Table 3.

Summary of biomaterial approaches for rotator cuff repair

Study	Study type	Source/model	Design	Outcomes
Santoni et al.96	Chronic rotator cuff rupture model	Sheep model	Non-resorbable polyurethane scaffold mesh	Scaffold mesh provides greater mechanical strength in the critical healing period than that of traditional suture anchor repair
Moffat et al.97	In vitro cellular testing	Human-derived fibroblasts	PLGA nanofiber in the aligned versus unaligned orientation with cultured fibroblasts	Biomechanical properties of aligned nanofiber scaffolds were significantly higher than those of the unaligned, and nanofiber organization has a profound effect on cellular response and matrix properties.
Liu et al.100	In vitro cellular testing	Rat-derived AD- MSCs	Nanofiber-based scaffold with a graded mineral coating to mimic the mineral composition of the native tendon-to-bone insertion	A gradient in mineral content on the surface of a nanofiber scaffold is capable of inducing graded differentiation of ASCs into osteoblasts for enthesis repair.
Yin et al.103	In vivo mouse model	Human-derived T-MSCs; mouse model	Develop a nanofiber nanotopography that induces tendon progenitor stem cell differentiation for tendon–bone site	Aligned fibers led to greater differentiation into tendon-like cells and induction of spindle-shaped cells and tendon-like tissue in vivo.
Tokunaga et al.109	In vivo rat rotator cuff model	Rat model	Gelatin hydrogel sheets loaded with PDGF-BB to promote healing and biomechanical strength	DGF-BB–loaded hydrogel sheets produced significantly greater collagen fiber orientation, ultimate failure loads, stiffness, and stress to failure at 12 weeks.
Kabuto et al.110	In vivo rat rotator cuff model	Rat model	Gelatin hydrogel sheets loaded with BMP-7 for sustained release to stimulate tendon–bone integration	The BMP-7–loaded hydrogel sheets demonstrated sustained release of BMP7, leading to favorable cartilage matrix production and tendon orientation with a maturing score and higher force-to-failure.
Chen et al.112	In vivo rabbit rotator cuff model	Rabbit-derived stem cells; rabbit model	Injectable hydrogel loaded with stem cells and BMP-2 to enhance tendon–bone healing	Increased fibrocartilage, bone layer formation, and expression of aggrecan and collagen II was observed.