The frequency with which tendon ruptures occur is increasing due to medical advances that allow an aging population to remain physically active longer than previously possible. There is a great deal of controversy in the orthopaedic community regarding the most effective way to treat such injuries. While progress has been made in improving the method of fixation of torn tendons, further advancements are needed to allow for earlier and more aggressive rehabilitation with fewer complications such as rerupture or tendon stretching. Some tendon repair techniques include use of a graft to reinforce conventional primary suture repair of the rupture. These grafts are secured to the injured tissues at only a few points via suture. Thus, loads in the tendon are concentrated at these suture points, as well as at the primary repair suture site. By securing the graft to the repair, and distributing the load over the entire graft/tendon interface, the patient can potentially begin postoperative rehabilitation much sooner. Early mobilization has been found to be critical in regenerating well-organized and functional tendons. Marine mussels provide the inspiration for the new technology presented in this proposal. By releasing rapidly hardening, tightly binding adhesive proteins, marine mussels have the ability to anchor themselves to various surfaces in a wet, turbulent, and saline environment. Both natural proteins and their synthetic mimics have been shown to bind strongly to various substrates ranging from metal surfaces to biological tissues. In this proposal, biomimetic synthetic adhesives will be combined with natural scaffolds to create a novel bioadhesive membrane. The intent is to secure such a construct over the entire surface area of a ruptured tendon, reinforcing traditional suture repair, and creating a repair that is stronger than with sutures alone. The feasibility of using such a construct as an augmentation device for tendon repair will be developed and tested.
The incidence of tendon injuries has been increasing over the past several decades. Tendon ruptures require a prolonged period of recovery, and dramatically affect a patient's quality of life. Numerous surgical and rehabilitative treatments have been introduced, but none have been overwhelmingly successful and widely accepted. In an effort to enhance and accelerate tendon healing, a novel bioadhesive membrane construct to augment tendon repair is proposed and developed herein.
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