A durable load bearing muscle to prosthetic coupling
A durable load bearing muscle to prosthetic coupling
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DOI：
10.1097/01.mat.0000065369.46216.9c
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发表时间：
2003-05-01
期刊：
影响因子：
4.2
通讯作者：
Clarson, SJ
中科院分区：
文献类型：
--
作者：
Melvin, DB;Klosterman, B;Clarson, SJ
骨骼肌已经成功地与动力机械支持装置紧密相连。然而，所需的承重肌肉与假体界面并不持久。组织可能根本无法承受所产生的重复压力，当必要的力满足缝线或夹钳固定可触及的横截面积时，压力范围为40，000 mm Hg。通过在远端肌肉物质中分散超细聚合物纤维来显著增加力传递表面是称为MyoCoupler的耦合装置的原理。早些时候，有效的力传递是通过计算预测的，并在30天的家兔试验中得到证实，拔出强度是所需的几倍。这项研究测试了较长时间后的粘合强度，并检查了假设的纤维组织整合。将器械和对照品（单独支撑缝线固定）对侧植入28只家兔的胫骨后肌中长达90天。在28只家兔中，21只用于粘合强度试验，3只用于组织学试验。10-30天（n = 7）、31-60天（n = 10）、61-90天（n = 4）和所有（n = 21）的拔出强度水平分别为107.1 +/- 58.1、111.4 +/- 42.7、97.0 +/- 21.3、MyoCoupler为107.2 +/- 43.9，对照动物为58.4 +/- 19.4、52.3 +/- 34.7、40.5 +/- 13.0和52.1 +/- 26.9。差异具有统计学显著性（配对数据的单尾West），并且每个连续时期的概率标准逐渐提高（10-30天p < 0.05，31-60天p <0.01，90天p < 0.001，所有p < 0.00001）。组织学显示纤维组织浸润。在360个随机纤维表面位点中，88%的位点比其他纤维更接近纤维组织结构。这些发现支持了对人工心脏、辅助装置和心脏壁致动器的肌肉动力机制的积极追求。
Skeletal muscles have been successfully linked to power mechanical support devices acutely. However, the required load bearing muscle to prosthetic interfaces have not been consistently durable. Tissue simply may not tolerate the repetitive pressure generated, ranging to 40,000 mm Hg when necessary forces meet the cross-sectional areas accessible by suture or clamp fixation. Dramatically increasing the force transfer surface by dispersing ultrafine polymer fibers in the distal muscle substance is the principle of a coupling device termed the MyoCoupler. Earlier, effective force transfer was computationally projected and confirmed in a pilot 30 day rabbit trial, with pull-out strength several times need. This investigation tested bonding strength after longer periods and examined the postulated fiber tissue integration. Devices and controls (buttressed suture fixation alone) were implanted contralaterally in the posterior tibial muscles of 28 rabbits for up to 90 days. Of the 28 rabbits, 21 were used for bond strength testing, and 3 were used for histology. Infection or procedural error disqualified 4 of the rabbits.Pull-out strength levels at 10-30 days (n = 7), 31-60 days (n = 10), 61-90 days (n = 4), and all (n = 21) were, respectively, 107.1 +/- 58.1, 111.4 +/- 42.7, 97.0 +/- 21.3, and 107.2 +/- 43.9 for MyoCouplers and 58.4 +/- 19.4, 52.3 +/- 34.7, 40.5 +/- 13.0, and 52.1 +/- 26.9 for the control animals. Differences were statistically significant (one-tailed West for paired data) and at progressively higher standards of probability for each successive period (p < 0.05 at 10-30 days, p < 0.01 at 31-60 days, p < 0.001 at 90 days, and p < 0.00001 for all). Histology showed fibrous tissue insinuation. Of 360 random fiber surface sites, 88% were closer to fibrous tissue structures than to other fibers. These findings support the aggressive pursuit of muscle powered mechanisms for artificial hearts, assist devices, and heart wall actuators.