Enhanced tendon-to-bone repair through adhesive films.

Enhanced tendon-to-bone repair through adhesive films.
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DOI:
10.1016/j.actbio.2018.01.032
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发表时间:
2018-04-01
期刊:
影响因子:
9.7
通讯作者:
Thomopoulos S
Thomopoulos S
中科院分区:
工程技术1区
文献类型:
--
作者:
Linderman SW;Golman M;Gardner TR;Birman V;Levine WN;Genin GM;Thomopoulos S

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肌腱到骨的外科修复的失败率高得令人无法接受,可能是因为它们不能重现天然吻合处的负荷转移机制。手术修复不是将载荷分布在广泛的附着区,而是将剪应力集中在少数缝合锚点上。这推动了将剪应力从缝合线锚定分布到整个假体足迹的技术的发展。在这里,我们提供了预测和概念验证实验,表明机械优化的粘接膜可以模拟健康附着的自然负荷传递机制,并增加修复的负荷耐受性。基于有限元分析证实的剪滞模型的力学优化表明,相对高强度和低刚度的粘结剂理论上可以加强肌腱到骨的修复10倍以上。使用肌腱和骨板的搭接剪切测试验证了力学模型在一系列粘接硬度和强度方面的有效性。使用多组分粘合剂对身体组织进行体外修复的人体冈上肌显示出强度的显著增加。结果表明,粘结剂强化修复可以提高修复强度,并促使人们寻找最佳粘结剂。
Tendon-to-bone surgical repairs have unacceptably high failure rates, possibly due to their inability to recreate the load transfer mechanisms of the native enthesis. Instead of distributing load across a wide attachment footprint area, surgical repairs concentrate shear stress on a small number of suture anchor points. This motivates development of technologies that distribute shear stresses away from suture anchors and across the enthesis footprint. Here, we present predictions and proof-of-concept experiments showing that mechanically-optimized adhesive films can mimic the natural load transfer mechanisms of the healthy attachment and increase the load tolerance of a repair. Mechanical optimization, based upon a shear lag model corroborated by a finite element analysis, revealed that adhesives with relatively high strength and low stiffness can, theoretically, strengthen tendon-to-bone repairs by over 10-fold. Lap shear testing using tendon and bone planks validated the mechanical models for a range of adhesive stiffnesses and strengths. Ex vivo human supraspinatus repairs of cadaveric tissues using multipartite adhesives showed substantial increase in strength. Results suggest that adhesive-enhanced repair can improve repair strength, and motivate a search for optimal adhesives.
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影响因子: --
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