Comparison of Achilles Tendon Repair Techniques in a Sheep Model Using a Cross-linked Acellular Porcine Dermal Patch and Platelet-rich Plasma Fibrin Matrix for Augmentation

Advances in injured tendon engineering with emphasis on the role of collagen implants

“…This is the art of tissue engineering technology 9,25,32 . Porcine dermal (PD) collagen has been used for reinforcement of several human body tissues with success and has been shown to act as a durable, permanent tissue scaffold that assists healing 20,27,32 . Use of PD collagen as an augmentation graft in treatment of massive rotator cuff tears has been shown to be safe, providing excellent pain relief with a moderate improvement in active ranges of motion and strength and in most patients, and is associated with improved clinical outcome 32 .…”

“…In the autogeneic and allogeneic transplantation of the tissue, there are some degrees of tissue reaction and tolerable host immune response after implantation of the graft 9,11 . Most biological materials used in tissue engineering technologies, such as collagen-based structures, are provided from animal tissues such as the dermis, subcutaneous area, submucosa of the intestine, tendon and other connective tissues containing cellular elements 27,[41][42][43] . Direct implantation of these tissues to an in vivo model amplifies the host immune response and is sometimes associated with rejection 41 .…”

“…A collagenous material as an excellent biological and biocompatible biomaterial has been lionised by many investigators and used to fill the defect area of the ruptured tendons and ligaments both under in vitro and in vivo conditions resulting in promising effects on tissue regeneration and physical performance of the injured tendons [17][18][19][20][21][22] . Many different collagen structures with a variety of curative effects have been used with or without a combination of some other bioactive molecules or stem cells 6,[23][24][25][26][27] . Therefore, the aim of the present study was to review the most recent investigations on the effects of tissueengineered biocompatible and biodegradable collagen-based scaffolds/ implants on tendon healing.…”

A Comparative Histopathological Study of Repaired Tendons Wrapped with Two Biological Matrices in Bucks

“…In control group the inflammatory response was less noticed as compared to treated groups which were characterized by increased inflammatory cells infiltration at the injured site this improved the development of granulation tissue in the tenorrahphy site and this result are similar to Meimandi-Parizi (2013). The evidence of cellular infiltration into the scaffold may indicate fibroblasts invasion into the scaffold and integrated the scaffold with the tendon and surrounding tissues before ultimate deterioration which may restrict fibrosis and tendon contracture (Sarrafian et al, 2010). In addition, increased inflammation in PECM group in this study may be related to a cross linked pericardium scaffold which was used and this came in accordance with the opinion of some investigators who revealed that the cross linking masked the surface proteins and thereby decreased antigenicity and this would normally initiate a cellular hypersensitivity response ( Jarman-Smith et al, 2004;Coons and Alan, 2006).…”

“…Sharma and Maffulli (2008) referred that tenorrhaphy is the most advantageous treatment for ruptured tendon, which provide good anastomosis with minimal gap formation; but, if a large part of the tendon has been lost the elongation and transplantation techniques could be useful treatment for the defect area. Tissue engineering techniques have been developed as advancing strategies that aim to induce repair and replacement or regeneration of tissues and organs, a collagenous material considered as an excellent biomaterial which give promising effects on tissue regeneration and physical function of the injured tendons and ligaments ( Juncosa-Melvin et al, 2005;Nicholson et al, 2007;Provencher et al, 2007;Kim et al, 2008;Lee, 2008;Sarrafian et al, 2010;Hao et al, 2010;Nillesen et al, 2011). Recent researches attempted to develop alternative non-toxic, easily prepared, and economically cheap therapeutics that lead to the local release of growth factors which accelerate hard and soft tissue healing.…”