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Annals of Biomedical Engineering

, Volume 43, Issue 3, pp 819–831 | Cite as

Scaffolds for Tendon and Ligament Repair and Regeneration

  • Anthony Ratcliffe
  • David L. Butler
  • Nathaniel A. Dyment
  • Paul J. CagleJr.
  • Christopher S. Proctor
  • Seena S. Ratcliffe
  • Evan L. Flatow
Article

Abstract

Enhanced tendon and ligament repair would have a major impact on orthopedic surgery outcomes, resulting in reduced repair failures and repeat surgeries, more rapid return to function, and reduced health care costs. Scaffolds have been used for mechanical and biologic reinforcement of repair and regeneration with mixed results. This review summarizes efforts made using biologic and synthetic scaffolds using rotator cuff and ACL as examples of clinical applications, discusses recent advances that have shown promising clinical outcomes, and provides insight into future therapy.

Keywords

Tendon Ligament Rotator cuff ACL repair Healing Regeneration Scaffold Reinforcement Augmentation Clinical repair of tendon Tensile properties Tensile stiffness Tensile strength 

Notes

Acknowledgments

The manuscript was written in part with support of NIH Grants R44AR060032 (AR), AR056943 (DB), AR54713 (ND), AR052374 (ND), DE021989 (ND), AR052743 (ELF), AG039561 (ELF), and NSF IGERT 0333377 (DB). Dr Anthony Ratcliffe and Seena Ratcliffe are employees of Synthasome, Inc. Drs. David Butler, Nathanial Dyment, Paul J. Cagle Jr, Christopher S. Proctor, and Evan L. Flatow have no financial conflicts.

References

  1. 1.
    Aurora, A., J. A. Mccarron, A. J. Van Den Bogert, J. E. Gatica, J. P. Iannotti, and K. A. Derwin. The biomechanical role of scaffolds in augmented rotator cuff tendon repairs. J. Shoulder Elb. Surg. 21:1064–1071, 2012.CrossRefGoogle Scholar
  2. 2.
    Baker, A. R., J. A. Mccarron, C. D. Tan, J. P. Iannotti, and K. A. Derwin. Does augmentation with a reinforced fascia patch improve rotator cuff repair outcomes? Clin. Orthop. Relat. Res. 470:2513–2521, 2012.CrossRefPubMedCentralPubMedGoogle Scholar
  3. 3.
    Barber, F. A., J. P. Burns, A. Deutsch, M. R. Labbe, and R. B. Litchfield. A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthroscopy 28:8–15, 2012.CrossRefPubMedGoogle Scholar
  4. 4.
    Beimers, L., P. H. Lam, and G. A. Murrell. The biomechanical effects of polytetrafluoroethylene suture augmentations in lateral-row rotator cuff repairs in an ovine model. J. Shoulder Elb. Surg. 23:1545–1552, 2014.CrossRefGoogle Scholar
  5. 5.
    Bishop, J., S. Klepps, I. K. Lo, J. Bird, J. N. Gladstone, and E. L. Flatow. Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J. Shoulder Elb. Surg. 15:290–299, 2006.CrossRefGoogle Scholar
  6. 6.
    Boileau, P., N. Brassart, D. J. Watkinson, M. Carles, A. M. Hatzidakis, and S. G. Krishnan. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J. Bone Joint Surg. Am. 87:1229–1240, 2005.CrossRefPubMedGoogle Scholar
  7. 7.
    Boughebri, O., X. Roussignol, O. Delattre, J. Kany, and P. Valenti. Small supraspinatus tears repaired by arthroscopy: are clinical results influenced by the integrity of the cuff after two years? Functional and anatomic results of forty-six consecutive cases. J. Shoulder Elb. Surg. 21:699–706, 2012.CrossRefGoogle Scholar
  8. 8.
    Butler, D. L., N. A. Dyment, J. T. Shearn, K. R. Kinneberg, A. P. Breidenbach, A. L. Lalley, S. D. Gilday, C. Gooch, M. B. Rao, C. F. Liu, and C. Wylie. Evolving strategies in mechanobiology to more effectively treat damaged musculoskeletal tissues. J. Biomech. Eng. 135:020301, 2013.CrossRefPubMedGoogle Scholar
  9. 9.
    Butler, D. L., E. S. Grood, F. R. Noyes, M. L. Olmstead, R. B. Hohn, S. P. Arnoczky, and M. G. Siegel. Mechanical properties of primate vascularized vs. nonvascularized patellar tendon grafts; changes over time. J. Orthop. Res. 7:68–79, 1989.CrossRefPubMedGoogle Scholar
  10. 10.
    Butler, D. L., N. Juncosa-Melvin, G. P. Boivin, M. T. Galloway, J. T. Shearn, C. Gooch, and H. Awad. Functional tissue engineering for tendon repair: a multidisciplinary strategy using mesenchymal stem cells, bioscaffolds, and mechanical stimulation. J. Orthop. Res. 26:1–9, 2008.CrossRefPubMedGoogle Scholar
  11. 11.
    Carbone, S., S. Gumina, V. Arceri, V. Campagna, C. Fagnani, and F. Postacchini. The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes. J. Shoulder Elb. Surg. 21:56–60, 2012.CrossRefGoogle Scholar
  12. 12.
    Charvet, B., F. Ruggiero, and D. Le Guellec. The development of the myotendinous junction. A review. Muscles Ligaments Tendons J. 2:53–63, 2012.PubMedCentralPubMedGoogle Scholar
  13. 13.
    Cheng, C. W., L. D. Solorio, and E. Alsberg. Decellularized tissue and cell-derived extracellular matrices as scaffolds for orthopaedic tissue engineering. Biotechnol. Adv. 32:462–484, 2014.CrossRefPubMedCentralPubMedGoogle Scholar
  14. 14.
    Choung, E. W., and V. Tan. Foreign-body reaction to the Artelon CMC joint spacer: case report. J. Hand Surg. Am. 33:1617–1620, 2008.CrossRefPubMedGoogle Scholar
  15. 15.
    Creaney, L., and B. Hamilton. Growth factor delivery methods in the management of sports injuries: the state of play. Br. J. Sports Med. 42:314–320, 2008.CrossRefPubMedGoogle Scholar
  16. 16.
    Debnath, U. K., J. A. Fairclough, and R. L. Williams. Long-term local effects of carbon fibre in the knee. Knee 11:259–264, 2004.CrossRefPubMedGoogle Scholar
  17. 17.
    Defranco, M. J., B. Bershadsky, J. Ciccone, J. K. Yum, and J. P. Iannotti. Functional outcome of arthroscopic rotator cuff repairs: a correlation of anatomic and clinical results. J. Shoulder Elb. Surg. 16:759–765, 2007.CrossRefGoogle Scholar
  18. 18.
    Derwin, K. A., A. R. Baker, R. K. Spragg, D. R. Leigh, and J. P. Iannotti. Commercial extracellular matrix scaffolds for rotator cuff tendon repair. Biomechanical, biochemical, and cellular properties. J. Bone Joint Surg. Am. 88:2665–2672, 2006.CrossRefPubMedGoogle Scholar
  19. 19.
    Derwin, K. A., M. J. Codsi, R. A. Milks, A. R. Baker, J. A. Mccarron, and J. P. Iannotti. Rotator cuff repair augmentation in a canine model with use of a woven poly-l-lactide device. J. Bone Joint Surg. Am. 91:1159–1171, 2009.CrossRefPubMedCentralPubMedGoogle Scholar
  20. 20.
    Dugas, J. R., D. A. Campbell, R. F. Warren, B. H. Robie, and P. J. Millett. Anatomy and dimensions of rotator cuff insertions. J. Shoulder Elb. Surg. 11:498–503, 2002.CrossRefGoogle Scholar
  21. 21.
    Dyment, N. A., N. Kazemi, L. E. Aschbacher-Smith, N. J. Barthelery, K. Kenter, C. Gooch, J. T. Shearn, C. Wylie, and D. L. Butler. The relationships among spatiotemporal collagen gene expression, histology, and biomechanics following full-length injury in the murine patellar tendon. J. Orthop. Res. 30:28–36, 2012.CrossRefPubMedCentralPubMedGoogle Scholar
  22. 22.
    Dyment, N. A., C. F. Liu, N. Kazemi, L. E. Aschbacher-Smith, K. Kenter, A. P. Breidenbach, J. T. Shearn, C. Wylie, D. W. Rowe, and D. L. Butler. The paratenon contributes to scleraxis-expressing cells during patellar tendon healing. PLoS ONE 8:e59944, 2013.CrossRefPubMedCentralPubMedGoogle Scholar
  23. 23.
    Encalada-Diaz, I., B. J. Cole, J. D. Macgillivray, M. Ruiz-Suarez, J. S. Kercher, N. A. Friel, and F. Valero-Gonzalez. Rotator cuff repair augmentation using a novel polycarbonate polyurethane patch: preliminary results at 12 months’ follow-up. J. Shoulder Elb. Surg. 20:788–794, 2011.CrossRefGoogle Scholar
  24. 24.
    Galatz, L. M., C. M. Ball, S. A. Teefey, W. D. Middleton, and K. Yamaguchi. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J. Bone Joint Surg. Am. 86(2):219–224, 2004.PubMedGoogle Scholar
  25. 25.
    Gerber, C., B. Fuchs, and J. Hodler. The results of repair of massive tears of the rotator cuff. J. Bone Joint Surg. Am. 82:505–515, 2000.PubMedGoogle Scholar
  26. 26.
    Gerhardt, C., K. Hug, S. Pauly, T. Marnitz, and M. Scheibel. Arthroscopic single-row modified mason-allen repair versus double-row suture bridge reconstruction for supraspinatus tendon tears: a matched-pair analysis. Am. J. Sports Med. 40:2777–2785, 2012.CrossRefPubMedGoogle Scholar
  27. 27.
    Glezos, C. M., A. Waller, H. E. Bourke, L. J. Salmon, and L. A. Pinczewski. Disabling synovitis associated with LARS artificial ligament use in anterior cruciate ligament reconstruction: a case report. Am. J. Sports Med. 40:1167–1171, 2012.CrossRefPubMedGoogle Scholar
  28. 28.
    Goutallier, D., J. M. Postel, P. Gleyze, P. Leguilloux, and S. Van Driessche. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J. Shoulder Elb. Surg. 12:550–554, 2003.CrossRefGoogle Scholar
  29. 29.
    Halder, A., M. E. Zobitz, E. Schultz, and K. N. An. Structural properties of the subscapularis tendon. J. Orthop. Res. 18:829–834, 2000.CrossRefPubMedGoogle Scholar
  30. 30.
    Harryman, 2nd, D. T., L. A. Mack, K. Y. Wang, S. E. Jackins, M. L. Richardson, and F. A. Matsen, 3rd. Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J. Bone Joint Surg. Am. 73:982–989, 1991.PubMedGoogle Scholar
  31. 31.
    Holden, J. P., E. S. Grood, D. L. Korvick, J. F. Cummings, D. L. Butler, and D. I. Bylski-Austrow. In vivo forces in the anterior cruciate ligament: direct measurements during walking and trotting in a quadruped. J. Biomech. 27:517–526, 1994.CrossRefPubMedGoogle Scholar
  32. 32.
    Hug, K., C. Gerhardt, H. Haneveld, and M. Scheibel. Arthroscopic knotless-anchor rotator cuff repair: a clinical and radiological evaluation. Knee Surg. Sports Traumatol. Arthrosc. 2014. doi: 10.1007/s00167-014-3026-1.
  33. 33.
    Iannotti, J. P., M. J. Codsi, Y. W. Kwon, K. Derwin, J. Ciccone, and J. J. Brems. Porcine small intestine submucosa augmentation of surgical repair of chronic two-tendon rotator cuff tears. A randomized, controlled trial. J. Bone Joint Surg. Am. 88:1238–1244, 2006.CrossRefPubMedGoogle Scholar
  34. 34.
    Iannotti, J. P., A. Deutsch, A. Green, S. Rudicel, J. Christensen, S. Marraffino, and S. Rodeo. Time to failure after rotator cuff repair: a prospective imaging study. J. Bone Joint Surg. Am. 95:965–971, 2013.CrossRefPubMedGoogle Scholar
  35. 35.
    Itoi, E., L. J. Berglund, J. J. Grabowski, F. M. Schultz, E. S. Growney, B. F. Morrey, and K. N. An. Tensile properties of the supraspinatus tendon. J. Orthop. Res. 13:578–584, 1995.CrossRefPubMedGoogle Scholar
  36. 36.
    Janssen, R. P., and S. U. Scheffler. Intra-articular remodelling of hamstring tendon grafts after anterior cruciate ligament reconstruction. Knee Surg. Sports Traumatol. Arthrosc. 22:2102–2108, 2014.CrossRefPubMedCentralPubMedGoogle Scholar
  37. 37.
    Juncosa, N., J. R. West, M. T. Galloway, G. P. Boivin, and D. L. Butler. In vivo forces used to develop design parameters for tissue engineered implants for rabbit patellar tendon repair. J. Biomech. 36:483–488, 2003.CrossRefPubMedGoogle Scholar
  38. 38.
    Keener, J. D., A. S. Wei, H. M. Kim, E. S. Paxton, S. A. Teefey, L. M. Galatz, and K. Yamaguchi. Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome. J. Bone Joint Surg. Am. 92:590–598, 2010.CrossRefPubMedGoogle Scholar
  39. 39.
    Klepps, S., J. Bishop, J. Lin, O. Cahlon, A. Strauss, P. Hayes, and E. L. Flatow. Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am. J. Sports Med. 32:1716–1722, 2004.CrossRefPubMedGoogle Scholar
  40. 40.
    Ko, S. H., C. C. Lee, D. Friedman, K. B. Park, and J. J. Warner. Arthroscopic single-row supraspinatus tendon repair with a modified mattress locking stitch: a prospective, randomized controlled comparison with a simple stitch. Arthroscopy 24:1005–1012, 2008.CrossRefPubMedGoogle Scholar
  41. 41.
    Koh, K. H., K. C. Kang, T. K. Lim, M. S. Shon, and J. C. Yoo. Prospective randomized clinical trial of single-versus double-row suture anchor repair in 2- to 4-cm rotator cuff tears: clinical and magnetic resonance imaging results. Arthroscopy 27:453–462, 2011.CrossRefPubMedGoogle Scholar
  42. 42.
    Korvick, D. L., J. F. Cummings, E. S. Grood, J. P. Holden, S. M. Feder, and D. L. Butler. The use of an implantable force transducer to measure patellar tendon forces in goats. J. Biomech. 29:557–561, 1996.CrossRefPubMedGoogle Scholar
  43. 43.
    Le, B. T., X. L. Wu, P. H. Lam, and G. A. Murrell. Factors predicting rotator cuff retears: an analysis of 1000 consecutive rotator cuff repairs. Am. J. Sports Med. 42:1134–1142, 2014.CrossRefPubMedGoogle Scholar
  44. 44.
    Lee, D. K. A preliminary study on the effects of acellular tissue graft augmentation in acute Achilles tendon ruptures. J. Foot Ankle Surg. 47:8–12, 2008.CrossRefPubMedGoogle Scholar
  45. 45.
    Li, H., Z. Yao, J. Jiang, Y. Hua, J. Chen, Y. Li, K. Gao, and S. Chen. Biologic failure of a ligament advanced reinforcement system artificial ligament in anterior cruciate ligament reconstruction: a report of serious knee synovitis. Arthroscopy 28:583–586, 2012.CrossRefPubMedGoogle Scholar
  46. 46.
    Liem, D., S. Lichtenberg, P. Magosch, and P. Habermeyer. Magnetic resonance imaging of arthroscopic supraspinatus tendon repair. J. Bone Joint Surg. Am. 89:1770–1776, 2007.CrossRefPubMedGoogle Scholar
  47. 47.
    Lohmander, L. S., P. M. Englund, L. L. Dahl, and E. M. Roos. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am. J. Sports Med. 35:1756–1769, 2007.CrossRefPubMedGoogle Scholar
  48. 48.
    Malaviya, P., D. L. Butler, D. L. Korvick, and F. S. Proch. In vivo tendon forces correlate with activity level and remain bounded: evidence in a rabbit flexor tendon model. J. Biomech. 31:1043–1049, 1998.CrossRefPubMedGoogle Scholar
  49. 49.
    Mascarenhas, R., B. J. Erickson, E. T. Sayegh, N. N. Verma, B. J. Cole, C. Bush-Joseph, and B. R. Bach, Jr. Is there a higher failure rate of allografts compared with autografts in anterior cruciate ligament reconstruction: a systematic review of overlapping meta-analyses. Arthroscopy. 2014.Google Scholar
  50. 50.
    Mccarron, J. A., R. A. Milks, X. Chen, J. P. Iannotti, and K. A. Derwin. Improved time-zero biomechanical properties using poly-l-lactic acid graft augmentation in a cadaveric rotator cuff repair model. J. Shoulder Elb. Surg. 19:688–696, 2010.CrossRefGoogle Scholar
  51. 51.
    Mccarron, J. A., R. A. Milks, M. Mesiha, A. Aurora, E. Walker, J. P. Iannotti, and K. A. Derwin. Reinforced fascia patch limits cyclic gapping of rotator cuff repairs in a human cadaveric model. J. Shoulder Elb. Surg. 21:1680–1686, 2012.CrossRefGoogle Scholar
  52. 52.
    Mccormick, F., A. Gupta, B. Bruce, J. Harris, G. Abrams, H. Wilson, K. Hussey, and B. J. Cole. Single-row, double-row, and transosseous equivalent techniques for isolated supraspinatus tendon tears with minimal atrophy: a retrospective comparative outcome and radiographic analysis at minimum 2-year followup. Int. J. Shoulder Surg. 8:15–20, 2014.CrossRefPubMedCentralPubMedGoogle Scholar
  53. 53.
    Millennium Research Group. US Markets for Orthopaedic Extremity Devices, 2010.Google Scholar
  54. 54.
    Miller, B. S., B. K. Downie, R. B. Kohen, T. Kijek, B. Lesniak, J. A. Jacobson, R. E. Hughes, and J. E. Carpenter. When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am. J. Sports Med. 39:2064–2070, 2011.CrossRefPubMedGoogle Scholar
  55. 55.
    Murray, M. M., and B. C. Fleming. Biology of anterior cruciate ligament injury and repair: kappa delta ann doner vaughn award paper 2013. J. Orthop. Res. 31:1501–1506, 2013.CrossRefPubMedCentralPubMedGoogle Scholar
  56. 56.
    Murray, A. W., and M. F. Macnicol. 10–16 year results of Leeds-Keio anterior cruciate ligament reconstruction. Knee 11:9–14, 2004.CrossRefPubMedGoogle Scholar
  57. 57.
    Newman, S. D., H. D. Atkinson, and C. A. Willis-Owen. Anterior cruciate ligament reconstruction with the ligament augmentation and reconstruction system: a systematic review. Int. Orthop. 37:321–326, 2013.CrossRefPubMedCentralPubMedGoogle Scholar
  58. 58.
    Neyton, L., A. Godeneche, L. Nove-Josserand, Y. Carrillon, J. Clechet, and M. B. Hardy. Arthroscopic suture-bridge repair for small to medium size supraspinatus tear: healing rate and retear pattern. Arthroscopy 29:10–17, 2013.CrossRefPubMedGoogle Scholar
  59. 59.
    Nho, S. J., M. K. Shindle, R. S. Adler, R. F. Warren, D. W. Altchek, and J. D. Macgillivray. Prospective analysis of arthroscopic rotator cuff repair: subgroup analysis. J. Shoulder Elb. Surg. 18:697–704, 2009.CrossRefGoogle Scholar
  60. 60.
    Nich, C., C. Mutschler, E. Vandenbussche, and B. Augereau. Long-term clinical and MRI results of open repair of the supraspinatus tendon. Clin. Orthop. Relat. Res. 467:2613–2622, 2009.CrossRefPubMedCentralPubMedGoogle Scholar
  61. 61.
    Papadopoulos, P., D. Karataglis, A. Boutsiadis, A. Fotiadou, J. Christoforidis, and A. Christodoulou. Functional outcome and structural integrity following mini-open repair of large and massive rotator cuff tears: a 3–5 year follow-up study. J. Shoulder Elb. Surg. 20:131–137, 2011.CrossRefGoogle Scholar
  62. 62.
    Pedowitz, R. A., K. Yamaguchi, C. S. Ahmad, R. T. Burks, E. L. Flatow, A. Green, J. P. Iannotti, B. S. Miller, R. Z. Tashjian, W. C. Watters, 3rd, K. Weber, C. M. Turkelson, J. L. Wies, S. Anderson, J. St Andre, K. Boyer, L. Raymond, P. Sluka, and R. Mcgowan. Optimizing the management of rotator cuff problems. J. Am. Acad. Orthop. Surg. 19:368–379, 2011.PubMedGoogle Scholar
  63. 63.
    Proctor, C. S. Rotator cuff repair augmented with endogenous fibrin clot. Arthrosc. Tech. 1:e79–e82, 2012.CrossRefPubMedCentralPubMedGoogle Scholar
  64. 64.
    Proctor, C. S. Long-term successful arthroscopic repair of large and massive rotator cuff tears with a functional and degradable reinforcement device. J. Shoulder Elb. Surg. 23:1508–1513, 2014.CrossRefGoogle Scholar
  65. 65.
    Rading, J., and L. Peterson. Clinical experience with the Leeds-Keio artificial ligament in anterior cruciate ligament reconstruction. A prospective two-year follow-up study. Am. J. Sports Med. 23:316–319, 1995.CrossRefPubMedGoogle Scholar
  66. 66.
    Randelli, P. S., P. Arrigoni, P. Cabitza, P. Volpi, and N. Maffulli. Autologous platelet rich plasma for arthroscopic rotator cuff repair. A pilot study. Disabil. Rehabil. 30:1584–1589, 2008.CrossRefPubMedGoogle Scholar
  67. 67.
    Robinson, P. M., and L. T. Muir. Foreign body reaction associated with Artelon: report of three cases. J. Hand Surg. Am. 36:116–120, 2011.CrossRefPubMedGoogle Scholar
  68. 68.
    Sethi, P. M., B. C. Noonan, J. Cunningham, E. Shreck, and S. Miller. Repair results of 2-tendon rotator cuff tears utilizing the transosseous equivalent technique. J. Shoulder Elb. Surg. 19:1210–1217, 2010.CrossRefGoogle Scholar
  69. 69.
    Sharma, P., and N. Maffulli. Basic biology of tendon injury and healing. Surgeon 3:309–316, 2005.CrossRefPubMedGoogle Scholar
  70. 70.
    Sundar, S., C. J. Pendegrass, and G. W. Blunn. Tendon bone healing can be enhanced by demineralized bone matrix: a functional and histological study. J. Biomed. Mater. Res. B 88:115–122, 2009.CrossRefGoogle Scholar
  71. 71.
    Tan, Q., P. P. Lui, Y. F. Rui, and Y. M. Wong. Comparison of potentials of stem cells isolated from tendon and bone marrow for musculoskeletal tissue engineering. Tissue Eng. A 18:840–851, 2012.CrossRefGoogle Scholar
  72. 72.
    Tempelhof, S., S. Rupp, and R. Seil. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J. Shoulder Elb. Surg. 8:296–299, 1999.CrossRefGoogle Scholar
  73. 73.
    Thomazeau, H., E. Boukobza, N. Morcet, J. Chaperon, and F. Langlais. Prediction of rotator cuff repair results by magnetic resonance imaging. Clin. Orthop. Relat. Res. 344:275–283, 1997.PubMedGoogle Scholar
  74. 74.
    Van Der Zwaal, P., B. J. Thomassen, T. A. Urlings, T. P. De Rooy, J. W. Swen, and E. R. Van Arkel. Preoperative agreement on the geometric classification and 2-dimensional measurement of rotator cuff tears based on magnetic resonance arthrography. Arthroscopy 28:1329–1336, 2012.CrossRefPubMedGoogle Scholar
  75. 75.
    Visser, L. C., S. P. Arnoczky, O. Caballero, A. Kern, A. Ratcliffe, and K. L. Gardner. Growth factor-rich plasma increases tendon cell proliferation and matrix synthesis on a synthetic scaffold: an in vitro study. Tissue Eng. A 16:1021–1029, 2010.CrossRefGoogle Scholar
  76. 76.
    Walton, J. R., N. K. Bowman, Y. Khatib, J. Linklater, and G. A. Murrell. Restore orthobiologic implant: not recommended for augmentation of rotator cuff repairs. J. Bone Joint Surg. Am. 89:786–791, 2007.CrossRefPubMedGoogle Scholar
  77. 77.
    Weiss, A. B., M. E. Blazina, A. R. Goldstein, and H. Alexander. Ligament replacement with an absorbable copolymer carbon fiber scaffold—early clinical experience. Clin. Orthop. Relat. Res. 196:77–85, 1985.PubMedGoogle Scholar
  78. 78.
    West, J. R., N. Juncosa, M. T. Galloway, G. P. Boivin, and D. L. Butler. Characterization of in vivo Achilles tendon forces in rabbits during treadmill locomotion at varying speeds and inclinations. J. Biomech. 37:1647–1653, 2004.CrossRefPubMedGoogle Scholar
  79. 79.
    Wong, I., J. Burns, and S. Snyder. Arthroscopic GraftJacket repair of rotator cuff tears. J. Shoulder Elb. Surg. 19:104–109, 2010.CrossRefGoogle Scholar
  80. 80.
    Wu, X. L., L. Briggs, and G. A. Murrell. Intraoperative determinants of rotator cuff repair integrity: an analysis of 500 consecutive repairs. Am. J. Sports Med. 40:2771–2776, 2012.CrossRefPubMedGoogle Scholar
  81. 81.
    Wurgler-Hauri, C. C., L. M. Dourte, T. C. Baradet, G. R. Williams, and L. J. Soslowsky. Temporal expression of 8 growth factors in tendon-to-bone healing in a rat supraspinatus model. J. Shoulder Elb. Surg. 16:S198–S203, 2007.CrossRefGoogle Scholar
  82. 82.
    Yamaguchi, K., K. Ditsios, W. D. Middleton, C. F. Hildebolt, L. M. Galatz, and S. A. Teefey. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J. Bone Joint Surg. Am. 88:1699–1704, 2006.CrossRefPubMedGoogle Scholar
  83. 83.
    Yamamoto, A., K. Takagishi, T. Osawa, T. Yanagawa, D. Nakajima, H. Shitara, and T. Kobayashi. Prevalence and risk factors of a rotator cuff tear in the general population. J. Shoulder Elb. Surg. 19:116–120, 2010.CrossRefGoogle Scholar
  84. 84.
    Yoo, J. C., J. H. Ahn, K. H. Koh, and K. S. Lim. Rotator cuff integrity after arthroscopic repair for large tears with less-than-optimal footprint coverage. Arthroscopy 25:1093–1100, 2009.CrossRefPubMedGoogle Scholar

Copyright information

© Biomedical Engineering Society 2015

Authors and Affiliations

  • Anthony Ratcliffe
    • 1
  • David L. Butler
    • 2
  • Nathaniel A. Dyment
    • 3
  • Paul J. CagleJr.
    • 4
  • Christopher S. Proctor
    • 5
  • Seena S. Ratcliffe
    • 1
  • Evan L. Flatow
    • 4
  1. 1.Synthasome, Inc.San DiegoUSA
  2. 2.Tissue Engineering and Biomechanics Laboratories, Biomedical Engineering Program, College of Engineering and Applied SciencesUniversity of CincinnatiCincinnatiUSA
  3. 3.Department of Reconstructive Sciences, School of Dental MedicineUniversity of Connecticut Health CenterFarmingtonUSA
  4. 4.Leni and Peter W. May Department of OrthopaedicsIcahn School of Medicine at Mount SinaiNew YorkUSA
  5. 5.Alta OrthopaedicsSanta BarbaraUSA

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