Rotator cuff tear is the main form of shoulder joint injury, which seriously affects shoulder joint function. This study aimed to clarify the function and mechanism of exosomes containing polylactic acid (PLA), polylactic acid copolymer and BMP-2 in tendon bone healing of rotator cuff tear. First, CD44 expression in bone marrow mesenchymal stem cells (BMSCs) and CD90 and CD44 in exosomes were analyzed by flow cytometry. Then, stability and targeting identification of exosome-delivered bone morphogenetic protein (BMP)-2 and PLA microcapsules were measured by transmission electron microscopy (TEM), DiO/DiI staining. Finally, tendon-bone repair after acute rotator cuff rupture in rabbits was established, and the function of BMP-2 exosomes for tendon bone healing in rotator cuff tear was evaluated by micro-CT, biomechanical determination and histochemical staining methods. The results showed that the exosomes of polyaspartic acid-polylactic acid-glycolic acid copolymer (PASP-PLGA) microcapsules were successfully established which showed good stability and targeting. The bone mineral density (BMD), tissue mineral density (TMD) and bone volume fraction (BV/TV) were higher, while the stiffness and the ultimate load strength of the tendon interface were enhanced under treatment with exosomes of PASP-PLGA microcapsules. Histochemical staining showed that exosomes of PASP-PLGA microcapsules promoted tendon and bone interface healing after rotator cuff injury. The tendon regeneration- and cartilage differentiation-related protein expressions were significantly upregulated under treatment with exosomes of PASP-PLGA microcapsules. In conclusion, exosome-delivered BMP-2 and PLA promoted tendon bone healing in rotator cuff tear via Smad/RUNX2 pathway. Our findings may provide a new insight for promoting tendon healing.
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http://dx.doi.org/10.1080/21655979.2021.2019871 | DOI Listing |
PLoS One
January 2025
Orthopaedic Surgery and Traumatology, University Hospital Basel, Basel, Switzerland.
The ARCR_Pred study was initiated to document and predict the safety and effectiveness of arthroscopic rotator cuff repair (ARCR) in a representative Swiss patient cohort. In the present manuscript, we aimed to describe the overall and baseline characteristics of the study, report on functional outcome data and explore case-mix adjustment and differences between public and private hospitals. Between June 2020 and November 2021, primary ARCR patients were prospectively enrolled in a multicenter cohort across 18 Swiss and one German orthopedic center.
View Article and Find Full Text PDFHealthcare (Basel)
December 2024
Interlevel Clinical Management Unit of Physical Medicine and Rehabilitation, Reina Sofía University Hospital, Córdoba and Guadalquivir Health District, 14011 Córdoba, Spain.
: Shoulder pain is a very common health issue among adults, being 8% due to calcifying tendinopathies (CT) of the shoulder. The evolutionary process of this lesion can be classified according to Bianchi Martinoli, depending on the ultrasound appearance. In 50% of cases, with first-line treatments, they resolve spontaneously.
View Article and Find Full Text PDFF1000Res
January 2025
University of Antwerp, Pain in Motion, Antwerp, Antwerp Province, 2000, Belgium.
Introduction: Rotator cuff (RC) tears are the most common and disabling musculoskeletal ailments among patients with shoulder pain. Although most individuals show improvement in function and pain following arthroscopic rotator cuff repair (ARCR), a subgroup of patients continue to suffer from persistent shoulder pain following the surgical procedure. Identifying these factors is important in planning preoperative management to improve patient outcomes.
View Article and Find Full Text PDFAm J Sports Med
January 2025
Service de chirurgie orthopédique et traumatologique, CHU de Toulouse, France.
Background: The surgical management of bursal-sided partial-thickness rotator cuff tendon tears is controversial. The 2 methods used are in situ repair (ISR), preserving the contingent of intact articular tendon fiber, or tear completion before repair (TCBR) according to the operating surgeon's usual technique. No study with sufficient power has demonstrated a superior technique.
View Article and Find Full Text PDFArthroscopy
January 2025
HSS Sports Medicine Institute, Hospital for Special Surgery; Orthopaedic Soft Tissue Research Program, Hospital for Special Surgery Research Institute. Electronic address:
The pathophysiology of rotator cuff disease is complex, involving intrinsic and extrinsic factors that contribute to mechanical alterations, inflammation, apoptosis, and neovascularization. These changes result in structural and cellular disruptions, including inflammatory cell infiltration and collagen disorganization. Macrophages have recently gained attention as critical mediators of tissue repair and regeneration.
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