5/18/2023 0 Comments Rotator cuff stem cell treatment![]() Unfortunately, the clinical outcomes remained after surgery, and the overall failure rate of healing was 43% at 12 months postsurgical repair ( Rashid et al., 2017), and even up to 90% in the elderly ( Galatz et al., 2004). Nevertheless, acute shoulder trauma may cause partial or complete tendon tears, which require surgical treatment to repair the continuity of the structure or surgery to reattach the tendon back to its bony insertion.Ī previous systematic review that included 15 studies and 371 patients after rotator cuff injury demonstrated improved clinical outcomes with an earlier time of receiving surgery ( Mukovozov et al., 2013). In some cases, patients with tendinopathy may have an increased risk of tendon rupture, especially among those in the older population ( Yasui et al., 2017). ![]() ![]() Generally, tendinopathy does not cause substantial problems therefore, patients with tendinopathy are initially recommended for a course of conservative management, such as physiotherapy and analgesia ( Seida et al., 2010). Rotator cuff injuries may start from tendinopathy and progressively develop into partial or complete tendon tears ( Lewis, 2010), which typically result in pain, loss of motion, and functional impairment of the shoulder ( Craig et al., 2017). According to the continuum of the tendon pathology model, mechanical loading plays an important role in pathological changes ( Lewis, 2010), and a repeated and biomechanical loading on the rotator cuff tendon increases the risk of rotator cuff injury ( Edmonds and Dengerink, 2014). While the intrinsic risks decrease the structural resilience of rotator cuff, the extrinsic risks, such as occupations and sports activities, cause excessive mechanical loading on it, involving rotator cuff injury ( Whittle and Buchbinder, 2015). ![]() It was found that the prevalence of sonographic full-thickness rotator cuff tears was 10.7% in the 50s, 15.2% in the 60s, 26.5% in the 70s, and 36.6% in the 80s ( Minagawa et al., 2013). Among these factors, age-related degeneration is considered the main reason for rotator cuff disease, and the prevalence of rotator cuff tears increases with age in the general population. Intrinsic factors contribute to rotator cuff disease, including age, obesity, smoking, diabetes mellitus, genetics, and narrow anatomical subacromial spaces ( Titchener et al., 2014). It is estimated that the prevalence of shoulder problems in primary care is 2.4% in the UK ( Linsell et al., 2006), and 30%–70% of shoulder pain results from rotator cuff diseases ( Mitchell et al., 2005). Rotator cuff injury is one of the leading musculoskeletal diseases worldwide and the most common condition that leads to the complaint of shoulder pain ( Picavet and Schouten, 2003). Future studies need to explore stem cell therapy in combination with cellular factors, gene therapy, and novel biomaterial delivery systems. In this review, we summarize the advances of stem cells and stem cell-derived EVs in rotator cuff repair and highlight the underlying mechanism of stem cells and stem cell-derived EVs and biomaterial delivery systems. Therefore, stem cell-based therapy is a promising therapeutic strategy that has great potential for rotator cuff healing. Additionally, stem cell-derived extracellular vesicles (EVs) can increase collagen synthesis and inhibit inflammation and adhesion formation by carrying regulatory proteins and microRNAs. Stem cells have high proliferation, strong paracrine action, and multiple differentiation potential, which promote tendon remodeling and fibrocartilage formation and increase biomechanical strength. ![]() Despite the clinical outcomes of the surgical procedures being satisfactory, the repair of the rotator cuff remains problematic, such as through failure of healing, adhesion formation, and fatty infiltration. Rotator cuff injury is a common upper extremity musculoskeletal disease that may lead to persistent pain and functional impairment. ![]()
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