The Journal of Bone and Joint Surgery (American) 84:822-832 (2002)
© 2002 The Journal of Bone and Joint Surgery, Inc.
Muscle Injuries and Repair: Current Trends in Research
Johnny Huard, PhD,
Yong Li, PhD, MD and
Freddie H. Fu, MD
Investigation performed at the Growth and Development Laboratory,
Children's Hospital of Pittsburgh; the University of Pittsburgh;
and the Department of Orthopaedic Surgery, University of Pittsburgh
Medical Center, Pittsburgh, Pennsylvania
Johnny Huard, PhD
Yong Li, PhD, MD
Growth and Development Laboratory, Children's Hospital of Pittsburgh,
4151 Rangos Research Center, 3705 Fifth Avenue, Pittsburgh, PA 15213.
E-mail address for J. Huard: jhuard+@pitt.edu
Freddie H. Fu, MD
Department of Orthopaedic Surgery, University of Pittsburgh Medical
Center, Liliane S. Kaufmann Building, 3471 Fifth Avenue, Suite 1010,
Pittsburgh, PA 15213
In support of the research or preparation of this manuscript,
one of the authors (J.H.) received grants from the National Institutes
of Health (NIH 1 RO1 AR47973-01) and the Orris C. Hirtzel and Beatrice
Dewey Hirtzel Memorial Foundation. This work also was supported
by the William F. and Jean W. Donaldson Chair at Children's Hospital
of Pittsburgh. The authors did not receive payments or other benefits
or a commitment or agreement to provide such benefits from a commercial
entity. No commercial entity paid or directed, or agreed to pay or
direct, any benefits to any research fund, foundation, educational
institution, or other charitable or nonprofit organization with
which the authors are affiliated or associated.
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Introduction
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After injury, muscle healing occurs through different phases,
including (1) degeneration and inflammation, (2) muscle regeneration,
and (3) development of fibrosis.
The severity and type of muscle injury influence the healing
process.
Enhancement of muscle regeneration and prevention of muscle fibrosis
can improve muscle healing.
Growth factors, including basic fibroblast growth factor (bFGF),
insulin-like growth factor-1 (IGF-1), and nerve growth factor (NGF),
can improve muscle regeneration, but the post-injury healing process remains
incomplete.
The use of anti-fibrosis agents that antagonize the effect of
transforming growth factor-ß1 (TGF-ß1) can prevent
fibrosis and improve muscle healing, resulting in nearly complete
recovery.
Optimal muscle recovery may require the use of novel technologies,
such as gene therapy and tissue engineering, to achieve both high
levels and long-term persistence of these growth factors and cytokines
within the injured muscle.
Muscle injury presents a challenging problem in traumatology,
as injured muscles heal very slowly and often . . . [Full Text of this Article]
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