Enhanced tendon-to-bone repair through adhesive films.

摘要: Abstract Tendon-to-bone surgical repairs have unacceptably high failure rates, possibly due to their inability recreate the load transfer mechanisms of native enthesis. Instead distributing across a wide attachment footprint area, concentrate shear stress on small number suture anchor points. This motivates development technologies that distribute stresses away from anchors and enthesis footprint. Here, we present predictions proof-of-concept experiments showing mechanically-optimized adhesive films can mimic natural healthy increase tolerance repair. Mechanical optimization, based upon lag model corroborated by finite element analysis, revealed adhesives with relatively strength low stiffness can, theoretically, strengthen tendon-to-bone over 10-fold. Lap testing using tendon bone planks validated mechanical models for range stiffnesses strengths. Ex vivo human supraspinatus cadaveric tissues multipartite showed substantial in strength. Results suggest adhesive-enhanced repair improve strength, motivate search optimal adhesives. Statement Significance Current techniques indicating initial is insufficient prevent gapping or rupture. In rotator cuff, apply compression interface achieve contact healing between bone, but almost all force only few points where sutures puncture tendon. Therefore, evaluated ability an film, implanted enhance minimize likelihood demonstrated optimally designed would Experiments idealized clinically-relevant these models. work demonstrates opportunity dramatically appropriate material properties.