Bioadhesive Membrane Constructs to Augment Tendon Repair

描述(由申请人提供)：肌腱损伤的发生频率正在增加，这是由于医学的进步，使日益老龄化的人口能够比以前更长时间地保持身体活动。对于治疗此类损伤的最佳和最有效的方法，骨科学界存在着很大的争议。虽然在改进撕裂肌腱的固定方法方面取得了进展，但仍需要进一步改进目前采用的方法，以实现更早的康复，并减少术后疼痛、手术并发症和修复组织复发的发生率。传统的增强方法仅通过缝合将受损组织和/或移植物固定在几个点上，从而在缝合部位施加很大的张力。通过更好地将移植物固定到修复，并分散整个移植物表面的张力，患者可能会更早地开始术后康复。早期活动被发现对于再生组织良好和有功能的肌腱(肌腱中的纤维)至关重要。海洋贻贝为这项提案中提出的新技术提供了灵感。通过释放快速硬化、紧密结合的黏附蛋白，海洋贻贝能够在潮湿、动荡和盐碱的环境中将自己锚定在各种表面上。从生物组织到金属表面，天然蛋白质及其合成的模拟物都能与各种底物强烈结合。在这项计划中，仿生合成粘合剂将与天然支架相结合，创建一种新型的生物粘附膜。这种构造的目的是通过将材料固定在被修复的整个表面区域来创建比单独缝合更牢固的修复。使用这种材料作为肌腱修复的增强装置的可行性将得到测试。与公共卫生相关：肌腱损伤在过去几十年里一直在以越来越普遍的方式发生。目前的固定方法和材料都取得了好坏参半的效果，但每种方法都有局限性。本文介绍了一种用于肌腱修复的新型生物粘附膜的研制和评价。

DESCRIPTION (provided by applicant): The frequency with which tendon injuries are occurring is increasing due to medical advances that allow an increasingly aging population to remain physically active longer than previously possible. There is a great deal of controversy among the orthopedic community regarding the best and most effective method of treating such injuries. While progress has been made in improving the method of fixation of torn tendons, there remains a need to further enhance the currently employed methods to allow for earlier rehabilitation and fewer incidences of post-operative pain, surgical complications, and rerupture of the repaired tissues. Conventional methods of augmentation secure the injured tissue and/or graft at only a few points via suture, thus placing a great strain at the suture sites. By better securing the graft to the repair, and dispersing the tension over the entire graft surface, the patient can potentially begin post-operative rehabilitation much sooner. Early mobilization has been found to be critical in regenerating well-organized and functional (fibers in) tendons. Marine mussels provided 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 biological tissues to metal surfaces. In this proposal, biomimetic synthetic adhesives will be combined with a natural scaffold to create a novel bioadhesive membrane. The intent of such a construct is to create a repair that is stronger than sutures alone by securing the material over the entire surface area being repaired. The feasibility of using such a material as an augmentation device for tendon repair will be tested. PUBLIC HEALTH RELEVANCE: Injuries of tendons have been occurring with increasing prevalence over the last several decades. Current fixation methods and materials have exhibited mixed success, but each has limitations. The development and evaluation of a novel bioadhesive membrane construct to augment tendon repair is described here.