Chinese Journal of Tissue Engineering Research ›› 2025, Vol. 29 ›› Issue (22): 4761-4770.doi: 10.12307/2025.445

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Bio-3D printed bionic scaffold promotes healing after rotator cuff injury

Xu Jie1, Jiu Jingwei1, Liu Haifeng1, Zhao Bin1, 2   

  1. 1Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China; 2Shanxi Key Laboratory of Bone and Soft Tissue Repair, Taiyuan 030000, Shanxi Province, China
  • Received:2024-03-23 Accepted:2024-05-18 Online:2025-08-08 Published:2024-12-06
  • Contact: Zhao Bin, MD, Chief physician, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China; Shanxi Key Laboratory of Bone and Soft Tissue Repair, Taiyuan 030000, Shanxi Province, China
  • About author:Xu Jie, Master candidate, Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
  • Supported by:
    Shanxi Provincial Health Commission Major Science and Technology Research Project, No. 2020XM11 (to ZB)

Abstract: BACKGROUND: Most rotator cuff injuries occur in the supraspinatus tendon. Clinical treatment of rotator cuff injuries is very limited due to the lack of blood vessels and the complex anatomical structure of the rotator cuff. The rapid development of tissue engineering technology and stem cell biology has brought new hope for improving the quality of tendon repair. 
OBJECTIVE: To prepare human umbilical cord mesenchymal stem cells/gelatin methacrylate composite scaffolds by bio-3D printing technology to observe the effect of this scaffold on repairing rotator cuff injury.
METHODS: (1) In vitro cell assay: The gelatin microcarrier was prepared. The tissue engineered stem cells were constructed by inoculating human umbilical cord mesenchymal stem cells on the surface of gelatin microcarrier. Gelatin methacrylate hydrogel printing ink was prepared. Tissue engineered stem cells were re-suspended with gelatin methacrylate hydrogel printing ink and put into the bio-ink container of 3D printer for printing. Human umbilical cord mesenchymal stem cells/gelatin methacrylate composite scaffold was obtained after 5 minutes of blue light irradiation and curing. The activity of human umbilical cord mesenchymal stem cells in scaffolds was detected by dead/alive staining and CCK-8 assay. (2) In vivo animal experiments: A random block design method was used to randomly assign 24 SD rats to 4 groups with 6 rats in each group. No treatment was given in the normal group. The rotator cuff injury model of supratinatus tendon tear was established in the rotator cuff injury group, the simple scaffold group, and the cellular scaffold group. The gelatin methacrylate scaffold and human umbilical cord mesenchymal stem cell/gelatin methacrylatecomposite scaffold were implanted into the tendon injury after the model was made in the simple scaffold group and the cellular scaffold group, respectively. Four weeks after operation, behavioral tests and histopathological morphology observation of supraspinatus tendon of rotator cuff were performed.
RESULTS AND CONCLUSION: (1) In vitro cellular assay: The dead/alive staining showed that gelatin microcarrier could reduce the damage of human umbilical cord mesenchymal stem cells caused by 3D printing process. With the extension of culture time, the survival rate of human umbilical cord mesenchymal stem cells increased in the scaffold. The results of CCK-8 assay showed that with the extension of culture time, the activity of human umbilical cord mesenchymal stem cells in the scaffold did not change significantly. (2) In vivo animal experiments: Behavioral test results showed that compared with rotator cuff injury group and simple scaffold group, cellular scaffold group significantly improved limb motor function. The results of hematoxylin-eosin and Masson staining of rotator cuff supraspinatus tendon showed that compared with rotator cuff injury group and simple scaffold group, the muscle fiber arrangement in the cellular scaffold group was more regular; there was no obvious inflammatory cell infiltration, and the percentage of collagen volume decreased. The results of immunofluorescence staining showed that the expression levels of interleukin 6 and tumor necrosis factor α in the rotator cuff supraspinatus tendon were significantly decreased in the cellular scaffold group compared with the rotator cuff injury group and the simple scaffold group. (3) The results showed that bio-3D-printed cell scaffolds encapsulating human umbilical cord mesenchymal stem cells/gelatin methacrylate could promote tissue repair and regeneration of rotator cuff injuries. 

Key words: rotator cuff injury, supraspinatus tendon injury, human umbilical cord mesenchymal stem cell, cell therapy, tissue engineered stem cell, biological scaffold, gelatin methacrylate, bio-3D printing

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