Sawadkar, P;
Alexander, S;
Tolk, M;
Wong, J;
McGrouther, D;
Bozec, L;
Mudera, V;
(2013)
Development of a Surgically Optimized Graft Insertion Suture Technique to Accommodate a Tissue-Engineered Tendon In Vivo.
BioResearch Open Access
, 2
(5)
327 - 335.
10.1089/biores.2013.0028.
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Abstract
The traumatic rupture of tendons is a common clinical problem. Tendon repair is surgically challenging because the tendon often retracts, resulting in a gap between the torn end and its bony insertion. Tendon grafts are currently used to fill this deficit but are associated with potential complications relating to donor site morbidity and graft necrosis. We have developed a highly reproducible, rapid process technique to manufacture compressed cell-seeded type I collagen constructs to replace tendon grafts. However, the material properties of the engineered constructs are currently unsuitable to withstand complete load bearing in vivo. A modified suture technique has been developed to withstand physiological loading and off load the artificial construct while integration occurs. Lapine tendons were used ex vivo to test the strength of different suture techniques with different sizes of Prolene sutures and tissue-engineered collagen constructs in situ. The data were compared to standard modified Kessler suture using a standard tendon graft. Mechanical testing was carried out and a finite element analysis stress distribution model constructed using COMSOL 3.5 software. The break point for modified suture technique with a tissue-engineered scaffold was significantly higher (50.62 N) compared to a standard modified Kessler suture (12.49 N, p<0.05). Distributing suture tension further proximally and distally from the tendon ends increased the mechanical strength of the repairs. We now have ex vivo proof of concept that this suture technique is suitable for testing in vivo, and this will be the next stage of our research.
Type: | Article |
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Title: | Development of a Surgically Optimized Graft Insertion Suture Technique to Accommodate a Tissue-Engineered Tendon In Vivo |
Open access status: | An open access version is available from UCL Discovery |
DOI: | 10.1089/biores.2013.0028 |
Publisher version: | http://dx.doi.org/10.1089/biores.2013.0028 |
Language: | English |
Additional information: | This work is licensed under a Creative Commons Attribution 3.0 United States License. You are free to copy, distribute, transmit and adapt this work, but you must attribute this work as ‘"BioResearch Open Access. Copyright 2013 Mary Ann Liebert, Inc. http://liebertpub.com/biores, used under a Creative Commons Attribution License: http://creativecommons.org/licenses/by/3.0/us/". PMCID: PMC3776617 |
Keywords: | Biomaterials, extracellular matrix, tissue engineering, wounds |
UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute |
URI: | https://discovery-pp.ucl.ac.uk/id/eprint/1403703 |
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