The effects of bi‐functional anti‐adhesion scaffolds on flexor tendon healing in a rabbit model

Abstract

Progressive tendon adhesion is a major challenge in flexor tendon repair. The authors developed a bifunctional anti-adhesion scaffold and hypothesized that its application would reduce adhesion formation and deliver mesenchymal stem cells (MSCs) to enhance tendon healing. The scaffold was fabricated by an electrospinning machine before surface modification. The flexor tendons of 29 New Zealand rabbits underwent surgical repair and randomized to control, scaffold and scaffold loaded with MSC group. At 3 and 8 weeks post-surgery, range of motion (ROM), biomechanical properties, and histology were examined. There was no significant increase in ROM and biomechanical properties between the three groups. The histology showed successful delivery of MSCs but no significant difference in nuclear morphometry. This barrier delivers and retains MSCs within the tendon repair site. However, its sheet form and wrapping around the repair site may not be optimal for tendon healing. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2605-2614, 2018.

Advances in the Development of Anti-Adhesive Biomaterials for Tendon Repair Treatment

“…(3) More deliberation needs to be given to the microstructure of the material. For example, the thickness, pore diameter and porosity of the membrane affects the space of the tendon sheath, tendon slipping ability, infiltration of cells and various functional molecules as the result of a bi-functional anti-adhesion scaffold studied by Liao et al [34] (4) Lack of clinical practices. It should be remembered that in animal experiments, there are aspects different from humans [11], including anatomical characteristics, healing potentials, and resistance to infection, tolerance of foreign matter or immune responses, as well as compliance in the process of treatment, etc.…”

“…This indicates that without affecting the range of motion of the healed joint, hydrogels can be used as a scaffold for tendon cell extension in the process of tendon repair with a certain degree of toughness to protect the tendon from rerupturing and provide a proper molding time to ensure that it can wrap around the repaired parts better. Besides, as a solution, hydrogels type barriers are easier to apply but may be washed out readily and render lower efficacy [34].…”

Fibrous Systems as Potential Solutions for Tendon and Ligament Repair, Healing, and Regeneration

“…[ 2 ] In order to design a proper scaffold for tendon and ligament engineering, various natural materials, biodegradable polymers, and composite biomaterials have been considered. [ 67–76 ] Commercial materials used to produce and fabricate scaffolds for this application include synthetic degradable, synthetic nondegradable, biological, and naturally derived materials. [ 2 ] Synthetic biomaterials have the great advantage of improving tissue repair by sharing mechanical loads with the host tissue.…”

“…The architecture and structure of electrospun scaffolds allow the incorporation of natural components into the synthetic system to improve its biological responses and tissue healing. [ 71,72 ] In order to enhance the biocompatibility of synthetic scaffolds, the components of the ECM, e.g., collagen, can be added. [ 68,180 ] Even though collagen has high biocompatibility, its low mechanical properties have suggested that it should be combined with synthetic polymers, which have superior mechanical behavior.…”

Quercetin reduces tendon adhesion in rat through suppression of oxidative stress

“…Many methods have been used to prevent tendon adhesion, such as the improvement of surgical technology, the use of barriers, systemic or local application of drugs and chemicals. Although these methods can reduce adhesions to some extent, the residual or recurrent adhesions still need to be resolved [5][6][7][8].…”