Cellular therapy in bone-tendon interface regeneration

Abstract

The intrasynovial bone-tendon interface is a gradual transition from soft tissue to bone, with two intervening zones of uncalcified and calcified fibrocartilage. Following injury, the native anatomy is not restored, resulting in inferior mechanical properties and an increased risk of re-injury. Recent in vivo studies provide evidence of improved healing when surgical repair of the bone-tendon interface is augmented with cells capable of undergoing chondrogenesis. In particular, cellular therapy in bone-tendon healing can promote fibrocartilage formation and associated improvements in mechanical properties. Despite these promising results in animal models, cellular therapy in human patients remains largely unexplored. This review highlights the development and structure-function relationship of normal bone-tendon insertions. The natural healing response to injury is discussed, with subsequent review of recent research on cellular approaches for improved healing. Finally, opportunities for translating in vivo findings into clinical practice are identified.

Keywords: :

• bone-tendon healing
• enthesis
• fibrocartilage
• mesenchymal stem cells
• insertion

10.4161/org.27404

Disclosure of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Acknowledgments

This work was supported in part by Commonwealth of Pennsylvania Department of Health (SAP4100050913), NIH (T32-EB001026 and 1R01 AR062947), and the U.S. Department of Defense (W81XWH-11-2-0143).