title: Mesenchymal stem cell therapy regenerates the native bone-tendon junction after surgical repair in a degenerative rat model.
abstract: BACKGROUND
  The enthesis, which attaches the tendon to the bone, naturally disappears with aging, thus limiting joint mobility. Surgery is frequently needed but the clinical outcome is often poor due to the decreased natural healing capacity of the elderly. This study explored the benefits of a treatment based on injecting chondrocyte and mesenchymal stem cells (MSC) in a new rat model of degenerative enthesis repair.
  
  
  METHODS
  The Achilles' tendon was cut and the enthesis destroyed. The damage was repaired by classical surgery without cell injection (group G1, n = 52) and with chondrocyte (group G2, n = 51) or MSC injection (group G3, n = 39). The healing rate was determined macroscopically 15, 30 and 45 days later. The production and organization of a new enthesis was assessed by histological scoring of collagen II immunostaining, glycoaminoglycan production and the presence of columnar chondrocytes. The biomechanical load required to rupture the bone-tendon junction was determined.
  
  
  RESULTS
  The spontaneous healing rate in the G1 control group was 40%, close to those observed in humans. Cell injection significantly improved healing (69%, p = 0.0028 for G2 and p = 0.006 for G3) and the load-to-failure after 45 days (p<0.05) over controls. A new enthesis was clearly produced in cell-injected G2 and G3 rats, but not in the controls. Only the MSC-injected G3 rats had an organized enthesis with columnar chondrocytes as in a native enthesis 45 days after surgery.
  
  
  CONCLUSIONS
  Cell therapy is an efficient procedure for reconstructing degenerative entheses. MSC treatment produced better organ regeneration than chondrocyte treatment. The morphological and biomechanical properties were similar to those of a native enthesis.
authors.affiliation: UR 4, Pierre & Marie Curie University, Paris, France.
authors.forename: Geoffroy
authors.initials: G
authors.lastname: Nourissat
authors.forename: Amadou
authors.initials: A
authors.lastname: Diop
authors.forename: Nathalie
authors.initials: N
authors.lastname: Maurel
authors.forename: Colette
authors.initials: C
authors.lastname: Salvat
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dumont
authors.forename: Audrey
authors.initials: A
authors.lastname: Pigenet
authors.forename: Marjolaine
authors.initials: M
authors.lastname: Gosset
authors.forename: Xavier
authors.initials: X
authors.lastname: Houard
authors.forename: Francis
authors.initials: F
authors.lastname: Berenbaum
mesh_terms: D000818:Animals; D001842:Bone and Bones / Q000166:cytology / Q000502:physiology*; D002417:Cattle; D019902:Chondrocytes / Q000637:transplantation; D006801:Humans; D007267:Injections; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D051381:Rats; D017208:Rats, Wistar; D012038:Regeneration; D015203:Reproducibility of Results; D013710:Tendons / Q000166:cytology / Q000502:physiology*; D013997:Time Factors
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