Multilayer Film with Bioactive and Antiadhesive Layers for Accelerated Tendon Regeneration.

Despite advances in surgical techniques for tendon injuries and improvements in rehabilitation, the challenge of achieving sufficient tendon regeneration and preventing postoperative tissue adhesions persists for orthopedic surgeons. In this study, we developed a multilayer film with a platelet-derived growth factor-BB (PDGF-BB)-immobilized leaf-stacked structure (LSS) layer (bioactive layer) and an alginate layer (antiadhesive layer) on both sides of a PCL film (PDGF/FLSS-Alg). The porous LSS layer on the PCL film was fabricated using a heating-cooling method with tetraglycol, where PDGF-BB was adsorbed onto the LSS layer. An alginate coating was applied on the opposite side to form the antiadhesion layer. The PDGF-BB loaded on the LSS layer provided a sustained release at effective concentrations for over 29 days. From in vitro cell culture and in vivo animal studies, the alginate layer proved effective in preventing cell/tissue adhesion; meanwhile, the bioactive layer facilitated tenogenic differentiation in hBMSCs and supported tendon regeneration. Accordingly, we propose that PDGF/FLSS-Alg offers a viable strategy for effective tendon regeneration in clinical practice.