Flexor tendon repair using a reinforced tubular, medicated electrospun construct.
electrospinning
flexor tendon repair
medication release
rabbit model
tubular braided construct
Journal
Journal of orthopaedic research : official publication of the Orthopaedic Research Society
ISSN: 1554-527X
Titre abrégé: J Orthop Res
Pays: United States
ID NLM: 8404726
Informations de publication
Date de publication:
Mar 2022
Mar 2022
Historique:
revised:
20
04
2021
received:
25
10
2020
accepted:
10
05
2021
pubmed:
16
5
2021
medline:
19
4
2022
entrez:
15
5
2021
Statut:
ppublish
Résumé
A reinforced tubular, medicated electrospun construct was developed for deep flexor tendon repair. This construct combines mechanical strength with the release of anti-inflammatory and anti-adhesion drugs. In this study, the reinforced construct was evaluated using a rabbit model. It was compared to its components (a tubular, medicated electrospun polymer without reinforcement and a tubular braid as such) on the one hand to a modified Kessler suture as a control group. Forty New Zealand rabbits were randomly divided into two groups. Surgery was performed in the second and fourth deep flexor tendons of one hind paw of the rabbits in the two groups using four repair techniques. Biomechanical tensile testing and macroscopic and histological evaluations were performed at 3 and 8 weeks postoperatively. A two-way analysis of variance with pairwise comparisons revealed that the three experimental surgical techniques (a reinforced tubular medicated electrospun construct, tubular-medicated construct, and tubular braid as such) showed similar strength as that of a modified Kessler suture repair, which was characterized by a mean load at ultimate failure of 19.85 N (standard deviation [SD] 5.29 N) at 3 weeks and 18.15 N (SD 8.01 N) at 8 weeks. Macroscopically, a significantly different adhesion pattern was observed at the suture knots, either centrally or peripherally, depending on the technique. Histologically, a qualitative assessment showed good to excellent repair at the tendon repair site, irrespective of the applied technique. This study demonstrates that mechanical and biological repair strategies for flexor tendon repair can be successfully combined.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
750-760Informations de copyright
© 2021 Orthopaedic Research Society. Published by Wiley Periodicals LLC.
Références
Liao JCY, He M, Gan AWT, Wen F, Tan LP, Chong AKS. The effects of bi-functional anti-adhesion scaffolds on flexor tendon healing in a rabbit model. J Biomed Mater Res- Part B Appl Biomater. 2018;106(7):2605-2614. https://pubmed.ncbi.nlm.nih.gov/29424966/
Lui YS, Lewis MP, Loo SCJ. Sustained-release of naproxen sodium from electrospun-aligned PLLA-PCL scaffolds. J Tissue Eng Regen Med. 2017;11(4):1011-1021. https://doi.org/10.1002/term.2000
Chen C-H, Chen S-H, Shalumon KT, Chen J-P. Dual functional core-sheath electrospun hyaluronic acid/polycaprolactone nanofibrous membranes embedded with silver nanoparticles for prevention of peritendinous adhesion. Acta Biomater. 2015;26:225-235. https://www.sciencedirect.com/science/article/pii/S1742706115300398
Banik BL, Lewis GS, Brown JL. Multiscale poly-(ϵ-caprolactone) scaffold mimicking non-linearity in tendon tissue mechanics. Regen Eng Transl Med. 2016;2(1):1-9. https://pubmed.ncbi.nlm.nih.gov/27141530/
Pien N, Peeters I, Deconinck L, et al. Design and development of a reinforced tubular electrospun construct for the repair of ruptures of deep flexor tendons. Mater Sci Eng C. 2020;119:111504. https://linkinghub.elsevier.com/retrieve/pii/S0928493120334226
Chen CT, Chen CH, Sheu C, Chen JP. Ibuprofen-loaded hyaluronic acid nanofibrous membranes for prevention of postoperative tendon adhesion through reduction of inflammation. Int J Mol Sci. 2019;20(20):5038. https://pubmed.ncbi.nlm.nih.gov/31614502/
Akduman C, Özgüney I, Kumbasar EPA. Preparation and characterization of naproxen-loaded electrospun thermoplastic polyurethane nanofibers as a drug delivery system. Mater Sci Eng C. 2016;64:383-390.
Shalumon KT, Sheu C, Chen C-H, et al. Multi-functional electrospun antibacterial core-shell nanofibrous membranes for prolonged prevention of post-surgical tendon adhesion and inflammation. Acta Biomater. 2018;72:121-136. https://www.sciencedirect.com/science/article/pii/S1742706118301752
Kim SJ, Shin JM, Lee EJ, et al. Efficacy of hyaluronic acid and hydroxyethyl starch in preventing adhesion following endoscopic sinus surgery. Eur. Arch. Oto-Rhino-Laryngology. 2017;274(10):3643-3649. https://link.springer.com/article/10.1007/s00405-017-4669-6
Miller JA, Ferguson RL, Powers DL, Burns JW, Shalaby SW. Efficacy of hyaluronic acid/nonsteroidal anti-inflammatory drug systems in preventing postsurgical tendon adhesions. J Biomed Mater Res. 1997;38(1):25-33.
Berglund M, Hart DA, Wiig M. The inflammatory response and hyaluronan synthases in the rabbit flexor tendon and tendon sheath following injury. J Hand Surg Eur. 2007;32(5):581-587. https://pubmed.ncbi.nlm.nih.gov/17950228/
Chou PY, Chen SH, Chen CH, Chen SH, Fong YT, Chen JP. Thermo-responsive in-situ forming hydrogels as barriers to prevent post-operative peritendinous adhesion. Acta Biomater. 2017;63:85-95. https://pubmed.ncbi.nlm.nih.gov/28919215/
Chen S-H, Chen C-H, Fong YT, Chen J-P. Prevention of peritendinous adhesions with electrospun chitosan-grafted polycaprolactone nanofibrous membranes. Acta Biomater. 2014;10(12):4971-4982. https://www.sciencedirect.com/science/article/pii/S1742706114003754
Jiang S, Yan H, Fan D, Song J, Fan C. Multi-layer electrospun membrane mimicking tendon sheath for prevention of tendon adhesions. Int J Mol Sci. 2015;16(4):6932-6944. http://www.ncbi.nlm.nih.gov/pubmed/25822877
Tang Jbo, Ishii S, Masamichi U, Aoki M. Dorsal and circumferential sheath reconstructions for flexor sheath defect with concomitant bony injury. J Hand Surg Am. 1994;19(1):61-69.
Chen SH, Chou PY, Chen ZY, Lin FH. Electrospun water-borne polyurethane nanofibrous membrane as a barrier for preventing postoperative peritendinous adhesion. Int J Mol Sci. 2019;20(7):1625
Kim SH, Yoo JC, Wang JH, Choi KW, Bae TS, Lee CY. Arthroscopic sliding knot: how many additional half-hitches are really needed? Arthrosc - J Arthrosc Relat Surg. 2005;21(4):405-411.
Wong YR, Jais ISM, Chang MK, Lim BH, Tay SC. An exploratory study using semi-tabular plate in Zone II flexor tendon repair. J Hand Surg Asian-Pacific. 2018;23(4):547-553.
Zhao C, Amadio PC, Tanaka T, et al. Effect of gap size on gliding resistance after flexor tendon repair. J. Bone Jt Surg - Ser A. 2004;86(11):2482-2488. https://pubmed.ncbi.nlm.nih.gov/15523022/
Zimmermann US, Clerici TJ. The histological aspects of fillers complications. Semin Cutan Med Surg. 2004;23(4):241-250. https://pubmed.ncbi.nlm.nih.gov/15745233/