J Knee Surg 2019; 32(05): 434-440
DOI: 10.1055/s-0038-1646930
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Evaluation of a Novel Degradable Synthetic Biomaterial Patch for Augmentation of Tendon Healing in a Large Animal Model

Wayne K. Gersoff
1  Advanced Orthopedic and Sports Medicine Specialists, Denver, Colorado
,
Chantelle C. Bozynski
2  Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
3  Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
Cristi R. Cook
2  Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
3  Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
Ferris M. Pfeiffer
2  Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
,
Keiichi Kuroki
2  Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
,
James L. Cook
2  Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
3  Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
› Author Affiliations
Funding This study received some external funding from Artelon (Nashville, TN).
Further Information

Publication History

23 January 2018

20 March 2018

Publication Date:
27 April 2018 (eFirst)

Abstract

Tendon injury is common in sports. The standard of care (SOC) for tendon repair is surgical treatment. However, restored tendons often lack complete strength and functionality, and surgical repair is often unsuccessful. This controlled laboratory study investigates the healing of an Artelon patch (AP)-augmented tendon versus tendon repair alone in a preclinical canine patellar tendon defect model. Full-thickness proximal and distal flap defects were created in the patella tendons of eight purpose-bred research mongrel dogs. Dogs were randomly allocated into either the AP-augmented repair group or the SOC group (N = 8; four knees per group). Outcomes measures included limb function and pain; range of motion (ROM) and ultrasound assessment at 2, 4, and 8 weeks; and measurements of elongation, biomechanical testing, and histology at 8 weeks. Data were compared for statistically significant differences to preoperative measures and between groups (p < 0.05). The AP group had higher limb function scores compared with the SOC group at 2, 4, and 8 weeks, with statistically significant differences observed at 2 weeks (AP: 7.1 ± 1.4, SOC: 5.5 ± 0.4, p < 0.05) and 8 weeks (AP: 9.5 ± 0.7, SOC: 7.0 ± 0.9, p < 0.05). The ROM was significantly higher for the AP group at 4 weeks (AP: 105 degrees ± 4, SOC: 89 degrees ± 5, p < 0.05). Pain scores were statistically significantly lower in the AP group at 4 (AP: 0.6 ± 0.5, SOC: 2.2 ± 0.5) and 8 weeks (p < 0.05 for both comparisons). All animals in the AP group displayed full bridging tissue at week 4, while most animals of the SOC group displayed full bridging by week 8. Minimal tendon elongation was observed in both groups. Significantly more force was required to elongate tendons in the AP group compared with the SOC group (p < 0.05). Animals with AP-augmented tendon repair show an earlier regain of function, earlier regain of range of movement, less postoperative pain, and improved tendon strength when compared with animals treated with tendon repair alone.

Note

This study was approved by our university's Animal Care and Use Committee.