Polymer-Based Constructs for Flexor Tendon Repair: A Review

Abstract

A flexor tendon injury is acquired fast and is common for athletes, construction workers, and military personnel among others, treated in the emergency department. However, the healing of injured flexor tendons is stretched over a long period of up to 12 weeks, therefore, remaining a significant clinical problem. Postoperative complications, arising after traditional tendon repair strategies, include adhesion and tendon scar tissue formation, insufficient mechanical strength for early active mobilization, and infections. Various researchers have tried to develop innovative strategies for developing a polymer-based construct that minimalizes these postoperative complications, yet none are routinely used in clinical practice. Understanding the role such constructs play in tendon repair should enable a more targeted approach. This review mainly describes the polymer-based constructs that show promising results in solving these complications, in the hope that one day these will be used as a routine practice in flexor tendon repair, increasing the well-being of the patients. In addition, the review also focuses on the incorporation of active compounds in these constructs, to provide an enhanced healing environment for the flexor tendon.

Functional biomaterials for tendon/ligament repair and regeneration

“…Polyesters, such as PCL, poly ( l -lactic acid) and polylactic acid (PLA), are the main biodegradable scaffolds for T/L injury [ 64 ]. They have greater mechanical strength, better mechanical properties and better degradation rates in vivo than natural polymer materials [ 65–68 ].…”

Amination of Polymeric Braid Structures to Improve Tendon Healing: An Experimental Comparison

“…Tendons are connective tissues that bind muscle to bone, with great ability to transmit forces, withstand tension, and release stored energy, providing strength and the necessary stability for human posture and locomotion. [1][2][3] These tissues are constantly under repeated motions and degeneration, presenting high vulnerability to injury. Surgical intervention is often needed because tendons show limited selfhealing capacity.…”

“…Surgical intervention is often needed because tendons show limited selfhealing capacity. [2,4] Traditional reconstruction techniques based on sutures or autografts/allografts present associated disadvantages, often failing to accomplish an adequate long-term solution. [2,5] Synthetic grafts can be designed to present similar mechanical properties and dimensions to the native tissues.…”

“…[2,4] Traditional reconstruction techniques based on sutures or autografts/allografts present associated disadvantages, often failing to accomplish an adequate long-term solution. [2,5] Synthetic grafts can be designed to present similar mechanical properties and dimensions to the native tissues. [2] However, these synthetic prostheses have been mainly produced from non-degradable polymers.…”

“…[2,5] Synthetic grafts can be designed to present similar mechanical properties and dimensions to the native tissues. [2] However, these synthetic prostheses have been mainly produced from non-degradable polymers. Commonly reported problems include insufficient long-term mechanical durability and lack of biointegration capacity to enable appropriate biological tissue ingrowth into their structure.…”