A new decellularized tendon scaffold for rotator cuff tear – Evaluation in Rabbits

Abstract Background Scaffolds have shown considerable progress in recent years. In orthopaedic surgery, scaffolds have been used as grafts in procedures involving tendon and ligament reconstruction. This paper aims to produce and evaluate decellularized tendon scaffolds from biomechanical, microscopic, macroscopic and in vivo perspectives.Methods Bilateral gastrocnemius muscle tendons from 18 (eighteen) adult New Zealand rabbits were collected. Of these 36 (thirty-six) tendons, 11 (eleven) were used as controls (Group A), and 25 (twenty-five) were used in the decellularization protocol (Group B). The groups were subjected to histological, biomechanical and macroscopic analyseis, and group B was subjected to an additional in vivo evaluation. Regarding the decellularization protocol, we used a combination of aprotinin, EDTA (ethylenediamine tetraacetic acid, 0,1% w/v), SDS (sodium dodecyl sulfate) and Triton X-100 (t-octyl-phenoxypolyethoxyethanol) for six days. During the six days, the scaffold was kept at room temperature on a shaker with constant rotation.Results The decellularized tendon scaffold showed an increased cross-sectional area and inter-fascicular distance, without changing parallelism or matrix organization. The nuclear material was not organized in the decellularized tendon scaffolds, as it was in the control. In the biomechanical analysis, a significant difference was not found between the groups after analysis of ultimate tensile load, stiffness, and elongation at the ultimate tensile load. During the in vivo evaluation, infiltration of mononuclear cells was noted.Conclusions The evaluated decellularization protocol efficiently made a decellularized tendon scaffold, maintained the most important biomechanical characteristics and permitted cell infiltration.