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3D printing and testing of rose thorns or limpet teeth inspired anchor device for tendon tissue repair

Rodriguez Reinoso Mariana, Civera Marco, Burgio Vito, Bergamin Federic, Ruiz Oliver Grimaldo, Pugno Nicola Maria, Surace Cecilia

Acta of Bioengineering and Biomechanics

2021

Vol. 23, no. 4

63--74

Purposes: Advancements in medical technology have enabled medical specialists to resolve significant problems concerning tendon injuries. However, despite the latest improvements, surgical tendon repair remains challenging. This study aimed to explore the capabilities of the current state-of-the-art technologies for implantable devices. Methods: After performing extensive patent landscaping and literature review, an anchored tissue fixation device was deemed the most suitable candidate. This design was firstly investigated numerically, realizing a Finite Element Model of the device anchored to two swine tendons stumps, to simulate its application on a severed tendon. Two different hook designs, both bio-inspired, were tested while retaining the same device geometry and anchoring strategy. Then, the applicability of a 3D-printed prototype was tested on swine tendons. Finally, the device-tendon stumps ensemble was subjected to uniaxial tensile tests. Results: The results show that the investigated device enables a better load distribution during the immobilized limb period in comparison to standard suture-based approaches, yet it still presents several design flaws. Conclusions: The current implantable solutions do not ensure an optimal result in terms of strength recovery. This and other weak points of the currently available proposals will serve as a starting point for future works on bio-inspired implantable devices for tendon repair.

Comparison of different suture techniques for Achilles tendon repair in rat model using collagen scaffolds

Gabler C., Gierschner S., Tischer T., Bader R.

Acta of Bioengineering and Biomechanics

2018

Vol. 20, no. 2

73--77

Tendon injury is an increasing problem in medicine due to aging of the population and increased activity demands. Many rodent animal models are used in order to evaluate tendon reconstruction. Although tendon reruptures are a known problem, the outcomes of tendon repair in animal models are rarely discussed in the literature. The goal of the present experimental study was to compare the primary fixation stability of three suture techniques for repair of Achilles tendon defects in a rat model using a collagen scaffold. Methods: Cadaveric left hind limbs of Sprague-Dawley rats were prepared with an Achilles tendon defect of 3 mm and rejoined using a collagen scaffold. Three suture configurations (simple, simple stitch with additional framing suture, and modified Mason–Allen stitch; n = 5 each) underwent tensile testing until complete failure was observed. Results: Under a load of a mean value of 6.6 N, the failure load of simple stitches was the significantly lowest ( p < 0.01). Both, modified Mason–Allen stitches and simple stitches with additional framing suture showed a mean failure load of more than 14 N. Regardless of the suture technique, most of the samples showed failure of tendon due to suture tear-out. The suture material as well as the scaffold remained mostly intact. Conclusions: Although simple end-toend suture techniques are common in the literature, stitches with more suture strands should be preferred. Using techniques like an additional framing suture or modified Mason–Allen stitch, maximum failure load can be doubled and the risk of tendon rerupture may be decreased in vivo.

In vivo characterization poly-L/D-lactide (PLDLA) 96/4 sutures in the Achilles tendon of rabbits

Kangas J., Palaja A., Leppilahti J., Ryhanen J., Lansman S., Tormala P., Waris T., Ashammakhi N.

Inżynieria Biomateriałów

2004

R. 7, nr 38-42

10-11