Rotator cuff repair augmentation using osteoinductive growth factors

Rotator cuff injuries (RCIs) present a major health problem due to high incidences of degenerative tears greater than 3 cm and prevalence of re-tears following surgical procedures. Since healing and functional restoration relies upon bone ingrowth into the tendon, it is hypothesised that sustained d...

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Main Authors: Rhea S. Menon, Nicholas M. Wragg, Sammy Wilson
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Published: 2019
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Online Access:https://hdl.handle.net/2134/36696
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spelling rr-article-95611132019-01-01T00:00:00Z Rotator cuff repair augmentation using osteoinductive growth factors Rhea S. Menon (7211333) Nicholas M. Wragg (7206149) Sammy Wilson (1259568) Mechanical engineering not elsewhere classified Rotator cuff Bone morphogenetic proteins Enthesis healing Growth Factors Mechanical Engineering not elsewhere classified Rotator cuff injuries (RCIs) present a major health problem due to high incidences of degenerative tears greater than 3 cm and prevalence of re-tears following surgical procedures. Since healing and functional restoration relies upon bone ingrowth into the tendon, it is hypothesised that sustained delivery of osteoinductive factors including bone morphogenetic proteins (BMPs), specifically BMP2–7, may significantly improve RCI tendon-bone healing. Here, growth factor candidates and delivery mechanisms are reviewed, specifically for improved RCI healing through enhanced bone ingrowth. In addition to BMPs, other potentially osteogenic factors including platelet-derived growth factors (PDGF), fibroblast growth factor (FGF), transforming growth beta isoforms (TGF-β1 and TGF-3) and parathyroid hormone (PTH) are evaluated since they can induce bone formation at the healing tendon attachment site. Several challenges must be addressed prior to clinical translation. The majority of published studies utilise in vivo animal models. In general, BMP-7 demonstrates a stronger stimulating effect when compared to BMP-2; the reported effectiveness of BMP-2 is often conflicting. Alternative factors, including PDGF and PTH, also demonstrate potential for assisting bone growth in enthesis healing. The use of sustained and biomimetic delivery systems appears to have the greatest positive effects. Some studies have demonstrated a dose-dependent effect, in conjunction with varying age, indicating that stratified therapies could be a viable solution for RCI healing. To adequately resolve potential treatments for RCI, further expanded and correlated animal trials must be undertaken, and indicative human trials are required with consideration of surgical and patient-specific influences. 2019-01-01T00:00:00Z Text Journal contribution 2134/36696 https://figshare.com/articles/journal_contribution/Rotator_cuff_repair_augmentation_using_osteoinductive_growth_factors/9561113 CC BY 4.0
institution Loughborough University
collection Figshare
topic Mechanical engineering not elsewhere classified
Rotator cuff
Bone morphogenetic proteins
Enthesis healing
Growth Factors
Mechanical Engineering not elsewhere classified
spellingShingle Mechanical engineering not elsewhere classified
Rotator cuff
Bone morphogenetic proteins
Enthesis healing
Growth Factors
Mechanical Engineering not elsewhere classified
Rhea S. Menon
Nicholas M. Wragg
Sammy Wilson
Rotator cuff repair augmentation using osteoinductive growth factors
description Rotator cuff injuries (RCIs) present a major health problem due to high incidences of degenerative tears greater than 3 cm and prevalence of re-tears following surgical procedures. Since healing and functional restoration relies upon bone ingrowth into the tendon, it is hypothesised that sustained delivery of osteoinductive factors including bone morphogenetic proteins (BMPs), specifically BMP2–7, may significantly improve RCI tendon-bone healing. Here, growth factor candidates and delivery mechanisms are reviewed, specifically for improved RCI healing through enhanced bone ingrowth. In addition to BMPs, other potentially osteogenic factors including platelet-derived growth factors (PDGF), fibroblast growth factor (FGF), transforming growth beta isoforms (TGF-β1 and TGF-3) and parathyroid hormone (PTH) are evaluated since they can induce bone formation at the healing tendon attachment site. Several challenges must be addressed prior to clinical translation. The majority of published studies utilise in vivo animal models. In general, BMP-7 demonstrates a stronger stimulating effect when compared to BMP-2; the reported effectiveness of BMP-2 is often conflicting. Alternative factors, including PDGF and PTH, also demonstrate potential for assisting bone growth in enthesis healing. The use of sustained and biomimetic delivery systems appears to have the greatest positive effects. Some studies have demonstrated a dose-dependent effect, in conjunction with varying age, indicating that stratified therapies could be a viable solution for RCI healing. To adequately resolve potential treatments for RCI, further expanded and correlated animal trials must be undertaken, and indicative human trials are required with consideration of surgical and patient-specific influences.
format Default
Article
author Rhea S. Menon
Nicholas M. Wragg
Sammy Wilson
author_facet Rhea S. Menon
Nicholas M. Wragg
Sammy Wilson
author_sort Rhea S. Menon (7211333)
title Rotator cuff repair augmentation using osteoinductive growth factors
title_short Rotator cuff repair augmentation using osteoinductive growth factors
title_full Rotator cuff repair augmentation using osteoinductive growth factors
title_fullStr Rotator cuff repair augmentation using osteoinductive growth factors
title_full_unstemmed Rotator cuff repair augmentation using osteoinductive growth factors
title_sort rotator cuff repair augmentation using osteoinductive growth factors
publishDate 2019
url https://hdl.handle.net/2134/36696
_version_ 1805072695885299712