ORCID Identifier(s)

0009-0002-5237-1009

Graduation Semester and Year

Summer 2025

Language

English

Document Type

Dissertation

Degree Name

Doctor of Philosophy in Biomedical Engineering

Department

Bioengineering

First Advisor

Liping Tang

Second Advisor

Joseph Borrelli

Third Advisor

Yi Hong

Fourth Advisor

Jun Liao

Abstract

Soft tissue injuries of the shoulder, particularly rotator cuff tendon tears and glenoid labral tears, are the leading causes of shoulder pain and dysfunction. These injuries are frequently treated arthroscopically using suture anchors, which restore mechanical alignment and joint stability. However, the biological healing of these tissues remains a major limitation of current techniques. Both rotator cuff and labral tissues exhibit poor vascularity and limited regenerative potential, resulting in inadequate healing and high re-tear or failure rates after surgery. The goal of this thesis is to understand biological constraints hindering the effective healing in torn rotator cuff and labrum tissues, and to develop bioadhesive-based strategies to enhance their regenerative outcomes. We first investigated the effects of suture anchor repair in a rat chronic partial-thickness rotator cuff tear model. The results highlight the limitations of surgical repair and underscore the importance of resolving inflammation and promoting progenitor cell activity. To address these iii challenges, we developed a click-chemistry-based injectable chitosan bioadhesive loaded with platelet-derived growth factor (PDGF). When applied alongside suture repair, PDGF bioadhesive significantly enhanced the regenerative potential of the torn rotator cuff tendon by promoting progenitor cell recruitment and differentiation, improving collagen fiber organization, and restoring functional outcomes in gait analysis. We then extended our approach to address the distinct biological challenges of labral repair. Although bone marrow stimulation is a promising arthroscopic technique for mobilizing marrow-derived progenitor cells, we demonstrated that bone marrow stimulation alone failed to drive progenitor cell migration into the labral tear site. Combining bone marrow stimulation with the PDGF bioadhesive treatment significantly enhanced progenitor cell migration, improved matrix composition and organization, and restored labral tissue structure and function. Together, these findings show the efficacy of a clinically translatable regenerative strategy that can be combined with the suture repair to enhance the autologous healing of shoulder soft tissues.

Keywords

Rotator cuff tear, Glenoid labrum tear, Bone marrow stimulation, Chronic tear model, Bioadhesive, Injectable biomaterials, Tissue engineering, Gait analysis, Shoulder injury, Arthroscopic repair

Disciplines

Animal Experimentation and Research | Biological Engineering | Biological Factors | Biomaterials | Laboratory and Basic Science Research | Molecular, Cellular, and Tissue Engineering | Musculoskeletal System | Orthopedics | Sports Medicine | Translational Medical Research

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Available for download on Monday, August 09, 2027

Share

COinS