Multifunctional hydrogel promotes rotator cuff healing through anti-inflammation and vascularization

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Orthopedic Surgery

Background:

• Rotator cuff tears (RCTs) present complex healing challenges, with disruptions in healing phases increasing re-tear risks.
• Current treatments often struggle to fully restore tendon-bone integrity and function.

Purpose of the Study:

• To develop and evaluate an injectable lactic acid-carboxymethyl chitosan-oxidized hyaluronic acid (LA-CMCS-OHA) hydrogel for enhanced rotator cuff tendon healing.
• To investigate the hydrogel's mechanisms in modulating inflammation and promoting vascularization.

Main Methods:

• Fabrication of the LA-CMCS-OHA hydrogel via Schiff base reaction, ensuring biocompatibility, injectability, and self-healing.
• In vitro assessment of the hydrogel's effects on nuclear factor kappa B (NF-κB) signaling and vascular endothelial growth factor (VEGF) expression.
• In vivo evaluation using a rat acute RCT model, including histological and biomechanical analyses.

Main Results:

• The LA-CMCS-OHA hydrogel effectively inhibited NF-κB signaling, promoting anti-inflammatory M2 macrophage polarization.
• The hydrogel significantly enhanced VEGF expression, stimulating endothelial cell proliferation and neovascularization.
• In vivo studies demonstrated accelerated tendon-bone regeneration and improved biomechanical properties in treated RCTs.

Conclusions:

• The injectable LA-CMCS-OHA hydrogel is a promising therapeutic agent for promoting rotator cuff tendon healing.
• The hydrogel's ability to modulate inflammation and enhance vascularization contributes to improved tissue regeneration.
• This biomaterial holds significant potential for clinical translation in treating rotator cuff tears.