Kwang-Il Lee

By Kwang-Il Lee, Ju-Woong Jang and Kwang-Won Lee

A rotator cuff tear is a common shoulder injury in sports medicine. However, a rotator cuff repair still has the high failure rate (57%) in large torn (>8 cm2) rotator cuff cases. One of the main reasons is failing at suture-tendon cause of continuous tensional and torsional stresses even after surgery, and thus, an ideal biologic augmentation to overcome large tears is an essential challenge. The ECM graft, the biological material can be useful for augment repair of large torn rotator cuff. Recombinant human bone morphogenetic protein 2 (rhBMP-2), which belongs to transforming growth factor-β superfamily, is well known as an osteoinductive growth factor. It plays an important role in the development of bone and cartilage. rhBMP-2 also facilitates chemotaxis in the host tissue. In this study, rhBMP-2-coated acellular dermal graft, which is isolated from human cadaveric donor, was transplanted in the rabbit with the chronic rotator cuff injury. The radiologic image, histomorphometric, histologic image analyses, and tensile test were performed to evaluate the effectiveness. The results showed the enhancement of increased host cell infiltration, new bone formation, and tensile mechanical property. The rhBMP-2-coated acellular dermal graft will be promising for chronic rotator cuff healing.

Part of the book: Biotechnology and Bioengineering

By Kwang-Il Lee, Ju-Woong Jang and Kwang-Won Lee

This rabbit animal study has a hypothesis that the collagen gel, which is injectable easily, can be an effective carrier for recombinant human bone morphogenetic protein 2 (rhBMP-2) for the tendon healing in a bone tunnel. The cut upper long digital extensor tendon of each rabbit was inserted into the proximal tibia bone tunnel, and rhBMP-2 conjugated collagen gel was injected into the tendon-bone tunnel interface using a syringe. Biomechanical and histological performances were analyzed at 3 and 6 weeks after surgery. The collagen sol at room temperature was transformed to a gel at 37°C. The rhBMP-2 was slowly released from the collagen gel for more than 4 weeks. The in vivo experiment showed the enhanced new fibrocartilage and bone tissue formation at 6 weeks after injecting the rhBMP-2-containing collagen gel. The calcification and enthesis-like tissue were detected radiologically in the repaired tendon-bone junction. The viscous collagen gel-containing rhBMP-2 increased the fusion rate of the repaired tendon in the bone tunnel. This study showed that viscous collagen gel can be an effective carrier for rhBMP-2 for tendon healing in the bone tunnel. The rhBMP-2-containing collagen gel will be promising for tendon-bone interface healing in the future.

Part of the book: Tendons