{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T08:05:00Z","timestamp":1792397100342,"version":"4.4.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tendons are primarily acellular, limiting their intrinsic regenerative capabilities. This limited regenerative potential contributes to delayed healing, rupture, and adhesion formation after tendon injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine if a tendon\u2019s intrinsic regenerative potential could be improved after the application of a purified exosome product (PEP) when loaded onto a collagen scaffold.<\/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                      An in vivo rabbit Achilles tendon model was used and consisted of 3 groups: (1) Achilles tenotomy with suture repair, (2) Achilles tenotomy with suture repair and collagen scaffold, and (3) Achilles tenotomy with suture repair and collagen scaffold loaded with PEP at 1 \u00d7 10\n                      <jats:sup>12<\/jats:sup>\n                      exosomes\/mL. Each group consisted of 15 rabbits for a total of 45 specimens. Mechanical and histologic analyses were performed at both 3 and 6 weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The load to failure and ultimate tensile stress were found to be similar across all groups ( P \u2265 .15). The tendon cross-sectional area was significantly smaller for tendons treated with PEP compared with the control groups at 6 weeks, which was primarily related to an absence of external adhesions ( P = .04). Histologic analysis confirmed these findings, demonstrating significantly lower adhesion grade both macroscopically ( P = .0006) and microscopically ( P = .0062) when tendons were treated with PEP. Immunohistochemical staining showed a greater intensity for type 1 collagen for PEP-treated tendons compared with collagen-only or control tendons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Mechanical and histologic results suggested that healing in the PEP-treated group favored intrinsic healing (absence of adhesions) while control animals and animals treated with collagen only healed primarily via extrinsic scar formation. Despite a smaller cross-sectional area, treated tendons had the same ultimate tensile stress. This pilot investigation shows promise for PEP as a means of effectively treating tendon injuries and enhancing intrinsic healing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>The production of a cell-free, off-the-shelf product that can promote tendon regeneration would provide a viable solution for physicians and patients to enhance tendon healing and decrease adhesions as well as shorten the time required to return to work or sports.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671211062929","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T12:59:26Z","timestamp":1639745966000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":32,"title":["Intrinsic Tendon Regeneration After Application of Purified Exosome Product: An In Vivo Study"],"prefix":"10.1177","volume":"9","author":[{"given":"Elizabeth P.","family":"Wellings","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tony Chieh-Ting","family":"Huang","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialun","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy E.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA."},{"name":"Van Cleve Cardiac Regeneration Medicine Program, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander W.","family":"Hooke","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Rosenbaum","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunfeng D.","family":"Zhao","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":"Department of Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA."},{"name":"Van Cleve Cardiac Regeneration Medicine Program, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven L.","family":"Moran","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Houdek","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"bibr1-23259671211062929","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199901000-00024"},{"key":"bibr2-23259671211062929","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2010.06.020"},{"key":"bibr3-23259671211062929","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.M.01273"},{"key":"bibr4-23259671211062929","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2008.00864.x"},{"key":"bibr5-23259671211062929","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7998.1986.tb03609.x"},{"key":"bibr6-23259671211062929","doi-asserted-by":"publisher","DOI":"10.1114\/1.1616931"},{"key":"bibr7-23259671211062929","unstructured":"Bowers MH, Huang TC, Sabbagh MD, Moran SL. 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