Enhanced Tendon-to-Bone Healing of Chronic Rotator Cuff Tears by Bone Marrow Aspirate Concentrate in a Rabbit Model

Overview

Journal Clin Orthop Surg

Specialty Orthopedics

Date 2018 Mar 23

PMID 29564054

Citations 15

Authors

Xiao Ning Liu

Cheol-Jung Yang

Ji Eui Kim

Zhen Wu Du

Ming Ren

Wei Zhang

Hong Yu Zhao

Kyung Ok Kim

Kyu-Cheol Noh

Affiliations

Soon will be listed here.

Abstract

Background: To evaluate the influence of bone marrow aspirate concentrate (BMAC) on tendon-to-bone healing in a rabbit rotator cuff model and to characterize the composition of growth factors in BMAC.

Methods: In this study, 40 rabbits were allocated into five groups: control (C), repair + saline (RS), repair + platelet-rich plasma (PRP; RP), repair + BMAC (RB) and repair + PRP + BMAC (RPB). A tear model was created by supraspinatus tendon transection at the footprint. Six weeks after transection, the torn tendon was repaired along with BMAC or PRP administration. Six weeks after repair, shoulder samples were harvested for biomechanical and histological testing. Ten rabbits were used for processing PRP and BMAC, followed by analysis of blood cell composition and the levels of growth factors .

Results: The ultimate load-to-failure was significantly higher in RPB group compared to RS group ( = 0.025). BMAC-treated groups showed higher values of biomechanical properties than RS group. The histology of BMAC-treated samples showed better collagen fiber continuity and orientation than RS group. BMAC contained significantly higher levels of the several growth factors than PRP.

Conclusions: Locally administered BMAC enhanced tendon-to-bone healing and has potential for clinical applications.

Citing Articles

Establishing metrics of clinically meaningful change for treating knee osteoarthritis with a combination of autologous orthobiologics.

Centeno C, Ghattas J, Dodson E, Steinmetz N, Murphy M, Berger D Sci Rep. 2025; 15(1):7244.

PMID: 40021765 PMC: 11871318. DOI: 10.1038/s41598-025-91972-3.

Evaluation of Safety and Efficacy of Cell Therapy Based on Osteoblasts Derived from Umbilical Cord Mesenchymal Stem Cells for Osteonecrosis of the Femoral Head: Study Protocol for a Single-Center, Open-Label, Phase I Clinical Trial.

Baek S, Shim B, Won H, Lee S, Lee Y, Park H Pharmaceuticals (Basel). 2024; 17(10).

PMID: 39459006 PMC: 11510171. DOI: 10.3390/ph17101366.

Repair potential of self-assembling peptide hydrogel in a mouse model of anterior cruciate ligament reconstruction.

Fujino K, Yamamoto N, Yoshimura Y, Yokota A, Hirano Y, Neo M J Exp Orthop. 2024; 11(3):e12061.

PMID: 38899049 PMC: 11185946. DOI: 10.1002/jeo2.12061.

Atelocollagen Scaffold Enhances Cartilage Regeneration in Osteochondral Defects: A Study in Rabbits.

Yoo J, Kim M, Sohn S, Woo S, Choi Y, Kwak A Tissue Eng Regen Med. 2023; 21(2):329-339.

PMID: 37853285 PMC: 10825099. DOI: 10.1007/s13770-023-00589-y.

Comparison of mesenchymal stem cells from bone marrow, umbilical cord blood, and umbilical cord tissue in regeneration of a full-thickness tendon defect and .

Yea J, Kim Y, Jo C Biochem Biophys Rep. 2023; 34:101486.

PMID: 37234487 PMC: 10206173. DOI: 10.1016/j.bbrep.2023.101486.

References

Gulotta L, Kovacevic D, Ehteshami J, Dagher E, Packer J, Rodeo S . Application of bone marrow-derived mesenchymal stem cells in a rotator cuff repair model. Am J Sports Med. 2009; 37(11):2126-33. DOI: 10.1177/0363546509339582. View

Xie X, Wang Y, Zhao C, Guo S, Liu S, Jia W . Comparative evaluation of MSCs from bone marrow and adipose tissue seeded in PRP-derived scaffold for cartilage regeneration. Biomaterials. 2012; 33(29):7008-18. DOI: 10.1016/j.biomaterials.2012.06.058. View

Hirose K, Kondo S, Choi H, Mishima S, Iwata H, Ishiguro N . Spontaneous healing process of a supraspinatus tendon tear in rabbits. Arch Orthop Trauma Surg. 2004; 124(6):374-7. DOI: 10.1007/s00402-004-0663-8. View

Cheung E, Silverio L, Sperling J . Strategies in biologic augmentation of rotator cuff repair: a review. Clin Orthop Relat Res. 2010; 468(6):1476-84. PMC: 2865611. DOI: 10.1007/s11999-010-1323-7. View

Nishimoto S, Fukuda K, Kawai K, Fujiwara T, Tsumano T, Fujita K . Supplementation of bone marrow aspirate-derived platelet-rich plasma for treating radiation-induced ulcer after cardiac fluoroscopic procedures: A preliminary report. Indian J Plast Surg. 2012; 45(1):109-14. PMC: 3385373. DOI: 10.4103/0970-0358.96599. View

Kovacevic D, Rodeo S . Biological augmentation of rotator cuff tendon repair. Clin Orthop Relat Res. 2008; 466(3):622-33. PMC: 2505220. DOI: 10.1007/s11999-007-0112-4. View

Yun J, Han S, Choi S, Lee M, Lee S, Song S . Effects of bone marrow-derived mesenchymal stem cells and platelet-rich plasma on bone regeneration for osseointegration of dental implants: preliminary study in canine three-wall intrabony defects. J Biomed Mater Res B Appl Biomater. 2013; 102(5):1021-30. DOI: 10.1002/jbm.b.33084. View

Harryman 2nd D, Mack L, Wang K, Jackins S, Richardson M, Matsen 3rd F . Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991; 73(7):982-9. View

Lyras D, Kazakos K, Verettas D, Botaitis S, Agrogiannis G, Kokka A . The effect of platelet-rich plasma gel in the early phase of patellar tendon healing. Arch Orthop Trauma Surg. 2009; 129(11):1577-82. DOI: 10.1007/s00402-009-0935-4. View

10.

Bosch G, van Schie H, de Groot M, Cadby J, van de Lest C, Barneveld A . Effects of platelet-rich plasma on the quality of repair of mechanically induced core lesions in equine superficial digital flexor tendons: A placebo-controlled experimental study. J Orthop Res. 2009; 28(2):211-7. DOI: 10.1002/jor.20980. View

11.

Hoffmann A, Gross G . Tendon and ligament engineering: from cell biology to in vivo application. Regen Med. 2007; 1(4):563-74. DOI: 10.2217/17460751.1.4.563. View

12.

Kim H, Nam H, Hur C, Park M, Yang H, Kim B . The effect of platelet rich plasma from bone marrow aspirate with added bone morphogenetic protein-2 on the Achilles tendon-bone junction in rabbits. Clin Orthop Surg. 2011; 3(4):325-31. PMC: 3232361. DOI: 10.4055/cios.2011.3.4.325. View

13.

Livermore R, Chong A, Prohaska D, Cooke F, Jones T . Knot security, loop security, and elongation of braided polyblend sutures used for arthroscopic knots. Am J Orthop (Belle Mead NJ). 2011; 39(12):569-76. View

14.

Uhthoff H, Seki M, Backman D, Trudel G, Himori K, Sano H . Tensile strength of the supraspinatus after reimplantation into a bony trough: an experimental study in rabbits. J Shoulder Elbow Surg. 2002; 11(5):504-9. DOI: 10.1067/mse.2002.126760. View

15.

Gerber C, Schneeberger A, Perren S, Nyffeler R . Experimental rotator cuff repair. A preliminary study. J Bone Joint Surg Am. 1999; 81(9):1281-90. DOI: 10.2106/00004623-199909000-00009. View

16.

Chung S, Song B, Kim Y, Park K, Oh J . Effect of platelet-rich plasma and porcine dermal collagen graft augmentation for rotator cuff healing in a rabbit model. Am J Sports Med. 2013; 41(12):2909-18. DOI: 10.1177/0363546513503810. View

17.

Lorbach O, Pape D, Raber F, Kohn D, Kieb M . Arthroscopic rotator cuff repair using a single-row of triple-loaded suture anchors with a modified suture configuration. Arch Orthop Trauma Surg. 2011; 131(8):1073-6. DOI: 10.1007/s00402-011-1283-8. View

18.

Aspenberg P, Virchenko O . Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand. 2004; 75(1):93-9. DOI: 10.1080/00016470410001708190. View

19.

Mazzocca A, McCarthy M, Chowaniec D, Dugdale E, Hansen D, Cote M . The positive effects of different platelet-rich plasma methods on human muscle, bone, and tendon cells. Am J Sports Med. 2012; 40(8):1742-9. DOI: 10.1177/0363546512452713. View

20.

Zhang J, Wang J . Platelet-rich plasma releasate promotes differentiation of tendon stem cells into active tenocytes. Am J Sports Med. 2010; 38(12):2477-86. DOI: 10.1177/0363546510376750. View