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Freeze-dried tendon implants prove effective in early studies
Date:1/8/2008

Donated, freeze-dried tendon grafts loaded with gene therapy may soon offer effective repair of injured tendons, a goal that has eluded surgeons to date. According to study data published today in the journal Molecular Therapy, a new graft technique may provide the first effective framework around which flexor tendon tissue can reorganize as it heals. Such tissue-engineering approaches could significantly improve repair of anterior cruciate ligaments and rotator cuffs as well, researchers said. The study was in a mouse model designed to resemble hard-to-repair flexor tendons in human hands, and the results should provide an impetus for future clinical trials.

Tendons are elastic cords that anchor muscle to bone and enable flexing muscle to move limbs. Related injuries represent nearly half of 33 million U.S. orthopaedic injuries each year, and a frequent cause of emergency room visits. In many standard repair attempts, surgeons implant an autograft, a piece of tendon from elsewhere in the same patient. Along with requiring patients to sacrifice tendon, the problem with live autografts is that both the graft and the graft site know they have been injured. That signals immune cells and chemicals to rush into the graft site, seeking to fight infection. Unfortunately, those same processes cause inflammation and scarring, which in turn cause implanted tendon to stick to the joint. To work properly, the tendon must be free to glide across the joint. Tendon adhesions, a longstanding post-surgical problem, cause pain and permanently limit range of motion.

Researchers next experimented with allografts: tendons donated from one person to another. Clinically, this technique fared worse than autografts because patients bodies would recognize the donated tendon as foreign, attempt to wall it off with fibrous proteins and in some cases reject the transplant. The field then looked at whether synthetic scaffolds made of gel or fiber mesh could serve as alte
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Contact: Greg Williams
Greg_Williams@urmc.rochester.edu
585-273-1757
University of Rochester Medical Center
Source:Eurekalert

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