title: The effect of collagen nerve conduits filled with collagen-glycosaminoglycan matrix on peripheral motor nerve regeneration in a rat model.
abstract: BACKGROUND
  Bioabsorbable unfilled synthetic nerve conduits have been used in the reconstruction of small segmental nerve defects with variable results, especially in motor nerves. We hypothesized that providing a synthetic mimic of the Schwann cell basal lamina in the form of a collagen-glycosaminoglycan (GAG) matrix would improve the bridging of the nerve gap and functional motor recovery.
  
  
  METHODS
  A unilateral 10-mm sciatic nerve defect was created in eighty-eight male Lewis rats. Animals were randomly divided into four experimental groups: repair with reversed autograft, reconstruction with collagen nerve conduit (1.5-mm NeuraGen, Integra LifeSciences), reconstruction with collagen nerve conduit filled with collagen matrix, and reconstruction with collagen nerve conduit filled with collagen-GAG (chondroitin-6-sulfate) matrix. Nerve regeneration was evaluated at twelve weeks on the basis of the compound muscle action potential, maximum isometric tetanic force, and wet muscle weight of the tibialis anterior muscle, the ankle contracture angle, and nerve histomorphometry.
  
  
  RESULTS
  The use of autograft resulted in significantly better motor recovery compared with the other experimental methods. Conduit filled with collagen-GAG matrix demonstrated superior results compared with empty conduit or conduit filled with collagen matrix with respect to all experimental parameters. Axon counts in the conduit filled with collagen-GAG matrix were not significantly different from those in the reversed autograft at twelve weeks after repair.
  
  
  CONCLUSIONS
  The addition of the synthetic collagen basal-lamina matrix with chondroitin-6-sulfate into the lumen of an entubulation repair significantly improved bridging of the nerve gap and functional motor recovery in a rat model.
  
  
  CONCLUSIONS
  Use of a nerve conduit filled with collagen-GAG matrix to bridge a motor or mixed nerve defect may result in superior functional motor recovery compared with commercially available empty collagen conduit. However, nerve autograft remains the gold standard for reconstruction of a segmental motor nerve defect.
authors.affiliation: Department of Orthopedic Surgery, St. Vincent's Hospital, The Catholic University of Korea, 93 Ji-dong, Paldal-gu, Suwon 442-723, South Korea. jylos1@gmail.com
authors.forename: Joo-Yup
authors.initials: JY
authors.lastname: Lee
authors.forename: Guilherme
authors.initials: G
authors.lastname: Giusti
authors.forename: Patricia F
authors.initials: PF
authors.lastname: Friedrich
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Archibald
authors.forename: John E
authors.initials: JE
authors.lastname: Kemnitzer
authors.forename: Jignesh
authors.initials: J
authors.lastname: Patel
authors.forename: Namrata
authors.initials: N
authors.lastname: Desai
authors.forename: Allen T
authors.initials: AT
authors.lastname: Bishop
authors.forename: Alexander Y
authors.initials: AY
authors.lastname: Shin
mesh_terms: D020341:Absorbable Implants; D000818:Animals; D002809:Chondroitin Sulfates / Q000494:pharmacology*; D003094:Collagen / Q000494:pharmacology; D004195:Disease Models, Animal; D004576:Electromyography / Q000379:methods; D006025:Glycosaminoglycans / Q000494:pharmacology; D048091:Guided Tissue Regeneration; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009416:Nerve Regeneration / Q000502:physiology*; D010525:Peripheral Nerves / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy / Q000601:surgery*; D011897:Random Allocation; D051381:Rats; D011917:Rats, Inbred Lew; D020127:Recovery of Function; D012016:Reference Values; D012584:Sciatic Nerve / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D006025:Glycosaminoglycans; D002809:Chondroitin Sulfates; D003094:Collagen