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Epanomeritakis IE, Eleftheriou A, Economou A, Lu V, Khan W. Mesenchymal Stromal Cells for the Enhancement of Surgical Flexor Tendon Repair in Animal Models: A Systematic Review and Meta-Analysis. Bioengineering (Basel) 2024; 11:656. [PMID: 39061739 PMCID: PMC11274147 DOI: 10.3390/bioengineering11070656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/09/2024] [Accepted: 06/24/2024] [Indexed: 07/28/2024] Open
Abstract
Flexor tendon lacerations are primarily treated by surgical repair. Limited intrinsic healing ability means the repair site can remain weak. Furthermore, adhesion formation may reduce range of motion post-operatively. Mesenchymal stromal cells (MSCs) have been trialled for repair and regeneration of multiple musculoskeletal structures. Our goal was to determine the efficacy of MSCs in enhancing the biomechanical properties of surgically repaired flexor tendons. A PRISMA systematic review was conducted using four databases (PubMed, Ovid, Web of Science, and CINAHL) to identify studies using MSCs to augment surgical repair of flexor tendon injuries in animals compared to surgical repair alone. Nine studies were included, which investigated either bone marrow- or adipose-derived MSCs. Results of biomechanical testing were extracted and meta-analyses were performed regarding the maximum load, friction and properties relating to viscoelastic behaviour. There was no significant difference in maximum load at final follow-up. However, friction, a surrogate measure of adhesions, was significantly reduced following the application of MSCs (p = 0.04). Other properties showed variable results and dissipation of the therapeutic benefits of MSCs over time. In conclusion, MSCs reduce adhesion formation following tendon injury. This may result from their immunomodulatory function, dampening the inflammatory response. However, this may come at the cost of favourable healing which will restore the tendon's viscoelastic properties. The short duration of some improvements may reflect MSCs' limited survival or poor retention. Further investigation is needed to clarify the effect of MSC therapy and optimise its duration of action.
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Affiliation(s)
| | - Andreas Eleftheriou
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK; (A.E.); (A.E.); (V.L.)
| | - Anna Economou
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK; (A.E.); (A.E.); (V.L.)
| | - Victor Lu
- School of Clinical Medicine, University of Cambridge, Cambridge CB2 0SP, UK; (A.E.); (A.E.); (V.L.)
| | - Wasim Khan
- Department of Trauma and Orthopaedic Surgery, Addenbrooke’s Hospital, University of Cambridge, Cambridge CB2 0QQ, UK
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2
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Zhang G, Zhou X, Hu S, Jin Y, Qiu Z. Large animal models for the study of tendinopathy. Front Cell Dev Biol 2022; 10:1031638. [PMID: 36393858 PMCID: PMC9640604 DOI: 10.3389/fcell.2022.1031638] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022] Open
Abstract
Tendinopathy has a high incidence in athletes and the aging population. It can cause pain and movement disorders, and is one of the most difficult problems in orthopedics. Animal models of tendinopathy provide potentially efficient and effective means to develop understanding of human tendinopathy and its underlying pathological mechanisms and treatments. The selection of preclinical models is essential to ensure the successful translation of effective and innovative treatments into clinical practice. Large animals can be used in both micro- and macro-level research owing to their similarity to humans in size, structure, and function. This article reviews the application of large animal models in tendinopathy regarding injuries to four tendons: rotator cuff, patellar ligament, Achilles tendon, and flexor tendon. The advantages and disadvantages of studying tendinopathy with large animal models are summarized. It is hoped that, with further development of animal models of tendinopathy, new strategies for the prevention and treatment of tendinopathy in humans will be developed.
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Affiliation(s)
- Guorong Zhang
- School of Clinical Medicine, Changchun University of Chinese Medicine, Changchun, China
- School of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
| | - Xuyan Zhou
- School of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
| | - Shuang Hu
- School of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
| | - Ye Jin
- School of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
- *Correspondence: Ye Jin, ; Zhidong Qiu,
| | - Zhidong Qiu
- School of Pharmacy, Changchun University of Chinese Medicine, Changchun, China
- *Correspondence: Ye Jin, ; Zhidong Qiu,
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3
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Peeters I, Pien N, Mignon A, Van Damme L, Dubruel P, Van Vlierberghe S, Mantovani D, Vermeulen V, Creytens D, Van Tongel A, Schauvliege S, Hermans K, De Wilde L, Martens A. Flexor tendon repair using a reinforced tubular, medicated electrospun construct. J Orthop Res 2022; 40:750-760. [PMID: 33991020 DOI: 10.1002/jor.25103] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 04/20/2021] [Accepted: 05/10/2021] [Indexed: 02/04/2023]
Abstract
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.
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Affiliation(s)
- Ian Peeters
- Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nele Pien
- Polymer Chemistry & Biomaterials Research Group, Centre of Macromolecular Chemistry (CMaC), Ghent University, Ghent, Belgium
- Laboratory for Biomaterials and Bioengineering, Department of Min-Met-Materials Engineering & Regenerative Medicine, CHU de Quebec Research Center, Laval University, Quebec, Quebec, Canada
| | - Arn Mignon
- Polymer Chemistry & Biomaterials Research Group, Centre of Macromolecular Chemistry (CMaC), Ghent University, Ghent, Belgium
- KU Leuven, Smart Polymeric Biomaterials, Surface and Interface Engineered Materials, Leuven, Flanders, Belgium
| | - Lana Van Damme
- Polymer Chemistry & Biomaterials Research Group, Centre of Macromolecular Chemistry (CMaC), Ghent University, Ghent, Belgium
| | - Peter Dubruel
- Polymer Chemistry & Biomaterials Research Group, Centre of Macromolecular Chemistry (CMaC), Ghent University, Ghent, Belgium
| | - Sandra Van Vlierberghe
- Polymer Chemistry & Biomaterials Research Group, Centre of Macromolecular Chemistry (CMaC), Ghent University, Ghent, Belgium
| | - Diego Mantovani
- Laboratory for Biomaterials and Bioengineering, Department of Min-Met-Materials Engineering & Regenerative Medicine, CHU de Quebec Research Center, Laval University, Quebec, Quebec, Canada
| | - Valérie Vermeulen
- Faculty of Veterinary Medicine, Surgery and Anaesthesiology of Domestic Animals, Ghent University, Merelbeke, Belgium
| | - David Creytens
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Alexander Van Tongel
- Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Stijn Schauvliege
- Faculty of Veterinary Medicine, Surgery and Anaesthesiology of Domestic Animals, Ghent University, Merelbeke, Belgium
| | - Katleen Hermans
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lieven De Wilde
- Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ann Martens
- Faculty of Veterinary Medicine, Surgery and Anaesthesiology of Domestic Animals, Ghent University, Merelbeke, Belgium
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4
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Brebels J, Mignon A. Polymer-Based Constructs for Flexor Tendon Repair: A Review. Polymers (Basel) 2022; 14:polym14050867. [PMID: 35267690 PMCID: PMC8912457 DOI: 10.3390/polym14050867] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/15/2022] [Accepted: 02/20/2022] [Indexed: 02/04/2023] Open
Abstract
A flexor tendon injury is acquired fast and is common for athletes, construction workers, and military personnel among others, treated in the emergency department. However, the healing of injured flexor tendons is stretched over a long period of up to 12 weeks, therefore, remaining a significant clinical problem. Postoperative complications, arising after traditional tendon repair strategies, include adhesion and tendon scar tissue formation, insufficient mechanical strength for early active mobilization, and infections. Various researchers have tried to develop innovative strategies for developing a polymer-based construct that minimalizes these postoperative complications, yet none are routinely used in clinical practice. Understanding the role such constructs play in tendon repair should enable a more targeted approach. This review mainly describes the polymer-based constructs that show promising results in solving these complications, in the hope that one day these will be used as a routine practice in flexor tendon repair, increasing the well-being of the patients. In addition, the review also focuses on the incorporation of active compounds in these constructs, to provide an enhanced healing environment for the flexor tendon.
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5
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Zebiri H, Van Den Berghe H, Paunet T, Wolf-Mandroux A, Bethry A, Taillades H, Noel YJ, Pirot N, Botteron C, Chammas M, Chammas PE, Garric X. Preliminary in vivo study of biodegradables PLA-PEU-PLA anti-adhesion membranes in a rat Achilles tendon model of peritendinous adhesions. Biomater Sci 2022; 10:1776-1786. [DOI: 10.1039/d1bm01150b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Peritendinous adhesions are complications known to occur up to 6 weeks after surgery and cause chronic pain and disability. Anti-adhesion barriers are currently the best option for prevention. In a...
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6
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Song BR, Park IS, Park DY, Kim YJ, Kim MS, Lee KB, Park SR, Choi BH, Min BH. Anti-adhesive effect of chondrocyte-derived extracellular matrix surface-modified with poly-L-lysine (PLL). J Tissue Eng Regen Med 2021; 16:279-289. [PMID: 34788485 DOI: 10.1002/term.3263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 12/08/2022]
Abstract
After an injury, soft tissue structures in the body undergo a natural healing process through specific phases of healing. Adhesions occur as abnormal attachments between tissues and organs through the formation of blood vessels and/or fibrinous adhesions during the regenerative repair process. In this study, we developed an adhesion-preventing membrane with an improved physical protection function by modifying the surface of chondrocyte-derived extracellular matrices (CECM) with anti-adhesion function. We attempted to change the negative charge of the CECM surface to neutral using poly-L-lysine (PLL) and investigated whether it blocked fibroblast adhesion to it and showed an improved anti-adhesion effect in animal models of tissue adhesion. The surface of the membrane was modified with PLL coating (PLL 10), which neutralized the surface charge. We confirmed that the surface characteristics except for the potential difference were maintained after the modification and tested cell attachment in vitro. Adhesion inhibition was identified in a peritoneal adhesion animal model at 1 week and in a subcutaneous adhesion model for 4 weeks. N-CECM suppressed fibroblast and endothelial cell adhesion in vitro and inhibited abdominal adhesions in vivo. The CECM appeared to actively inhibit the infiltration of endothelial cells into the injured site, thereby suppressing adhesion formation, which differed from conventional adhesion barriers in the mode of action. Furthermore, the N-CECM remained intact without degradation for more than four weeks in vivo and exerted anti-adhesion effects for a long time. This study demonstrated that PLL10 surface modification rendered a neutral charge to the polymer on the extracellular matrix surface, thereby inhibiting cell and tissue adhesion. Furthermore, this study suggests a means to modify extracellular matrix surfaces to meet the specific requirements of the target tissue in preventing post-surgical adhesions. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Bo Ram Song
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea.,Department of Molecular Science & Technology, Ajou University, Suwon, Republic of Korea
| | - In Su Park
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea
| | - Do Young Park
- Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Young Jick Kim
- Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Moon Suk Kim
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea
| | - Kyi Beom Lee
- Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - So Ra Park
- Department of Physiology, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Byung Hyune Choi
- Department of Biomedical Sciences, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Byoung-Hyun Min
- Cell Therapy Center, Ajou University Medical Center, Suwon, Republic of Korea.,Department of Orthopedic Surgery, School of Medicine, Ajou University, Suwon, Republic of Korea.,Department of Molecular Science & Technology, Ajou University, Suwon, Republic of Korea
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7
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Li ZJ, Yang QQ, Zhou YL. Basic Research on Tendon Repair: Strategies, Evaluation, and Development. Front Med (Lausanne) 2021; 8:664909. [PMID: 34395467 PMCID: PMC8359775 DOI: 10.3389/fmed.2021.664909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/30/2021] [Indexed: 01/07/2023] Open
Abstract
Tendon is a fibro-elastic structure that links muscle and bone. Tendon injury can be divided into two types, chronic and acute. Each type of injury or degeneration can cause substantial pain and the loss of tendon function. The natural healing process of tendon injury is complex. According to the anatomical position of tendon tissue, the clinical results are different. The wound healing process includes three overlapping stages: wound healing, proliferation and tissue remodeling. Besides, the healing tendon also faces a high re-tear rate. Faced with the above difficulties, management of tendon injuries remains a clinical problem and needs to be solved urgently. In recent years, there are many new directions and advances in tendon healing. This review introduces tendon injury and sums up the development of tendon healing in recent years, including gene therapy, stem cell therapy, Platelet-rich plasma (PRP) therapy, growth factor and drug therapy and tissue engineering. Although most of these therapies have not yet developed to mature clinical application stage, with the repeated verification by researchers and continuous optimization of curative effect, that day will not be too far away.
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Affiliation(s)
- Zhi Jie Li
- Research for Frontier Medicine and Hand Surgery Research Center, The Nanomedicine Research Laboratory, Research Center of Clinical Medicine, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.,Medical School of Nantong University, Nantong, China
| | - Qian Qian Yang
- Research for Frontier Medicine and Hand Surgery Research Center, The Nanomedicine Research Laboratory, Research Center of Clinical Medicine, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.,Medical School of Nantong University, Nantong, China
| | - You Lang Zhou
- Research for Frontier Medicine and Hand Surgery Research Center, The Nanomedicine Research Laboratory, Research Center of Clinical Medicine, Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, China.,Medical School of Nantong University, Nantong, China
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8
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Rinoldi C, Kijeńska-Gawrońska E, Khademhosseini A, Tamayol A, Swieszkowski W. Fibrous Systems as Potential Solutions for Tendon and Ligament Repair, Healing, and Regeneration. Adv Healthc Mater 2021; 10:e2001305. [PMID: 33576158 PMCID: PMC8048718 DOI: 10.1002/adhm.202001305] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/19/2020] [Indexed: 02/06/2023]
Abstract
Tendon and ligament injuries caused by trauma and degenerative diseases are frequent and affect diverse groups of the population. Such injuries reduce musculoskeletal performance, limit joint mobility, and lower people's comfort. Currently, various treatment strategies and surgical procedures are used to heal, repair, and restore the native tissue function. However, these strategies are inadequate and, in some cases, fail to re-establish the lost functionality. Tissue engineering and regenerative medicine approaches aim to overcome these disadvantages by stimulating the regeneration and formation of neotissues. Design and fabrication of artificial scaffolds with tailored mechanical properties are crucial for restoring the mechanical function of tendons. In this review, the tendon and ligament structure, their physiology, and performance are presented. On the other hand, the requirements are focused for the development of an effective reconstruction device. The most common fiber-based scaffolding systems are also described for tendon and ligament tissue regeneration like strand fibers, woven, knitted, braided, and braid-twisted fibrous structures, as well as electrospun and wet-spun constructs, discussing critically the advantages and limitations of their utilization. Finally, the potential of multilayered systems as the most effective candidates for tendon and ligaments tissue engineering is pointed out.
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Affiliation(s)
- Chiara Rinoldi
- Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Warsaw, 02-507, Poland
| | - Ewa Kijeńska-Gawrońska
- Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Warsaw, 02-507, Poland
- Centre for Advanced Materials and Technologies CEZAMAT, Warsaw University of Technology, Warsaw, 02-822, Poland
| | - Ali Khademhosseini
- Department of Bioengineering, Department of Chemical and Biomolecular Engineering, Department of Radiology, California NanoSystems Institute (CNSI), University of California, Los Angeles, CA, 90095, USA
- Terasaki Institute for Biomedical Innovation (TIBI), Los Angeles, CA, 90024, USA
| | - Ali Tamayol
- Department of Biomedical Engineering, University of Connecticut, Farmington, CT, 06030, USA
| | - Wojciech Swieszkowski
- Materials Design Division, Faculty of Materials Science and Engineering, Warsaw University of Technology, Warsaw, 02-507, Poland
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9
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Zebiri H, Van Den Berghe H, Sayegh S, Chammas PE, Pompée C, Chammas M, Garric X. Synthesis of PLA-poly(ether urethane)-PLA copolymers and design of biodegradable anti-adhesive membranes for orthopaedic applications. J Mater Chem B 2021; 9:832-845. [PMID: 33347521 DOI: 10.1039/d0tb02545c] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Peritendinous adhesions cause chronic pain and disability. Leading causes are trauma to tendons and surrounding tissues and immobilization after surgery. Adhesions occur between 24 hours to 6 weeks after surgery. Anti-adhesion barriers are currently the best option available to prevent peritendinous adhesions, but are ineffective and difficult to use. We developed an anti-adhesive membrane that can be easily applied during tendon surgery and effectively prevent adhesions. The membrane is based on a new triblock copolymer, is non-toxic, can be bio-eliminated, and has a degradation rate of more than 6 weeks for optimal anti-adhesion effect. We synthesized and characterized poly(ether urethane) (PEU) from poly(ethylene glycol). Triblock copolymers poly(lactic acid)-PEU-poly(lactic acid) (PLA-PEU-PLA) were then synthesized from PEU with PLA blocks of different lengths, and characterized. The membranes were shaped by hot molding and their mechanical properties, contact angle, water uptake, the kinetics of in vitro degradation and cytotoxicity were studied. Mechanical properties were developed according to the needs of orthopaedic surgeons. Results showed that membranes maintained their filmogenic integrity, have a degradation rate for optimal adhesion prevention, can be bioeliminated and biocompatible suggesting that they could be safely and effectively used as anti-adhesion orthopaedic devices. These results support the use of PLA-PEU-PLA membranes as a medical device, however, the effectiveness of the membranes in vivo needs to be further evaluated. A future study using an in vivo rat model of postoperative peritendinous adhesions is currently being developed.
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Affiliation(s)
- Hadda Zebiri
- Institut des Biomolécules Max Mousseron (IBMM), UMR 5247, CNRS, Université Montpellier, ENSCM, Faculté de Pharmacie, Bâtiment I, 15 Avenue Charles Flahault, BP14491, 34093 Montpellier Cedex 5, France.
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10
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Advances in the Development of Anti-Adhesive Biomaterials for Tendon Repair Treatment. Tissue Eng Regen Med 2020; 18:1-14. [PMID: 33150560 PMCID: PMC7862451 DOI: 10.1007/s13770-020-00300-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Peritendinous adhesion that simultaneous with tendon healing link the healing tendon to the surrounding tissue. It results in functional disability, and has a significant adverse impact on health as well as social and economic development. Methods: Based on a search in the PubMed and Web of Science database, the research articles were screened by their time, main idea, impact factor index, while the ones with no credibility were excluded. Afterwards, we go through the analysis of the reliability and characteristics of the results were further screened from selected articles. Results: A total of 17 biomaterials used to evaluate the adhesion mechanism and the properties of the material were found. All of these biomaterials contained randomized controlled studies and detailed descriptions of surgical treatment that support the reliability of their results which indicates that biomaterials act as barriers to prevent the formation of adhesion, and most of them exhibit satisfactory biocompatibility, biodegradability or selective permeability. Moreover, a few had certain mechanical strength, anti-inflammatory, or carrier capacities. However, there still existed some defects, such as time, technology, clinical trials, material targeting and different measurement standards which also lowered the reliability of their results. Conclusion: In future, anti-adhesion biomaterials should focus on affordable raw materials with wide sources, and the production process should be simplified, in this way, the versatility and targeting of materials will be improved.
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11
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Liang Y, Xu K, Zhang P, Zhang J, Chen P, He J, Fang Y, Zhou Y, Wang J, Bai J. Quercetin reduces tendon adhesion in rat through suppression of oxidative stress. BMC Musculoskelet Disord 2020; 21:608. [PMID: 32917186 PMCID: PMC7488677 DOI: 10.1186/s12891-020-03618-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/31/2020] [Indexed: 11/27/2022] Open
Abstract
Background Tendon adhesion is one of the most common clinical problems, which poses a considerable challenge to orthopedics doctors. Quercetin (QUE) as a popular drug at present, it has various biological functions, including anti-inflammatory, anti-ischemic, anti-peroxidation, and antioxidant. The purpose of this study was to investigate the effect of quercetin on tendon adhesion and whether quercetin can inhibit oxidative stress. Method Thirty-six rats were randomly divided into three groups, including control group, low QUE (50 mg/kg/day) group, and high QUE (100 mg/kg/day) group. After 1 week, the levels of SOD, MDA and GPx were measured. The degree of tendon adhesion was assessed by macroscopic evaluation and histological evaluation. After 4 weeks. Besides, the pharmacological toxicity of quercetin to main organs were evaluated by histological analysis. Results The extent of superoxide dismutase (SOD) and glutathione peroxidase (GPx) of tendon tissue in high QUE group was significantly higher than those of low QUE group and control group. And the extent of malondialdehyde (MDA) of tendon tissue in high QUE group was significantly lower than that of low QUE group and control group. By macroscopic evaluation and histological analysis, the extent of tendon adhesion in high QUE group was lower than low QUE group and control group. However, there were no significant changes of the major organs through histological analysis. Conclusions Quercetin may be a good and safe strategy in preventing tendon adhesion. But further clinical research is needed before its recommendation in the prevention and treatment of tendon adhesion.
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Affiliation(s)
- Yuan Liang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China
| | - Keteng Xu
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China
| | - Pei Zhang
- Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jiale Zhang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China
| | - Pengtao Chen
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China
| | - Jinshan He
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China
| | - Yongchao Fang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China
| | - Yuelai Zhou
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China
| | - Jingcheng Wang
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital, Nantong West Road 98, Yangzhou, 225001, China.
| | - Jianzhong Bai
- Department of Orthopedics, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China.
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12
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Alimohammadi M, Aghli Y, Fakhraei O, Moradi A, Passandideh-Fard M, Ebrahimzadeh MH, Khademhosseini A, Tamayol A, Mousavi Shaegh SA. Electrospun Nanofibrous Membranes for Preventing Tendon Adhesion. ACS Biomater Sci Eng 2020; 6:4356-4376. [PMID: 33455173 DOI: 10.1021/acsbiomaterials.0c00201] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Tendon injuries are frequent, and surgical interventions toward their treatment might result in significant clinical complications. Pretendinous adhesion results in the disruption of the normal gliding mechanism of a damaged tendon, painful movements, and an increased chance of rerupture in the future. To alleviate postsurgical tendon-sheath adhesions, many investigations have been directed toward the development of repair approaches using electrospun nanofiber scaffolds. Such methods mainly take advantage of nanofibrous membranes (NFMs) as physical barriers to prevent or minimize adhesion of a repaired tendon to its surrounding sheath. In addition, these nanofibers can also locally deliver antiadhesion and anti-inflammatory agents to reduce the risk of tendon adhesion. This article reviews recent advances in the design, fabrication, and characterization of nanofibrous membranes developed to serve as (i) biomimetic tendon sheaths and (ii) physical barriers. Various features of the membranes are discussed to present insights for further development of repair methods suitable for clinical practice.
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Affiliation(s)
- Mahdieh Alimohammadi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Mechanical Engineering, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Yasaman Aghli
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,LadHyx, École Polytechnique, Palaiseau, France
| | - Omid Fakhraei
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Moradi
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Ali Khademhosseini
- Department of Bioengineering, University of California-Los Angeles, Los Angeles, California 90095, United States of America.,Center for Minimally invasive Therapeutics (C-MIT), University of California-Los Angeles, Los Angeles, California 90095, United States of America.,Department of Radiology, University of California-Los Angeles, Los Angeles, California 90095, United States of America.,Department of Chemical and Biomolecular Engineering, University of California-Los Angeles, Los Angeles, California 90095, United States of America.,Terasaki Institute for Biomedical Innovation, Los Angeles, California 90024, United States of America
| | - Ali Tamayol
- University of Connecticut Health Center, Farmington, Connecticut 06030, United States of America
| | - Seyed Ali Mousavi Shaegh
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
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Nguyen PK, Baek K, Deng F, Criscione JD, Tuan RS, Kuo CK. Tendon Tissue-Engineering Scaffolds. Biomater Sci 2020. [DOI: 10.1016/b978-0-12-816137-1.00084-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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