AJSM - 2026-03-05 - Journal Article
Mechanically Preconditioned Biomimetic Gradient Scaffold for Tendon-to-Bone Regeneration in a Rabbit Rotator Cuff Tear Model.
Chen Y, Li Y, Aili D, Li J, Zhang C, Zhao C, Liu Q
Topics
Key Takeaway
Mechanically preconditioned BMSCS-encapsulated dTFBC scaffolds achieved a mean ultimate failure load of 203.9 N at 12 weeks, a 73% improvement over standard repair (118 N, P=.003) in a rabbit rotator cuff model.
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Summary
This controlled laboratory study evaluated whether mechanical preconditioning of BMSCS-encapsulated decellularized tendon fibrocartilage-bone composite scaffolds improves tendon-to-bone interface regeneration in a rabbit rotator cuff tear model. Four groups were compared: standard repair, dTFBC alone, dTFBC-BMSCS, and mechanically preconditioned mdTFBC-BMSCS. The mdTFBC-BMSCS group demonstrated superior ultimate failure load (203.9 N vs 118 N control, P=.003), enhanced fibrocartilage formation, improved collagen organization, and greater IL-10 and arginase-1 expression indicating a pro-regenerative anti-inflammatory environment.
Key Limitation
The rabbit model does not replicate the mechanical demands, tissue scale, or degenerative biology of human rotator cuff tears, limiting direct translational inference.
Original Abstract
BACKGROUND
Healing of the tendon-bone interface (TBI) after rotator cuff injury is limited, often leading to scar-mediated repair. Decellularized tendon fibrocartilage-bone composite (dTFBC) and bone marrow mesenchymal stem cell sheets (BMSCS) improve repair in preclinical models, but full scaffold encapsulation with mechanical preconditioning remains unexplored.
PURPOSE
To evaluate TBI regeneration using mechanically preconditioned, BMSCS-encapsulated dTFBC scaffolds in a rabbit model.
STUDY DESIGN
Controlled laboratory study.
METHODS
A total of 48 male New Zealand White rabbits were randomized into 4 groups (n = 12 each): (1) standard repair (control); (2) repair with dTFBC; (3) repair with dTFBC-BMSCS; and (4) repair with mechanically preconditioned dTFBC-BMSCS (mdTFBC-BMSCS). Healing at 12 weeks was assessed via gross observation, histomorphological and immunohistochemical analyses, and biomechanical testing.
RESULTS
The mdTFBC-BMSCS group demonstrated a higher ultimate failure load (mean, 203.9 ± 65.6 N) than both the control (118 ± 37.4 N; P = .003) and dTFBC groups (127 ± 44.1 N; P = .008), with no significant difference between the 2 BMSCS-treated groups. Histological analysis revealed enhanced fibrocartilage formation, improved collagen fiber organization, and reduced inflammation infiltration at the TBI in the mdTFBC-BMSCS group. Immunohistochemical analysis showed greater collagen type 2 alpha 1 chain-, interleukin 10-, and arginase 1-positive areas in the mdTFBC-BMSCS group than in the control and dTFBC groups.
CONCLUSION
Mechanically preconditioned, fully BMSCS-encapsulated dTFBC scaffolds promoted TBI regeneration, with enhanced cellular integration, fibrocartilage formation, and favorable biomechanical performance.
CLINICAL RELEVANCE
This biomimetic scaffold strategy may enhance biological healing and reduce the risk of retear after rotator cuff repair.