Tendon repair

Patients with severe disease may benefit from surgical procedures such as tenosynovectomy, tendon repair, and joint replacements. 

Young RG, Butler DL, Weber W, Caplan AI, Gordon SL, Fink DJ. Use of mesenchymal stem cells in a collagen matrix for Achilles tendon repair. J Orthop Res 1998 16 406 13. 

Other nonpharmaco logic therapeutic options include weight loss and surgery. Weight reduction helps to alleviate stress on inflamed joints. This should be instituted and monitored with close supervision of a health care professional. Tenosynovectomy, tendon repair, and joint replacements are surgical options for patients with rheumatoid arthritis. Such management usually is reserved for patients with severe disease. ... 

St. Onge R, Weiss C, Denhnger JL, Balazs EA. A prehminary assessment of Na-hyalnronate injection into no man s land for primary flexor tendon repair. Clin Orthop 1980 146 269-275. 

T.W. Gilbert, A.M. Stewart-Akers, A. Simmons-Byrd, S.F. Badylak, Degradation and remodeling of small intestinal submucosa in canine Achilles tendon repair, J. Bone Jt. Surg. 89 (2007) 621-630. 

In a recent stndy, patients were retrospectively assessed who presented with either a partial or fnfl mptnre of either the peroneus brevis, peroneus longus tendon, or posterior tibial tendon. All mptnres were symptomatic and required surgical repair ranging from complete reattachment to excision of mid-snbstance tears, hi each case, the site of the tendon repair was encircled with the same AM material. 

Despite the paucity of data related to the repair of peroneal and posterior tibial tendons in the hterature, the results from the current study seem to indicate that the chances for adhesion in these tendons is almost nonexistent, when the repair site is wrapped with AM. More importantly, since adhesions can manifest as stiffness, loss of range of motion, and pain at the repair site, the statistically significant improvement in both the BFS and FFI following tendon repair seems to indicate that there were no symptoms that we would normally associate with tendon adhesions. 

The use of human AM to wrap the PTT and PT at the conclusion of surgery in order to inhibit adhesion formation and improve the surgical outcome represents an innovative improvement in tendon repair. 

Demirkan F, Colakoglu N, Herek O, Erkula G. The use of amniotic membrane in flexor tendon repair an experimental model. Arch Orthop Trauma Surg 2002 122 396-9. 

Philip J, Hackl F, Canseco JA, Kamel RA, Kiwanuka E, et al. Amnion-derived multipotent progenitor cells improve Achilles tendon repair in rats. Eplasty June 19, 2013 225-34. 

Derwin KA, Baker AR, Spragg RK. Commercial extracellular matrix scaffolds for rotator cuff tendon repair. J Bone Jt Surg Am 2006 88 2665-72. 

What could be the next challenge The first could be improvement of the mechanical performance of the final nano-sized materials. As demonstrated above, in the cases when H-bonding in polymer blends exists, the final nanomorphology is similar to the 3-D nanofibriiiar network, which does not possess the superior mechanical properties of noninterconnected nanofibrils. Scaffolds with high mechanical performance (e.g., for bones and tendons repair) are frequently needed in tissue engineering, possibly prepared with the use of water only as a solvent. 

Flexor tendon repair ((a) 4 strand (b) = 8 strand) with knotted sutures (Barrie eta ., 2000). 

Abathi, R, Saint-Cyr, M., Brown, S., Noble, D., Hatef, D., Farkas, J. and Ruff, M. (October 2007). Flexor tendon repair with barbed suture. American Society of Plastic Surgeons Plastic Sirrgery 2007 Conference, Baltimore, USA. 

Amadeo, I.M., Chauhan A., Stuart J. and Warden P.T. (April 2011). Flexor tendon repair with a knotless barbed suture A comparative biomechanical study. The Journal of Hand and Shoulder, 36A, 1204-1208. 

Barrie, K. A.,Tomak, S. L., Cholewicki, J. and Wolfe, S. W. (July 2000). The role of multiple strands and locking sutures on gap formation of fl J., tendon repairs during cyclic loading. The Journal of Hand Surgery, 25A (4), 714-720. 

O Broin, E. S., Earley, M. J., Smyth, H. and Hooper, C. B. (1993). Absorbable sutures in tendon repair A comparison of PDS with Prolene in rabbit tendon repair. Journal of Hand Surgery (British and European), 20B (4), 505-508. 

Ouyang, H.W., et al. 2002. The efficacy of bone marrow stromal cell-seeded knitted PLGA fiber scaffold for achilles tendon repair. Armais of the New York Academy of Sciences 961(1) 126-129. 

Numerous biomimetic adhesives inspired by mussels haven been validated by in vitro or in vivo testing. Examples are adhesive-coated scaffolds tailor-made for the vascular system that promote cell proliferation (Ku and Park, 2010), adhesives for the immobilization of pancreatic transplants on the liver surface (Bilic et al., 2010), adhesive-coated biological meshes (eg, for hernia repair Murphy et al., 2010), scaffolds (eg, for Achilles tendon repair Brodie et al., 2011) or titanium implants (eg, for osteoblast proliferation promotion Hwang et al., 2010), and sealant for fetal membrane repair (Brubaker et al., 2010). 

Brodie, M., Vollenweider, L., Murphy, J.L., Xu, F., Lyman, A., Lew, W.D., Lee, B.P., 2011. Biomechanical properties of Achilles tendon repair augmented with a hioadhesive-coated... 

Russell, J. E., and Manske, P. R., 1991, Ascorbic acid requirement for optimal flexor tendon repair in vitro, J. Orthop. Res. 9 714-719. 

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