梯度多相支架材料促进肩袖肌腱-骨界面修复与再生的研究方法与进展  

Research methods and progress of gradient multiphase scaffold materials promoting rotator cuff tenon-bone interface repair and regeneration

作　　者：姜锦珊 于昕仪 董云生 王淑芳[1] Jiang Jinshan;Yu Xinyi;Dong Yunsheng;Wang Shufang(Key Laboratory of Bioactive Materials of Ministry of Education,School of Life Sciences,Nankai University,Tianjin 300071,China)

机构地区：[1]南开大学生命科学学院生物活性材料教育部重点实验室,天津300071

出　　处：《中华骨科杂志》2023年第14期991-998,共8页Chinese Journal of Orthopaedics

基　　金：国家重大专项(2020YFA0803701);天津市科技支撑重点项目(20YFZCSY01020)。

摘　　要：肩袖肌腱-骨界面的再生在肩袖损伤修复过程中至关重要。肌腱-骨界面由四个逐渐移行的区域构成,即肌腱区、未矿化纤维软骨区、矿化纤维软骨区和骨区。肌腱-骨界面中各区域的发育和再生受到生长因子、无机离子、机械刺激以及低氧环境的调节。受影响肌腱-骨界面发育和再生因素的启发,学者们转向设计促进肌腱-骨界面区域化再生的梯度支架系统,这些支架的梯度分布包括无机离子梯度和生长因子梯度。根据支架系统的不同梯度来促进肌腱-骨界面的细胞成肌腱、成软骨及成骨分化,同步完成促进肌腱-骨止点的愈合,实现肩袖肌腱-骨界面的修复与再生。目前的研究表明梯度多相支架材料具有很高的学术研究价值,支架材料的相关研究在肌腱-骨界面修复方面起到了一定程度的指导作用,有着较好的临床应用前景。在综述影响肌腱-骨界面发育和再生因素的基础上,总结各影响因素在促进肩袖肌腱-骨界面修复过程中对各区域促进成肌腱、成软骨和成骨的作用;探讨目前已报道的用于肩袖损伤修复的梯度多相支架材料,包括无机离子梯度支架与生长因子梯度支架的特性以及对损伤后肩袖组织的修复效果;分析现阶段梯度多相支架在肩袖损伤修复研究过程中所面临的问题和未来的发展方向。Regeneration of rotator cuff tendon-bone interface is crucial in rotator cuff repair.The tendon-bone interface consists of four continuous and gradual regions:the tendon region,the unmineralized fibrocartilage region,the mineralized fibrocartilage region,and the bone region.The development and regeneration of various regions in the tendon-bone interface is regulated by growth factors,inorganic ions,mechanical stimulation,and hypoxic environment.Inspired by factors affecting the development and regeneration of the tendon-bone interface,many researchers have designed gradient scaffold systems that promote regionalized regeneration of the tendon-bone interface.The gradient distribution of these scaffolds includes inorganic ion gradients and growth factor gradients.According to different gradients of the scaffold system,osteogenesis,chondrogenesis and tendon differentiation of cells at the tendon-bone interface are promoted,and the healing of the tendon-bone is synchronously completed to realize the repair and regeneration of the rotator cuff tendon-bone interface.Current studies indicated that gradient multiphase scaffolds had high academic research value and guided significance for future clinical applications in the reconstruction of the tendon-bone interface.In this paper,the factors affecting the development and regeneration of the tendon-bone interface are reviewed,and the effects of these factors on osteogenesis,chondrogenesis and tendon formation of various regions in promoting rotator cuff tendon-bone interface repair are summarized.The properties and effects of reported gradient multiphase scaffolds for rotator cuff injury are discussed,including gradient scaffolds containing inorganic ions and growth factors.Finally,the problems and future development opportunities of gradient multiphase support in rotator cuff repair are summarized.

关 键 词：回旋套损伤 肌腱-骨界面 再生 梯度多相支架 

分 类 号：TB34[一般工业技术—材料科学与工程] R318.08[医药卫生—生物医学工程]