Surgical repair of symptomatic chronic achilles tendon rupture using synthetic graft augmentation

Shoaib, A.; Mishra, Viren

doi:10.1016/j.fas.2016.04.006

Cited by 26 publications

(31 citation statements)

References 18 publications

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“…The postoperative mean scores were 97.6 points for the AOFAS score and 92.7 points for the ATRS, both of which were greater than previously reported scores for CATR, which ranged from 87 to 95 points for the AOFAS and 86 to 92.1 points for the ATRS. 8,[24][25][26] The average SF-36 physical and mental values were significantly improved.…”

Section: Discussionmentioning

confidence: 96%

Reconstruction of Myerson type III chronic Achilles tendon ruptures using semitendinosus tendon and gracilis tendon autograft

Jiang

Shen

Huang

et al. 2019

J Orthop Surg (Hong Kong)

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Background: Reconstruction of Myerson type III (defect size more than 5 cm) chronic Achilles tendon ruptures (CATRs) is a surgical challenge due to its large Achilles tendon defect. This study aims to describe our operative technique for Myerson type III CATR and its clinical outcomes. Patients and Methods: From May 2012 to April 2015, we treated seven patients (6 males, 1 female) with Myerson type III CATR using semitendinosus tendon and gracilis tendon autograft. The mean age was 47.3 years (range: 37-56). Patients were followed for a mean time of 31.3 months. All patients' defect size between Achilles ends after debridement was more than 5 cm and hence classified as Myerson type III. The clinical outcomes were evaluated by visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, Achilles tendon total rupture score (ATRS), and the Short Form 36 (SF-36). Results: All patients reported good postoperative clinical outcomes. The average AOFAS score increased from 54.29 points (range: 46-65 points) preoperatively to 97.57 points (range: 90-100 points) at last follow-up. The average ATRS increased from 51.43 points (range: 40-61 points) preoperatively to 92.71 points (range: 83-100 points) at last follow-up. And the average VAS for pain was 0 at the last follow-up. The mean value of SF-36 physical increased from 32.14 points (range: 25-35 points) to 90 points (range: 80-95 points). And the mean value of SF-36 mental was improved from 37.14 points (range: 32-40 points) to 90.86 points (range: 84-96 points). Conclusions: Semitendinosus tendon combined gracilis tendon autograft is a safe and effective technique in the reconstruction of Myerson type III CATR.

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Section: Discussionmentioning

confidence: 96%

Reconstruction of Myerson type III chronic Achilles tendon ruptures using semitendinosus tendon and gracilis tendon autograft

Jiang

Shen

Huang

et al. 2019

J Orthop Surg (Hong Kong)

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“…[292] Unlike many naturally derived ECM components such as elastin and collagen that have degradation half-lives on the order of decades, synthetic materials can provide superior mechanical properties and tunable degradation (e.g., PLGA). Another example is the Artelon® device composed of a bioabsorbable urethane urea for Achilles tendon repairs, [444] which can be modified to degrade in vivo. [445] Given the heterogeneity and biomechanical gradients present in tendon, it is important that these constructs not only mimic the central midsubstance, but tendon's insertion into bone (or muscle) if it is to be used as a complete replacement or serve as a template for new tendon tissue formation.…”

Section: Tendon Biomaterialsmentioning

confidence: 99%

Biomaterials to Mimic and Heal Connective Tissues

2019

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Connective tissue is one of the four major types of animal tissue and plays essential roles throughout the human body. Genetic factors, aging, and trauma all contribute to connective tissue dysfunction and motivate the need for strategies to promote healing and regeneration. The goal of this Review is to link a fundamental understanding of connective tissues and their multiscale properties to better inform the design and translation of novel biomaterials to promote their regeneration. We discuss major clinical problems in adipose tissue, cartilage, dermis, and tendon that inspire the need to replace native connective tissue with biomaterials. We then detail multiscale structure-function relationships in native soft connective tissues that may be used to guide material design. Several biomaterials strategies to improve healing of these tissues that incorporate biologics and are biologic-free are reviewed. Finally, we highlight important guidance documents and standards (ASTM, FDA, EMA) that are important to consider for translating new biomaterials into clinical practice.

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“…Alternatively, surgically replacing only the damaged area of the tendon with synthetic grafts including commercially available devices like GraftJacket or Artelon has shown promise in enhancing endogenous healing instead of replacing the entire tendon. 116,117 Another therapeutic avenue that has been long explored is the implantation of engineered scaffolds or surgical sutures embedded with biologics including connective tissue growth factor 118 or PRP 119 into the damaged area that may enhance tendon healing. Recent efforts have focused on an integrative approach in which materials are designed to elicit proper cellular responses to form more complex tissues such as the enthesis.…”

Section: Emerging Cell-based Treatments and Engineering Strategiesmentioning

confidence: 99%

Bringing tendon biology to heel: Leveraging mechanisms of tendon development, healing, and regeneration to advance therapeutic strategies

Tsai

Nödl

Galloway

2020

Developmental Dynamics

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Tendons are specialized matrix‐rich connective tissues that transmit forces from muscle to bone and are essential for movement. As tissues that frequently transfer large mechanical loads, tendons are commonly injured in patients of all ages. Following injury, mammalian tendons heal poorly through a slow process that forms disorganized fibrotic scar tissue with inferior biomechanical function. Current treatments are limited and patients can be left with a weaker tendon that is likely to rerupture and an increased chance of developing degenerative conditions. More effective, alternative treatments are needed. However, our current understanding of tendon biology remains limited. Here, we emphasize why expanding our knowledge of tendon development, healing, and regeneration is imperative for advancing tendon regenerative medicine. We provide a comprehensive review of the current mechanisms governing tendon development and healing and further highlight recent work in regenerative tendon models including the neonatal mouse and zebrafish. Importantly, we discuss how present and future discoveries can be applied to both augment current treatments and design novel strategies to treat tendon injuries.

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Surgical repair of symptomatic chronic achilles tendon rupture using synthetic graft augmentation

Cited by 26 publications

References 18 publications

Reconstruction of Myerson type III chronic Achilles tendon ruptures using semitendinosus tendon and gracilis tendon autograft

Reconstruction of Myerson type III chronic Achilles tendon ruptures using semitendinosus tendon and gracilis tendon autograft

Biomaterials to Mimic and Heal Connective Tissues

Bringing tendon biology to heel: Leveraging mechanisms of tendon development, healing, and regeneration to advance therapeutic strategies

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