Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom.
NIHR Biomedical Research Centre, Oxford, United Kingdom.
PLoS One. 2020 Jun 26;15(6):e0234982. doi: 10.1371/journal.pone.0234982. eCollection 2020.
Rotator cuff tendon repair in humans is a commonly performed procedure aimed at restoring the tendon-bone interface. Despite significant innovation of surgical techniques and suture anchor implants, only 60% of repairs heal successfully. One strategy to enhance repair is the use of bioactive sutures that provide the native tendon with biophysical cues for healing. We investigated the tissue response to a multifilament electrospun polydioxanone (PDO) suture in a sheep tendon injury model characterised by a natural history of failure of healing.
Eight skeletally mature English Mule sheep underwent repair with electrospun sutures. Monofilament sutures were used as a control. Three months after surgery, all tendon repairs healed, without systemic features of inflammation, signs of tumour or infection at necropsy. A mild local inflammatory reaction was seen. On histology the electrospun sutures were densely infiltrated with predominantly tendon fibroblast-like cells. In comparison, no cellular infiltration was observed in the control suture. Neovascularisation was observed within the electrospun suture, whilst none was seen in the control. Foreign body giant cells were rarely seen with either sutures.
This study demonstrates that a tissue response can be induced in tendon with a multifilament electrospun suture with no safety concerns.
在人类中，修复肩袖肌腱是一种常见的手术，旨在恢复肌腱-骨界面。尽管手术技术和缝线锚钉植入物有了重大创新，但只有 60%的修复能够成功愈合。一种增强修复的策略是使用提供天然肌腱愈合生物物理线索的生物活性缝线。我们研究了多纤维电纺聚对二氧环己酮（PDO）缝线在羊肌腱损伤模型中的组织反应，该模型具有愈合失败的自然病史。
8 只骨骼成熟的英国骡子羊接受了电纺缝线修复。单丝缝线用作对照。手术后 3 个月，所有肌腱修复均愈合，无全身性炎症特征、肿瘤或尸检时感染的迹象。可见轻度局部炎症反应。组织学上，电纺缝线被主要是肌腱成纤维细胞样的细胞密集浸润。相比之下，对照缝线中未观察到细胞浸润。电纺缝线内可见新生血管形成，而对照缝线中未见。两种缝线均很少见到异物巨细胞。
这项研究表明，多纤维电纺缝线可以在肌腱中引起组织反应，且无安全问题。
