ABSTRACT
BACKGROUND: Rotator cuff injury is the main cause of shoulder dysfunction in adults. The rate of retear is very high in patients with rotator cuff tear treated with simple surgical suture. Biological materials can optimize the biomechanical property after rotator cuff injury. OBJECTIVE: To review the latest research and clinical application of biomaterials in the repair of rotator cuff injury. METHODS: PubMed and Web of science databases were retrieved for the latest researches on the biomaterials for repair of rotator cuff. The search terms were “rotator cuff injuries; biological materials; autograft; extracellular matrix materials; synthetic materials; biological scaffold; biological patch; augmentation”. Fifty-seven articles were classified and compared to discuss the advantages and disadvantages of various repair biomaterials. RESULTS AND CONCLUSION: Currently, the biomaterials for repair of rotator cuff injury can be divided into three categories: untreated human tissue transplantation materials, extracellular matrix materials and synthetic materials. The latest clinical reports show that untreated human tissue transplantation materials often have different clinical effects. The results of extracellular matrix materials derived from human allogenic dermal materials are still acceptable. Most scholars do not recommend the use of small intestinal submucosal grafts from pigs. The latest three-dimensional collagen scaffolds and synthetic absorbable materials have good application prospects due to their good porosity and the ability to induce the healing of tendon and bone tissues. However, most of them are still in the stage of animal experiments, and more clinical trials are needed to confirm their safety and effectiveness. There is no safe and effective biomaterial to treat rotator cuff tear. With the development of tissue engineering technology and materials science, it is expected to find a satisfactory material in the future by combining the macroscopic properties of biological scaffolds or synthetic materials with the microscopic properties of stem cells or cytokines.
ABSTRACT
Objective: Growth factors have been applied in maxillary sinus augmentation with clinically successful results. The purpose of this article is to evaluate the effectiveness of growth factors in combination with various synthetic scaffolds. Methods and Materials: A systematic review of studies examining the effects of synthetic materials in combination with growth factors were performed. Results: Twelve (1 human and 11 animal) studies were eligible for inclusion. Due to the great heterogeneity of the studies regarding design, materials and outcomes, a meta-analysis was not performed. The majority of the studies show a reduction in healing time and enhancement of bone formation within the subantral environment. Bone Morphogenetic Protein-2 and GDF-5 were the two most common osteoinductive factors studied, showing a significant effect on new bone formation. Moreover, initial outcomes of trials with stem cells genetic transformation, that results in increased production of growth factors, are positive and justify further research. Conclusion: The incorporation of growth factors into the synthetic scaffold may be beneficial regarding the healing process.
ABSTRACT
BACKGROUND:Due to the much higher requirement of biocompatibility and anticoagulant of smal-diameter vascular grafts than those of large-diameter ones, in situ blood vessel regeneration occurs as a new research direction. OBJECTIVE:To summarize the recent research development of electrospun smal-diameter scaffolds and to explore the application of in situ blood vessel regeneration and the development tendency. METHODS:The first author retrieved China National Knowledge Infrastructure database, Wanfang data and ISI Web of Knowledge foreign database to retrieve literatures addressing the fabrication of electrospun smal-diameter nanofibrous vascular grafts, surface modification and mimicking extracel ular matrix, as wel as the evaluation of biocompatibility and security after grafting. RESULTS AND CONCLUSION:Electrospun smal-diameter nanofibrous vascular grafts have emerged as promising candidates in vascular tissue engineering. By using both natural and synthetic polymers, the scaffolds can achieve a good balance between mechanical property and biocompatibility. Meanwhile, the fabrication of multi-layered vascular scaffolds, functional surface modification and mimicking extracel ular matrix structural y and functional y are now becoming attractive research directions. However, at current stage, electrospun vascular scaffolds used clinical y are basical y formed by synthetic materials, which have limited biocompatibility and anticoagulant activity. In this case, more efforts should be paid to find an optimal ratio between natural and synthetic materials for the improvement of biocompatibility and anticoagulant ability of smal-diameter vascular grafts.