Reduction of Peritendinous Adhesions by Hydrogel Containing Biocompatible Phospholipid Polymer MPC for Tendon Repair
Reduction of Peritendinous Adhesions by Hydrogel Containing Biocompatible Phospholipid Polymer MPC for Tendon Repair
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DOI：
10.2106/jbjs.i.01634
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发表时间：
2011-01-19
影响因子：
5.3
通讯作者：
Kawaguchi, Hiroshi
中科院分区：
文献类型：
--
作者：
Ishiyama, Noriyuki;Moro, Toru;Kawaguchi, Hiroshi
背景：腱周粘连是肌腱手术修复后的严重并发症。作为抗粘连材料，我们专注于2-甲基丙烯酰氧基乙基磷酰胆碱（MPC）聚合物，我们最初的生物相容性聚合物，并制备了一种含MPC的聚合物的水溶液，称为聚（2-甲基丙烯酰氧基乙基磷酰胆碱-co-n-butyl methacrylate-co-p-vinylphenylboronic acid）（PMBV），它可以通过与另一种水性聚合物聚（乙烯醇）（PVA）混合形成水凝胶性能。本研究的目的是探讨MPC水凝胶的可能应用，减少肌腱周围粘连，肌腱愈合的影响进行了检查，通过组织学和力学分析，在大鼠跟腱模型和兔屈趾深肌腱模型的水凝胶。结果：2.5%和5.0%PMBV与2.5%PVA混合后立即形成水凝胶，并在植入后3周内保持具有纳米级孔的蜂窝状微结构。在动物模型中，由5.0%PMBV形成的水凝胶在长达三周的关键期内保留在缝合部位，并在六周时消失。MPC水凝胶在三周时在组织学上和机械上减少腱周粘连>25%，而不损害肌腱愈合，如通过机械分析所确定的。在细胞培养中，细胞迁移减少的MPC水凝胶，虽然细胞活力是不受影响的，表明物理预防，而不是细胞毒性，是抗adhesionmechanism.Conclusions：MPC水凝胶，这是由两种水溶液，5.0%PMBV和2：5%PVA的混合物，局部注射和形成，减少肌腱周围粘连，而不损害肌腱愈合。这种效果可能是由于其优异的生物相容性而没有异物反应，并且形成了物理上阻止细胞通过但允许细胞因子和生长因子通过以进行愈合的微观结构。
Background: Peritendinous adhesions are serious complications after surgical repair of tendons. As an anti-adhesion material, we focused on 2-methacryloyloxyethyl phosphorylcholine (MPC) polymer, our original biocompatible polymer, and prepared an aqueous solution of MPC-containing polymer called poly(2-methacryloyloxyethyl phosphorylcholine-co-n-butyl methacrylate-co-p-vinylphenylboronic acid) (PMBV), which can be formed into hydrogel properties by mixture with another aqueous polymer, poly(vinyl alcohol) (PVA). The objective of the present study was to examine the possible application of the MPC hydrogel for the reduction of peritendinous adhesions.Methods: The effects of the hydrogel on peritendinous adhesions and tendon healing were examined by means of histological and mechanical analyses in a rat Achilles tendon model and a rabbit flexor digitorum profundus tendon model. Cell migration and viability were examined with use of fibroblastic NIH3T3 cells cultured in a double chamber dish.Results: Among the concentrations examined, 2.5% and 5.0% PMBV formed hydrogel properties immediately after mixing with 2.5% PVA and maintained a honeycomb microstructure with nanometer-scaled pores for three weeks after implantation. In animal models, the hydrogel formed from 5.0% PMBV remained at the sutured site during the critical period up to three weeks and disappeared by six weeks. The MPC hydrogel reduced the peritendinous adhesions histologically and mechanically by >25% at three weeks, without impairing tendon healing as determined with mechanical analyses. In the cell culture, cell migration was reduced by the MPC hydrogel, although cell viability was unaffected, indicating physical prevention, rather than cytotoxicity, to be the anti-adhesion mechanism.Conclusions: The MPC hydrogel that was formed by a local injection and mixture of two aqueous solutions, 5.0% PMBV and 2:5% PVA, reduced peritendinous adhesions without impairing tendon healing. This effect may be due to its excellent biocompatibility without a foreign-body reaction and the formation of a microstructure that physically prevents passage of cells but allows cytokines and growth factors to pass for healing.