Two Washington University in St. Louis scientists are imitating nature as they attempt to solve one of the most difficult problems in orthopedic surgery: reattaching tendon to bone.
Their goal is to improve the success rate of rotator cuff repairs. The rotator cuff is the group of four tendons and muscles that surround the shoulder joint. When it is injured, the tendons tear or detach from the bone.
Commonly thought of as a sports injury or perhaps the scourge of orchestra conductors rotator cuff tears actually become more common with age. The highest incidence is in patients older than 60, the scientists say.
For the doctor or surgeon, the big challenge of these injuries is the limited ability of the tendon to repair itself or to reattach to the bone. Reported failure rates for rotator cuff surgeries range from 20 percent to 94 percent.
Younan Xia, PhD, the James M. McKelvey Professor in the School of Engineering & Applied Science, and Stavros Thomopoulos, PhD, associate professor of orthopaedic surgery in the School of Medicine, demonstrated an innovative solution to this problem several years ago, publishing their results in Nano Letters in 2009.
Together with co-principal investigator Leesa M. Galatz, associate professor of orthopaedic surgery in the School of Medicine, the research group has just received more than $2 million from the National Institutes of Health to take the next step toward clinical use of the biomimetic patch.
Over the next few years, they will be testing its success in repairing cuff tears in a small animal model, the rat.
The most flexible of joints
Like your hip, your shoulder is a ball and socket joint. But the head of your femur sits deep in its socket in the pelvis, so your hip joint is stable and hard to dislocate.
Not so your shoulder. The ball at the end of the humerus sits in a shallow indentation in the scapula like a golf ball sitting on
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Washington University in St. Louis