Development of biodegradable polycaprolactone film as an internal fixation material to enhance tendon repair: an in vitro study

BMC Musculoskeletal Disorders

Hong-Bin Lu³  Li-Hua Huang¹  Yong-Chun Zhou²  Jian-Zhong Hu² 

[1] Center for Medical Experiments, Third Xiangya Hospital, Central South University, Changsha 410013, China;Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha 410008, China;Department of Sports Medicine, Research Center of Sports Medicine, Xiangya Hospital, Central South University, Changsha 410008, China

关键词: Microstructure;    Biomechanics;    Internal fixation;    Tendon injury;   

Others  :  1129959
DOI  :  10.1186/1471-2474-14-246

 received in 2013-01-23, accepted in 2013-08-06,  发布年份 2013

【 摘 要 】

Background

Current tendon repair techniques do not provide sufficient tensile strength at the repair site, and thus early active motion rehabilitation after tendon repair is discouraged. To enhance the post-operative tensile strength, we proposed and tested an internal fixation technique using a polycaprolactone (PCL) biofilm. PCL was chosen for its good biocompatibility, excellent mechanical strength, and an appropriate degradation time scale.

Methods

PCL biofilms were prepared by a modified melt-molding/leaching technique, and the physical and mechanical properties and in vitro degradation rate were assessed. The pore size distribution of the biofilm and the paratenon of native tendons were observed using scanning electron microscopy. Next, we determined whether this biofilm could enhance the tensile strength of repaired tendons. We performed tensile tests on rabbit Achilles tendons that were first lacerated and then repaired: 1) using modified Kessler suture combined with running peripheral suture (‘control’ group), or 2) using biofilm to wrap the tendon and then fixation with sutures (‘biofilm’ group). The influence of different repair techniques on tendon tensile strength was evaluated by mechanical testing.

Results

The novel biofilm had supple texture and a smooth surface. The mean thickness of the biofilm was 0.25 mm. The mean porosity of the biofilm was 45.3%. The paratenon of the rabbit Achilles tendon had pores with diameters ranging from 1 to 9 μm, which were similar to the 4–12 μm diameter pores in the biofilm cross-section. The weight loss of the biofilms at 4 weeks was only 0.07%. The molecular weight of PCL biofilms did not change after immersion in phosphate buffered saline for 4 weeks. The failure loads of the biofilm were similar before (48 ± 9 N) and after immersion (47 ± 7 N, P > 0.1). The biofilm group had ~70% higher mean failure loads and 93% higher stiffness compared with the control group.

Conclusions

We proposed and tested an internal fixation technique using a PCL biofilm to enhance tendon repair. Internal fixation with the biofilm followed by standard suturing can significantly increase the tensile strength of tendon repair sites. This technique has the potential to allow active motion rehabilitation during the early post-operative period.

【 授权许可】

   
2013 Hu et al.; licensee BioMed Central Ltd.

【 图 表 】

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