The Role of Nanomaterials and Biological Agents on Rotator Cuff Regeneration

Abstract

The rotator cuff is a musculotendon unit responsible for movement in the shoulder. Rotator cuff tears represent a significant number of musculoskeletal injuries in the adult population. In addition, there is a high incidence of retear rates due to various complications within the complex anatomical structure and the lack of proper healing. Current clinical strategies for rotator cuff augmentation include surgical intervention with autograft tissue grafts and beneficial impacts have been shown, but challenges still exist because of limited supply. For decades, nanomaterials have been engineered for the repair of various tissue and organ systems. This review article provides a thorough summary of the role nanomaterials, stem cells and biological agents have played in rotator cuff repair to date and offers input on next generation approaches for regenerating this tissue.

Keywords: Rotator cuff regeneration; drug delivery vehicles; fatty infiltration; nanofibers; nanofibrous scaffolds.

Figure 1.

Rotator cuff anatomy and the involved tendons including Supraspinatus, Infraspinatus, Teres Minor and Subscapularis [3].

Figure 2.

Rotator cuff fatty infiltration in Sub-acute and Chronic injury.

Figure 3.

a) Masson trichrome staining of rotator cuff for different groups 12 weeks after surgery, I) Native tendon, II) Repaired group, III) Repaired group with matrix implantation without cell, IV) Repaired group with cell-seeded matrix implantation [56] (Reprinted from an open access article under terms Creative Commons Attribution License); b) Hematoxylin and eosin staining of rotator cuff for different groups 16 weeks after surgery, A) Uninjured group, B) Massive rotator cuff tear group 32 weeks after injury, C) Repaired group with matrix alone, and D) Repaired group with secretome-seeded matrix [59].