BACKGROUND: The efficacy of bone marrow aspirate concentrate (BMAC) in promoting bone-tendon interface (BTI) healing without any carriers remains a subject of debate. PURPOSE: To evaluate BMAC effects with different carriers on tendon regeneration in a rabbit model of chronic rotator cuff tear. STUDY DESIGN: Controlled laboratory study. METHODS: In vitro, the amount of growth factor and the differentiation potential of BMAC with different carriers (polydeoxyribonucleotide [PDRN] and atelocollagen [ATC]) were assessed. In vivo, 64 rabbits were randomly allocated into 4 groups. Different materials were injected into the repair site according to the allocated group: control, saline
BMAC, BMAC and saline
BMAC-PDRN, BMAC with PDRN
BMAC-ATC, BMAC with ATC (n = 16 in each). Genetic and histologic analyses were conducted at 4 and 12 weeks after repair, while biomechanical evaluations were performed at 12 weeks after repair. RESULTS: In vitro, the degree of multilineage differentiation was much stronger using BMAC with ATC as compared with administration of BMAC alone or BMAC with PDRN ( CONCLUSION: Local application of BMAC without appropriate carriers could not enhance BTI healing. However, BMAC with 2 different carriers effectively accelerated BTI healing, particularly in the ATC environment. Therefore, the combination of BMAC and ATC may act as a powerful biological agent to promote healing after rotator cuff repair in a chronic rotator cuff tear model using rabbits. CLINICAL RELEVANCE: Local application of BMAC without appropriate carriers could not enhance BTI healing. However, the combination of BMAC and ATC may synergistically promote rotator cuff tendon healing.