A layered electrospun and woven surgical scaffold to enhance endogenous tendon repair.
Surgical reattachments of tendon to bone in the rotator cuff are reported to fail in around 40% of cases. There are no adequate solutions to improve tendon healing currently available. Electrospun, sub-micron materials, have been extensively studied as scaffolds for tendon repair with promising results, but are too weak to be surgically implanted or to mechanically support the healing tendon. To address this, we developed a bonding technique that enables the processing of electrospun sheets into multi-layered, robust, implantable fabrics. Here, we show a first prototype scaffold created with this method, where an electrospun sheet was reinforced with a woven layer. The resulting scaffold presents a maximum suture pull out strength of 167N, closely matched with human rotator cuff tendons, and the desired nanofibre-mediated bioactivity in vitro and in vivo. This type of scaffold has potential for broader application for augmenting other soft tissues.
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, United Kingdom. Electronic address: osnat.hakimi@ndorms.ox.ac.uk.
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Hakimi
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, United Kingdom.
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Mouthuy
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, United Kingdom.
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Zargar
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, United Kingdom.
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Lostis
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, United Kingdom; Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.
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Morrey
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, England, United Kingdom.
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Carr
D000368:Aged; D055119:Elastic Modulus; D004595:Electroplating / Q000379:methods; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D048091:Guided Tissue Regeneration / Q000295:instrumentation*; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D013314:Stress, Mechanical; D013526:Surgical Mesh; D013708:Tendon Injuries / Q000503:physiopathology* / Q000601:surgery*; D013718:Tensile Strength; D054457:Tissue Scaffolds; D016896:Treatment Outcome
Electrospinning; Implant; Layering; Polydioxanone; Rotator cuff; Tendon