abstract

The formation of fibrocartilage at the healing site following a rotator cuff tear repair is a major problem in the field of tendon‑bone healing. The present study aimed to enhance the healing of the tendon‑bone interface following rotator‑cuff tear repair by the interposition of hydroxyapatite (HA) encapsulated with transforming growth factor β1 (TGFβ1). Using an acute rotator cuff repair model, rats were divided into three groups: i) Repair only (control); ii) HA group; and iii) HA‑TGFβ1 group. Animals were sacrificed at 2, 4 and 8 weeks following surgery. Micro‑computed tomography (CT), histomorphometric analyses and biomechanical tests were used to evaluate the supraspinatus tendon‑bone complex. The micro‑CT images revealed notable novel bone formation in the groups treated with HA‑TGFβ1. The histomorphometric analyses demonstrated improved fibrocartilage formation and collagen organization at the tendon‑bone interface. The HA‑TGFβ1 combination significantly improved the area of fibrocartilage, particularly at early time points (2 and 4 weeks). There was a significantly greater load‑to‑failure force achieved in the HA and HA‑TGFβ1 groups compared with the control group at 4 and 8 weeks. Augmentation of the ceramic powder with HA‑TGFβ1 at the tendon‑bone interface was demonstrated to strengthen the healing entheses, increase bone and fibrocartilage formation and improve collagen organization compared with surgical repair alone. Local application of HA‑TGFβ1 demonstrates potential in improving tendon‑bone healing following rotator cuff repair.

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Figure 1. Analysis of the structure of the proximal humerus. (A) Micro-CT images of the proximal humerus. (B) Analysis of BMD. (C) Analysis of BV/TV. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control. HA-TGFβ1, hydroxyapatite-transforming growth factor β1; CT, computed tomography; BMD, bone mineral density; BV/TV, bone volume/total volume.
Figure 1. Analysis of the structure of the proximal humerus. (A) Micro-CT images of the proximal humerus. (B) Analysis of BMD. (C) Analysis of BV/TV. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control. HA-TGFβ1, hydroxyapatite-transforming growth factor β1; CT, computed tomography; BMD, bone mineral density; BV/TV, bone volume/total volume.CC BY-NC-ND · PubMed Central
Figure 2. Hematoxylin and eosin-stained tissue sections of the healing enthesis at 2, 4 and 8 weeks postoperatively. B, bone; I, interface; T, tendon; HA, hydroxyapatite; HA-TGFβ1, hydroxyapatite-transforming growth factor β1.
Figure 2. Hematoxylin and eosin-stained tissue sections of the healing enthesis at 2, 4 and 8 weeks postoperatively. B, bone; I, interface; T, tendon; HA, hydroxyapatite; HA-TGFβ1, hydroxyapatite-transforming growth factor β1.CC BY-NC-ND · PubMed Central
Figure 3. Histological analysis of the healing enthesis. (A) Representative safranin O-stained tissue sections of the healing enthesis at 2, 4 and 8 weeks postoperatively. (B) Area of cartilage at the interface area with safranin O-stained slides. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control; ∆P<0.05 vs. HA. B, bone; I, interface; T, tendon; HA-TGFβ1, hydroxyapatite-transforming growth factor β1.
Figure 3. Histological analysis of the healing enthesis. (A) Representative safranin O-stained tissue sections of the healing enthesis at 2, 4 and 8 weeks postoperatively. (B) Area of cartilage at the interface area with safranin O-stained slides. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control; ∆P<0.05 vs. HA. B, bone; I, interface; T, tendon; HA-TGFβ1, hydroxyapatite-transforming growth factor β1.CC BY-NC-ND · PubMed Central
Figure 4. Further histological analysis of the healing enthesis. (A) Representative spicrosirius red-stained tissue sections of the healing enthesis at 2, 4 and 8 weeks postoperatively. (B) Area of collagen birefringence. Scale bar=100 µm. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control; ∆P<0.05 vs. HA. B, bone; I, interface; T, tendon; HA-TGFβ1, hydroxyapatite-transforming growth factor β1.
Figure 4. Further histological analysis of the healing enthesis. (A) Representative spicrosirius red-stained tissue sections of the healing enthesis at 2, 4 and 8 weeks postoperatively. (B) Area of collagen birefringence. Scale bar=100 µm. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control; ∆P<0.05 vs. HA. B, bone; I, interface; T, tendon; HA-TGFβ1, hydroxyapatite-transforming growth factor β1.CC BY-NC-ND · PubMed Central
Figure 5. Biomechanical test of the tendon-bone interface. (A) Cross-sectional areas. (B) Ultimate load to failure. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control. HA-TGFβ1, hydroxyapatite-transforming growth factor β1.
Figure 5. Biomechanical test of the tendon-bone interface. (A) Cross-sectional areas. (B) Ultimate load to failure. Data are presented as the mean ± standard deviation (n=5 for each group). *P<0.05 vs. control. HA-TGFβ1, hydroxyapatite-transforming growth factor β1.CC BY-NC-ND · PubMed Central

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Research works printed but not linked: 28

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Cited by

Metadata

Authors
You, X., Shen, Y., Yu, W., & He, Y.
Affiliations
  • Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, P.R. China
  • State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Science, Shanghai 200050, P.R. China
  • Shanghai Jiao Tong University (CN)
Corresponding author
He, Yaohua
ORCID
He, Yaohua
Venue
Molecular Medicine Reports
Publisher
Spandidos Publications
Published
2018-01-26
Volume
17
Issue
4
Pages
4981-4988
ISSN
  • 1791-2997 (ISSN-L)
  • 1791-3004
DOI
10.3892/mmr.2018.8499
PMC
PMC5865958
OpenAlex
W2787640574
Cited by
15
References
0
Citations by year
2026: 2 · 2025: 4 · 2023: 2 · 2021: 4 · 2020: 1 · 2019: 1 · 2018: 1
FWCI
1.82
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Molecular Medicine Reports (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
National Natural Science Foundation of China (81271961)
Topics
  • Health Sciences › Medicine › Surgery › Shoulder Injury and Treatment
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
  • Physical Sciences › Engineering › Biomedical Engineering › Bone Tissue Engineering Materials
Keywords
rotator cuff repair, tendon-bone healing, hydroxyapatite, TGF-β1, fibrocartilage formation, supraspinatus tendon, enthesis, collagen organization, bone formation, rotator cuff tear
MeSH terms
Rotator Cuff Injuries, Animals, Biocompatible Materials, Collagen, Disease Models, Animal, Immunohistochemistry, Male, Time Factors, Wound Healing, Durapatite, Rats, Transforming Growth Factor beta1, X-Ray Microtomography

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