{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:07:20Z","timestamp":1787018840722,"version":"build-2736575974"},"reference-count":53,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tendon-bone healing after rotator cuff injury is, or remains, a clinical challenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To examine the role of intraoperative use of purified exosome products (PEPs) in the treatment of rotator cuff injuries and to assess the effect of PEP on supraspinatus tendon-bone healing after rotator cuff repair in a rat model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Controlled laboratory study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      This study used 120 Sprague-Dawley rats that underwent an acute supraspinatus tendon transection from the insertion, followed by repair using a single transosseous suture. They were divided into 3 groups: a control group that received only sutures, a TISSEEL group that used a commercially available fibrin sealant patch (TISSEEL) of approximately 0.5 cm\n                      <jats:sup>2<\/jats:sup>\n                      , and a PEP-TISSEEL group that used a similarly sized TISSEEL patch combined with PEP. Autopsies were performed at 1, 3, 6, and 8 weeks after surgery. Analyses were performed using molecular biological, biomechanical, and histological techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      At 6 weeks, the PEP-TISSEEL group achieved greater failure load (mean, 27.5 \u00b1 5.3 N) than the control (mean, 16.4 \u00b1 4.2 N;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .012) and TISSEEL (mean, 23.4 \u00b1 5.0 N;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .041) groups, with superiority persisting at 12 weeks (27.2 \u00b1 6.5 N vs 13.1 \u00b1 2.6 N [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .002] for the control group and 21.1 \u00b1 5.8 N [\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .037] for the TISSEEL group). DigiGait showed earlier recovery of stride length and paw angle. Histology revealed organized collagen and reduced scarring, while molecular assays demonstrated early inflammatory modulation with subsequent upregulation of collagen type 1 or 3 and TGF-\u03b2, supporting accelerated tendon-bone healing.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Intraoperative application of PEP-TISSEEL enhanced tendon-bone healing in a rat model by improving biomechanical strength, promoting enthesis-specific histological regeneration, and accelerating functional recovery as evidenced by gait analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>The intraoperative application of PEP combined with TISSEEL significantly enhances rotator cuff tendon healing by modulating early inflammation, promoting collagen synthesis, and improving biomechanical properties in a rat model. These findings suggest that PEP-based therapies could offer a promising adjunct in surgical repair, potentially reducing retear rates and improving functional outcomes in patients with rotator cuff injuries. Further clinical studies are warranted to translate these benefits into human applications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251395275","type":"journal-article","created":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T08:00:51Z","timestamp":1767254451000},"page":"162-173","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Purified Exosome Product Enhances Tendon-Bone Healing in a Rat Rotator Cuff Repair Model"],"prefix":"10.1177","volume":"54","author":[{"given":"Gongyin","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Department of Orthopedics, The Second People\u2019s Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, China"},{"name":"Changzhou Medical Center, Nanjing Medical University, Changzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Tsukamoto","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farbod","family":"Yousefi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Moran","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atta","family":"Behfar","sequence":"additional","affiliation":[{"name":"Changzhou Medical Center, Nanjing Medical University, Changzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquin","family":"Sanchez-Sotelo","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunfeng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA"},{"name":"Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199808000-00001"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0260-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.32098\/mltj.03.2014.12"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2021.719047"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/FJC.0b013e3182116e39"},{"key":"e_1_3_2_7_2","unstructured":"Behfar A Terzie A Cook W Crespo R. Exosome delivery technology. US patent 2016\/0324794 A1. November 10 2016."},{"issue":"6","key":"e_1_3_2_8_2","first-page":"1229","article-title":"Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal?","volume":"87","author":"Boileau BN","year":"2005","unstructured":"Boileau BN, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005;87(6):1229-1240.","journal-title":"J Bone Joint Surg Am"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-021-02811-w"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-098161"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.02.018"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.10.020"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2014.11.015"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.01004"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.20668"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(03)00211-8"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2008.09.002"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bioactmat.2024.06.014"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fcl.2007.07.003"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrm1702"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1485876"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines12050942"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.46582\/jsrm.1101003"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2008.06.004"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2008.054817"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-022-02975-0"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2003.11.005"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.06.029"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506288850"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2007.00699.x"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e3182250c78"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/stem.2575"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.24587"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.85B4.12062"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2021.121019"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1038\/ncprheum0700"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.53.6.367"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2007.03.012"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199312000-00009"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.114.300639"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.2217\/rme-2022-0132"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1002\/jor.24859"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.2217\/rme.14.42"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(96)80070-X"},{"key":"e_1_3_2_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13287-021-02629-7"},{"key":"e_1_3_2_46_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(99)90148-9"},{"issue":"1","key":"e_1_3_2_47_2","first-page":"35","article-title":"The development and morphogenesis of the tendon-to-bone insertion\u2014what development can teach us about healing","volume":"10","author":"Thomopoulos S","year":"2010","unstructured":"Thomopoulos S, Galatz LM. The development and morphogenesis of the tendon-to-bone insertion\u2014what development can teach us about healing. J Musculoskelet Neuronal Interact. 2010;10(1):35-45.","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"e_1_3_2_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2016.11.008"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-bioeng-071811-150122"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2005.05.011"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2023.07.006"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211062929"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.E.00835"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25147715"}],"container-title":["The American Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465251395275","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03635465251395275","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465251395275","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:25:40Z","timestamp":1779269140000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03635465251395275"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":53,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/03635465251395275"],"URL":"https:\/\/doi.org\/10.1177\/03635465251395275","relation":{},"ISSN":["0363-5465","1552-3365"],"issn-type":[{"value":"0363-5465","type":"print"},{"value":"1552-3365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}