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Flexor tendon repair using a reinforced tubular, medicated electrospun construct
Author(s) -
Peeters Ian,
Pien Nele,
Mig Arn,
Van Damme Lana,
Dubruel Peter,
Van Vlierberghe Sandra,
Mantovani Diego,
Vermeulen Valérie,
Creytens David,
Van Tongel Alexander,
Schauvliege Stijn,
Hermans Katleen,
De Wilde Lieven,
Martens Ann
Publication year - 2022
Publication title -
journal of orthopaedic research®
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.25103
Subject(s) - tendon , fibrous joint , ultimate tensile strength , medicine , adhesion , surgery , ultimate load , biomedical engineering , anatomy , materials science , structural engineering , composite material , engineering , finite element method
A reinforced tubular, medicated electrospun construct was developed for deep flexor tendon repair. This construct combines mechanical strength with the release of anti‐inflammatory and anti‐adhesion drugs. In this study, the reinforced construct was evaluated using a rabbit model. It was compared to its components (a tubular, medicated electrospun polymer without reinforcement and a tubular braid as such) on the one hand to a modified Kessler suture as a control group. Forty New Zealand rabbits were randomly divided into two groups. Surgery was performed in the second and fourth deep flexor tendons of one hind paw of the rabbits in the two groups using four repair techniques. Biomechanical tensile testing and macroscopic and histological evaluations were performed at 3 and 8 weeks postoperatively. A two‐way analysis of variance with pairwise comparisons revealed that the three experimental surgical techniques (a reinforced tubular medicated electrospun construct, tubular‐medicated construct, and tubular braid as such) showed similar strength as that of a modified Kessler suture repair, which was characterized by a mean load at ultimate failure of 19.85 N (standard deviation [ SD ] 5.29 N) at 3 weeks and 18.15 N (SD 8.01 N) at 8 weeks. Macroscopically, a significantly different adhesion pattern was observed at the suture knots, either centrally or peripherally, depending on the technique. Histologically, a qualitative assessment showed good to excellent repair at the tendon repair site, irrespective of the applied technique. This study demonstrates that mechanical and biological repair strategies for flexor tendon repair can be successfully combined.