title: Augmentation of tendon-to-bone healing.
abstract: Tendon-to-bone healing is vital to the ultimate success of the various surgical procedures performed to repair injured tendons. Achieving tendon-to-bone healing that is functionally and biologically similar to native anatomy can be challenging because of the limited regeneration capacity of the tendon-bone interface. Orthopaedic basic-science research strategies aiming to augment tendon-to-bone healing include the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influence the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches, such as the use of coated sutures and interference screws, aim to deliver biological factors while achieving mechanical stability by means of various fixators. Controlled Level-I human trials are required to confirm the promising results from in vitro or animal research studies elucidating the mechanisms underlying tendon-to-bone healing and to translate these results into clinical practice.
authors.affiliation: Center for Musculoskeletal Care, NYU Hospital for Joint Diseases, 333 East 38th Street, New York, NY 10016.
authors.forename: Kivanc
authors.initials: K
authors.lastname: Atesok
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA 15213.
authors.forename: Freddie H
authors.initials: FH
authors.lastname: Fu
authors.affiliation: Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA 15213.
authors.forename: Megan R
authors.initials: MR
authors.lastname: Wolf
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minamimi-ku, Hiroshima 734-8551, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Ochi
authors.affiliation: Center for Musculoskeletal Care, NYU Hospital for Joint Diseases, 333 East 38th Street, New York, NY 10016.
authors.forename: Laith M
authors.initials: LM
authors.lastname: Jazrawi
authors.affiliation: Departments of Orthopaedics and Traumatology, and Sports Medicine, Hacettepe University School of Medicine, 06100 Sihhiye, Ankara, Turkey.
authors.forename: M Nedim
authors.initials: MN
authors.lastname: Doral
authors.affiliation: Taos Orthopaedic Institute, 1219A Gusdorf Road, Taos, NM 87571.
authors.forename: James H
authors.initials: JH
authors.lastname: Lubowitz
authors.affiliation: Sports Medicine and Shoulder Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY 10021. E-mail address for S. A. Rodeo: RodeoS@HSS.edu.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Rodeo
mesh_terms: D001672:Biocompatible Materials / Q000627:therapeutic use; D006801:Humans; D053657:Platelet-Rich Plasma; D019651:Plastic Surgery Procedures / Q000379:methods*; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery* / Q000628:therapy; D014945:Wound Healing / Q000502:physiology*
chemical_list: D001672:Biocompatible Materials