Sensory & Motor System Medicine, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8655, Japan.
J Bone Joint Surg Am. 2011 Jan 19;93(2):142-9. doi: 10.2106/JBJS.I.01634.
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.
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.
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.
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.
this nanotechnology could potentially improve the quality of surgical repair of tendon, especially the zone-II area of the digital flexor tendon.
腱修复术后腱周粘连是一种严重的并发症。作为一种防粘连材料，我们专注于 2-（甲基丙烯酰氧）乙基磷酸胆碱（MPC）聚合物，这是我们原有的生物相容性聚合物，并制备了一种含有 MPC 的聚合物水溶液，称为聚（2-（甲基丙烯酰氧）乙基磷酸胆碱-co-n-丁基甲基丙烯酸酯-co-p-乙烯基苯硼酸）（PMBV），它可以与另一种水溶性聚合物聚（聚乙烯醇）（PVA）混合形成水凝胶特性。本研究的目的是研究 MPC 水凝胶在减少腱周粘连方面的可能应用。
通过组织学和机械分析，在大鼠跟腱模型和兔屈肌腱深屈肌腱模型中研究水凝胶对腱周粘连和腱愈合的影响。用在双室培养皿中培养的成纤维细胞 NIH3T3 细胞研究细胞迁移和活力。
在所检查的浓度中，2.5%和 5.0%的 PMBV 在与 2.5%的 PVA 混合后立即形成水凝胶特性，并在植入后三周内保持具有纳米级孔的蜂窝状微观结构。在动物模型中，由 5.0%PMBV 形成的水凝胶在关键时期内保持在缝合部位，直到三周，六周后消失。MPC 水凝胶在三周时通过组织学和机械学降低了 >25%的腱周粘连，而不会通过机械分析损害腱愈合。在细胞培养中，MPC 水凝胶减少了细胞迁移，尽管细胞活力不受影响，表明其抗粘连机制是物理预防，而不是细胞毒性。
通过局部注射和两种水溶液（5.0%PMBV 和 2.5%PVA）的混合形成的 MPC 水凝胶可减少腱周粘连，而不损害腱愈合。这种效果可能是由于其具有优异的生物相容性，没有异物反应，形成了一种微观结构，物理上阻止细胞通过，但允许细胞因子和生长因子通过以促进愈合。
这项纳米技术有可能改善肌腱修复的质量，特别是数字屈肌腱的 II 区。
