Rotator Cuff Injuries: The Evolving Role of Tissue Engineering.

Aims: Rotator cuff injuries are a common injury associated with a combination of intrinsic and extrinsic causative factors. Although surgical reconstruction is a well established option, this is associated with variable re rupture rates. There is a growing body of interest in the potential tissue engineering in the management of rotator cuff injuries. This review aims to summarise the information in the literature on the evolving role of these techniques. Study design: Review Article Place and Duration of Study: University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom. Methodology: We reviewed the literature to identify studies on the use of tissue engineering therapy for the management of rotator cuff injuries Results: There is an increasing body of evidence suggesting that stem cell techniques, augmented by the use of appropriate scaffolds and the influence of growth factors may promote healing in rotator cuff injuries. Conclusion: Tissue engineering holds enormous promise to improve human health through prevention of disease and the restoration of healthy tissue functions. However to date, there is insufficient evidence to draw a solid conclusion. This field however presents a huge potential and warrants larger human studies to confirm any potential benefit.

Tendon and Ligament Injuries: The Evolving Role of Stem Cells and Tissue Engineering.

Aims: Musculoskeletal injuries are a common injury associated with a reduction in quality of life, increased morbidity and social and financial implications. Although surgical reconstruction is a well established option, outcomes are variable. There is a growing body of interest in the potential of mesenchymal stem cells (MSCs) in the management of tendon and ligament injuries. This review aims to summarise the information in the literature on the evolving role of these. Study design: Review Article. Place and Duration of Study: University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom. Methodology: We reviewed the literature to identify studies on the use of MSCs for the management of tendon and ligament injuries. Results: There is an increasing and encouraging body of evidence to suggest that MSCs have a significant role in the management of musculoskeletal injuries involving tendons and ligaments. They not only appear to promote healing but can be adapted to have further benefits such as osteointegration at the tendon-bone interfaces. Conclusion: MSCs appear to provide an encouraging treatment option for the treatment, repair and augmentation of tendon and ligament injuries. Their autologous nature make them a safe and viable option, however more studies are needed to evaluate their future role.

Cell-Based Therapies in Musculoskeletal Injuries: The Evolving Role of Bone Marrow- Derived Mesenchymal Stem Cells.

Aims: There is considerable interest in the potential of bone marrow-derived mesenchymal stem cells (BM-MSCs) in the management of musculoskeletal injuries. This review aims to summarise the information in the literature on the evolving role of these cells in the management of these complex heterogenous injuries. Study design: Review Article. Place and Duration of Study: University College London Institute of Orthopaedics and Musculoskeletal Sciences, Royal National Orthopaedic Hospital, Stanmore, Middlesex, HA7 4LP, United Kingdom. Methodology: We reviewed the literature to identify studies on the use of BM-MSCs for the management of musculoskeletal injuries. Results: There is an increasing and encouraging body of evidence to suggest that BMMSCs have a significant role in the management of musculoskeletal injuries involving muscles, tendons, ligaments, bone, cartilage, menisci and nervous tissue. Conclusion: Several characteristics of BM-MSCs make them ideal candidates in managing musculoskeletal injuries. Bone marrow is easy to obtain requiring minimal donor site morbidity, invasiveness and anaesthetic. Their autologous nature eliminates the issue of immunoreactions and ethical problems. The majority of studies in the literature however use small animal models, and further work in larger animals and ultimately ethically approved clinical trials should be explored before any significant clinical relevance can be assessed.