Repair of Achilles Tendon Ruptures with Dacron Vascular Graft

Lieberman, Jay R.; Lozman, Jeffrey; Czajka, John; Dougherty, James

doi:10.1097/00003086-198809000-00035

Cited by 70 publications

(30 citation statements)

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“…The non-resorbable fraction [low molecular weight poly (urethane urea) segments] is incorporated into the surrounding host tissue. Very few studies have reported about graft implantation as an augmentation material in Achilles tendon repair 20,21 , while no study has clearly demonstrated improved AT healing or clinical outcomes using synthetic reinforcement in patients compared to a control group. A comprehensive search of PubMed, Medline, Cochrane, CINAHL, and Embase databases about Tendon augmentation grafts by Longo et al, 2010 reports that many biomaterials are available in the market for tendon augmentation while scanty evidence is available for the use of these scaffolds 22 .…”

Section: Discussionmentioning

confidence: 99%

Failed synthetic graft after acute Achilles tendon repair

Mohamed

Oliva

Nardoni

et al. 2017

MLTJ

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SummaryBackground: The present case report aimed to determine the results of Flexor Hallucis Longus (FHL) transfer as a second surgery after synthetic tissue reinforcement graft (Artelon ® ) implanted to a primary repaired Achilles tendon (AT), that was undertaken by another orthopedic. One year postoperative the patient was referred to us with retrocalcaneal pain and difficulty in walking, associated with stiffness and significant impairment of daily living activities. Methods: MRI and full clinical examination were the outcome measures applied before and 1 year after surgery. Removal of the synthetic graft and subsequent FHL autologous transfer was undertaken and the graft was sent for histology examination. After removing the below knee leg cast, patient started rehabilitation program supervised by a trained physiotherapist. Results: The patient was allowed to return to his normal activities at the sixth postoperative month, 1 year post-surgery MRI showed correct position of the autograft in the calcaneous bone and in the centre of the native AT plus reduced oedema of the AT body, with clinical improvement of the patient who reported no pain and was able to walk on tiptoes. Conclusion: Synthetic patch augmentation to enhance tendon healing should be subjected to proper investigation before using it in routine parctice, as it may act as a barrier against proper tendon healing. Level of evidence: V.

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Section: Discussionmentioning

confidence: 99%

Failed synthetic graft after acute Achilles tendon repair

Mohamed

Oliva

Nardoni

et al. 2017

MLTJ

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“…To date, various tendon scaffolds, such as collagen-based tendon scaffolds, carbon implants, and Dacron, have been introduced. [34][35][36] However, they are all susceptible to infections, foreign body reactions, extrusion, and uncertain long-term immunologic interactions. One novel strategy suggested that the need for a scaffold could be avoided by inducing tendon fibroblasts to secrete and assemble their own matrix.…”

Section: Discussionmentioning

confidence: 99%

Co-effect of silk and amniotic membrane for tendon repair

Seo

Kim

Eo³

2016

Journal of Biomaterials Science, Polymer Edition

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The objective of the present study was to determine the feasibility and biocompatibility of a silk scaffold and a composite silk scaffold in terms of new tendon generation using a rabbit Achilles tendon model. The silk scaffold was constructed using a weaving machine, then soaked in a 1% collagen-hyaluronan (HA) solution and air-dried, whereas the composite silk scaffold was composed of a silk scaffold containing a lyophilized collagen-HA substrate. Tenocytes were cultured in vitro to compare cell populations in the two groups. The cellular densities on composite silk scaffolds were 40% higher on average than those on silk scaffolds in 30-day tenocyte cultures. The tendon scaffolds had implanted into Achilles tendon defects in 16 white New Zealand rabbits. Rabbits were randomly divided into the following three groups: group I, silk scaffold alone; group II, composite silk scaffold; and group III, composite silk scaffold wrapped by an amniotic membrane. Implants were harvested 2, 8, and 12 weeks post-implantation. Histological examinations were conducted using hematoxylin-eosin (H&E), Masson's trichrome, and by performing immunohistochemical staining for CD34. After 12 weeks, the three groups were distinguishable based on gross examination. The histological examination revealed more organized collagen fibrils in groups III, which showed a dense, parallel, linear organization of collagen bundles. CD34 staining revealed neoangiogenesis in groups III. The results of this research showed that collagen-HA substrates with amniotic membrane accelerate cellular migration and angiogenesis in neotendons.

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“…These materials include vascular grafts, carbon fiber composites, polyglycol threads, and polyester mesh (Lieberman et al, 1988;Parsons et al, 1989;Shedl & Fasol, 1979;Ozaki et al, 1989). The use of synthetic materials avoids the sacrifice of functional tendon structures and extensive incision and dissection.…”

Section: Synthetic Graftsmentioning

confidence: 99%