Animal study demonstrates improved tendon-to-bone healing in chronic rotator cuff tears using fibrinogen-based spheroid sheets, suggesting potential for enhanced repair strategies.
Since, stem cell-based therapy has been known to promote tendon remodeling and fibrocartilage formation after chronic rotator cuff repair (RCR), only a few studies have reported how administering mesenchymal stem cells can further promote tendon to bone healing. To evaluate the effect of fibrinogen-based stem cell and spheroid sheet (f-SCSS) on tendon to bone healing in a rat model of chronic rotator cuff tear (RCT). A total of 12 Wistar rats were randomly divided into two groups: group C (repair only, n=6) and group F (repair with f-SCSS). Fibrinogen-based spheroid cell sheets were transplanted between the footprint of greater tuberosity and torn tendons during RCR. Specimens were harvested 5 weeks post-surgery, and histologic analysis was performed to evaluate tendon healing grade (fiber structure and arrangement, rounding of the nuclei, vascularity, inflammation, and cell density) and collagen deposition in the tendon to bone junction. In group F, immunohistochemistry (IHC) was performed to analyze the survival rate and differentiation rate into type I collagen of the administered stem cells. In addition, tenocyte proliferation was evaluated through scleraxis (SCX) staining. In histologic analysis, group F had significantly lower scores in fiber structure, fiber arrangement, rounding of the nuclei, vascularity, inflammation and cell density compared to group C (p=0.05, all). Collagen deposition at the tendon-to-bone junction was significantly higher in group F compared to group C (31.2% vs. 19.9%, p=0.05). Among these, the fluorescence intensity of type I collagen staining was also measured to be higher in group F than in group C (20.4 vs. 14.5, p=0.05). At 5 weeks post-RCR, in group F, the administered stem cell survival rate assessed by HNA/DAPI (%) was 20.5%, and the differentiation rate into type I collagen was 24.1%. In SCX staining, the fluorescence intensity was 23.8 in group F and 13.6 in group C, showing significantly more tenocyte proliferation in group F than in group C (p=0.05). In a chronic rotator cuff tear model, f-SCSS promoted tendon-to-bone healing after RCR. Stem cells administered through fibrinogen-based cell spheroid sheets showed favorable survival rates at 5 weeks post-RCR and were effective for healing by differentiating into type I collagen at approximately 20%.
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Myung‐Seo Kim (2025) studied this question.