Alginate Nonwoven-Sponge Composite Scaffold for Rotator Cuff Tendon Repair
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ISSN 1229-9197 (print version) ISSN 1875-0052 (electronic version)
Alginate Nonwoven-Sponge Composite Scaffold for Rotator Cuff Tendon Repair Ga Young Park1, Jong Pil Yoon2,3, and Jin Hyun Choi1,3* 1
Department of Biofibers and Biomaterials Science, Kyungpook National University, Daegu 41566, Korea Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Daegu 41944, Korea 3 Joint Institute for Regenerative Medicine, Kyungpook National University, Daegu 41940, Korea (Received July 18, 2019; Revised December 16, 2019; Accepted December 22, 2019)
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Abstract: Growth factor-mediated healing of rotator cuff tendon requires to develop a clinically applicable biomaterial playing roles of mechanical support and growth factor release in vivo. In this study, the alginate (AG) nonwoven-sponge composite scaffold (AGNWSP) was fabricated through the formation of an AG sponge layer on the AG nonwoven scaffold (AGNW) surface, and rotator cuff repair with the AG-based scaffolds containing transforming growth factor-beta 1 (TGF-β1) was investigated with a rabbit model. AGNWSP had higher tensile strength, lower bioabsorbability, and higher sustained TGF-β1 release capacity than AGNW, which were highly correlated with tendon regeneration. AGNW and AGNWSP were fixed to the ruptured tendon-to-bone sites, and fresh solutions of TGF-β1 were injected into the scaffolds. When AGNWSP was applied, the repaired supraspinatus tendon had higher ultimate failure load and stress. In addition, well-organized collagen fibers and fibrocartilages were observed at the tendon-to-bone interface in this case. It is suggested that high degree of ruptured rotator cuff healing could be achieved with AGNWSP in combination with TGF-β1. Keywords: Rotator cuff tendon, Alginate, Nonwoven, Composite scaffold, Transforming growth factor-beta 1
undenatured growth factors should be delivered and localized at the rupture site for effective rotator cuff healing. Mechanical support and force-absorption by a biomaterial implanted at the tendon-to-bone site are also important for rotator cuff repair. Non-biodegradable and biodegradable synthetic polymers were used for reconstruction of a rotator cuff tendon [13-15]. Recently, there have been remarkable advances in rotator cuff tendon repair via the combination of mechanical reinforcement and biological enhancement of the patient’s original healing potential [16-18]. Alginate (AG) is a naturally derived polysaccharide that has been used extensively in cell delivery and tissue engineering applications [19]. Highly water-soluble sodium AG is crosslinked with multivalent metal cations, mostly Ca2+ to produce insoluble calcium AG in the form of hydrogels, sponges, sheets, beads, and nonwoven fabrics. In our previous study, the combined healing system using an AG sponge and TGF-β1 was developed for rotator cuff repair [20]. Incorporation, localization, and sustained release of TGF-β1 in vivo were achieved using the AG sponge. Despite excellent healing of ruptured rotator cuff tendon using AG sp
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