The clinical strategies for tendon repair with biomaterials: A review on rotator cuff and Achilles tendons

Veronesi, Francesca; Borsari, Veronica; Contartese, Deyanira; Xian, Jie; Baldini, Nicola; Fini, Milena

doi:10.1002/jbm.b.34525

Cited by 17 publications

(17 citation statements)

References 55 publications

(467 reference statements)

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“…These structures should improve the quality of the newly formed tissue and ensure long‐term functional results. They are meant to provide mechanical reinforcement at the beginning of the healing process, support the tissue's intrinsic healing potential, prevent re‐tearing, and allow cell infiltration and adequate tissue growth in time 15 . It is crucial to mimic the tendon's complex hierarchical morphology and consequent non‐linear mechanical response 26 .…”

Section: Resultsmentioning

confidence: 99%

Hybrid structures for Achilles' tendon repair

Peixoto

Carneiro

Pereira

et al. 2022

Polymers for Advanced Techs

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The management of extensive tendon injuries poses a considerable challenge. These cases typically require a partial replacement of the tissue, and conventional treatment options, either grafts or synthetic constructs, present disadvantages. Synthetic constructs may be produced with either non-biodegradable or biodegradable polymers. However, while the former lacks biointegration, the latter requires a compromise between tissue ingrowth and biodegradability, frequently malfunctioning due to inadequate mechanical properties. The present work presents a textile medical device designed to repair the Achilles tendon (AT). This device is based on a core/shell design that mimics the multiscale organization of the native tissue. The core comprises several hybrid braids based on poly(ethylene terephthalate) (PET) and poly(lactic acid) (PLA) yarns, and the shell consists on braided PET yarns surrounding the core. Different PET/PLA compositions of the core braids were studied to optimize biodegradability without compromising mechanical performance. The morphology and mechanical properties of the structures were studied. The hybrid structures presented a non-linear force-strain curve comparable to a representative curve described for a native tendon. A decrease in force and stiffness was observed as the PLA content in the structure increased. Nevertheless, the obtained values for the hybrid structures are promising for AT replacement. Besides, these hybrid structures demonstrated appropriate resistance to cyclic loading and a beneficial creep behavior. The results obtained in the present work fall within the range of values reported for the native AT.

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Section: Resultsmentioning

confidence: 99%

Hybrid structures for Achilles' tendon repair

Peixoto

Carneiro

Pereira

et al. 2022

Polymers for Advanced Techs

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“…A recent study was conducted by the Orthopedic Rizzoli Institute (Veronesi et al, 2020), where two groups of patients with irreversible rupture of the rotator cuff who received surgical treatment were evaluated: one group received the arthroscopic transfer of the tibial tendon (LDTT), and the other received a partial restoration of the arthroscopic rotator cuff. According to the results of the study, it was decided that both methods are effective.…”

Section: Discussionmentioning

confidence: 99%

Research Article Evaluation of the effectiveness of arthroscopic rotator cuff repair at the Thong Nhat Hospital in Vietnam

Toan¹,

Duong²

2021

Genet. Mol. Res.

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We evaluated the results of arthroscopic rotator cuff repair. Thirty cases of rotator cuff tear were treated by arthroscopic rotator cuff repair at the Thong Nhat hospital from 1/3/2012 to 30/6/2016. All patients were over 18 years old, had positive rotator cuff tear tests, and underwent X-ray and magnetic resonance imaging. The arthroscopic images showed rotator cuff tears, with indication for repair. The functional status of each patient was evaluated using the Constant-Murley Scale and the criteria of the University of California at Los Angeles (UCLA). During postoperative rehabilitation, we applied Cohen's protocol. Seventeen patients were female and 13 were male. The median age was 54 years (21-83). Sixteen patients had partial thickness tears and 14 patients had full-thickness tears. Repair technique: single-row in 13 patients, suture-bridge in 15 patients, transosseous-equivalent in two patients. Four patients with SLAP lesions were treated by debridement labrum for type I, and labral repair for more serious lesions. Five patients with long head biceps tendon rupture were treated with tenodesis. After surgery, 100% of patients were subjected to fluid extravasation through the shoulder joint, but did not have any compartment syndrome; all incisions healed good without infection or neurapraxia. The mean UCLA score was 32.4 (14 patients had excellent results, 14 ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 20 (1): gmr18745 V.T. Toan et al. 2good, and two fair). The mean Constant score was 38.5; the mean postoperative Constant score was 88.77 (p = 0.001). Among the patients, 90% achieved 80% function compared to a normal shoulder. All patients gave their consent to the study and were prepared for the full course of treatment and arthroscopic surgery. Repair of the rotator cuff was for some participants the only effective treatment and a way to restore the shoulder. Postoperative reconstruction of the rotator cuff of the shoulder resulted in a significant improvement in the indicators of the functional state of the shoulder joint.

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“…Several surgical interventions have been described for reconstruction of soft tissue defects, ranging from secondary skin healing to use of free flaps and amputation; the choice depends upon exposure of vital structures and tissue vascularity. 12,13 According to Monnere et al 14 , adequate neo-Achilles tendon can be formed with skin-soft tissue reconstruction without Achilles tendon repair. However, according to a meta-analysis by Ochen et al 15 , operative treatment is associated with reduced rate of re-rupture of the Achilles tendon.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Achilles region defects: a single-center experience

Eser¹,

Ceylan²,

Gencel³

et al. 2021

Preprint

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Background: Reconstruction of Achilles tendon and the overlying tissue defects is a challenging undertaking. The spectrum of available repair methods range from secondary healing to use of free flaps. Method: In this study, we retrospectively evaluated 14 patients who underwent reconstruction of Achilles region defect between 2016 and 2019 at a single center. Results: Reconstructions were performed with secondary healing (n=2), negative pressure wound therapy and skin grafting (n=2), free flaps (n=6), and local and distant flaps (n=4). Satisfactory aesthetic and functional outcomes were achieved in all patients. One patient developed partial skin graft loss. Marginal necrosis occurred in one of the local flaps. Wound dehiscence and flap retraction occurred in one of the free (superficial circumflex iliac artery perforator) flaps. One patient undergoing reconstruction with ulnar artery perforator flap developed intraoperative atrial fibrillation; the operation was terminated and reconstruction completed with skin grafting. Conclusion: Orthoplastic reconstruction should be kept in mind for Achilles tendon defects. Use of special digital imaging techniques facilitates flap surgery and helps minimize the risk of flap complications. Conventional approaches are suitable for shallow small skin lesions. Local flaps are good options for deeper skin defects owing to superior aesthetic outcomes. Superthin free flaps offer a distinct advantage in skillful hands. Use of multi-content free chimeric flaps for reconstruction of complex defects facilitates better anatomical repair. Cross leg or flow-through flaps may be considered in patients with compromised distal circulation. Selection of the most reliable approach for Achilles reconstruction is a key imperative to achieve favorable outcomes.

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The clinical strategies for tendon repair with biomaterials: A review on rotator cuff and Achilles tendons

Cited by 17 publications

References 55 publications

Hybrid structures for Achilles' tendon repair

Hybrid structures for Achilles' tendon repair

Research Article Evaluation of the effectiveness of arthroscopic rotator cuff repair at the Thong Nhat Hospital in Vietnam

Reconstruction of Achilles region defects: a single-center experience

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