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Development of a Rabbit Chronic-Like Rotator Cuff Injury Model for Study of Fibrosis and Muscular Fatty Degeneration
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Rotator Cuff Repair: Lessons from Immune Strategies, 3D Biofabrication and In Vivo Testing.

Yordan Sbirkov1,2, Atanas Valev1,3, Murad Redzheb3

  • 1Department of Medical Biology, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.

Cellular and Molecular Bioengineering
|December 2, 2025
PubMed
Summary
This summary is machine-generated.

Rotator cuff repair faces challenges due to poor tendon healing. Tissue engineering, immune strategies, and 3D biofabrication show promise for improving rotator cuff (RC) repair outcomes.

Keywords:
3D bioprintingBiofabricationImmune engineeringIn vivo modelsRepairRotator cuff

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Area of Science:

  • Regenerative Medicine
  • Tissue Engineering
  • Biomaterials

Background:

  • Rotator cuff injuries are common tendinopathies, affecting a significant portion of both young adults and the elderly.
  • Tendons possess limited regenerative capacity due to low vascularization and cell density, leading to fibrotic scar tissue and compromised mechanical properties.
  • Tissue engineering and biofabrication offer potential solutions for enhancing rotator cuff repair.

Purpose of the Study:

  • To review insights from immune-based strategies, 3D biofabrication, and in vivo testing for rotator cuff repair.
  • To highlight in vivo studies that bridge laboratory innovation with clinical translation.
  • To identify promising therapeutic avenues for future rotator cuff repair development.

Main Methods:

  • Review of immune-based strategies in rotator cuff repair.
  • Analysis of 3D biofabrication techniques for tendon regeneration.
  • Emphasis on in vivo studies and their role in clinical translation.

Main Results:

  • Despite progress in in vitro modeling and animal studies, clinical translation of rotator cuff repair (RCT) treatments remains challenging.
  • Difficulties in recapitulating human mechanical loading and chronic inflammation hinder progress.
  • Biologic variability, regulatory hurdles, and poor reproducibility further impede clinical translation.

Conclusions:

  • Multidisciplinary research is crucial to understand immune cell engagement, matrix deposition, and remodeling in rotator cuff healing.
  • Mimicking native tendon properties (topography, anisotropy, biomechanics) is essential for effective tissue engineering.
  • An integrative approach focusing on in vivo behavior and long-term functional performance is key to advancing rotator cuff repair strategies and improving clinical outcomes.