An electrospun polydioxanone patch for the localisation of biological therapies during tendon repair

Abstract

Rotator cuff tendon pathology is thought to account for 30-70 % of all shoulder pain. For cases that have failed conservative treatment, surgical re-attachment of the tendon to the bone with a non-absorbable suture is a common option. However, the failure rate of these repairs is high, estimated at up to 75 %. Studies have shown that in late disease stages the tendon itself is extremely degenerate, with reduced cell numbers and poor matrix organisation. Thus, it has been suggested that adding biological factors such as platelet rich plasma (PRP) and mesenchymal stem cells could improve healing. However, the articular capsule of the glenohumeral joint and the subacromial bursa are large spaces, and injecting beneficial factors into these sites does not ensure localisation to the area of tendon damage. Thus, the aim of this study was to develop a biocompatible patch for improving the healing rates of rotator cuff repairs. The patch will create a confinement around the repair area and will be used to guide injections to the vicinity of the surgical repair. Here, we characterised and tested a preliminary prototype of the patch utilising in vitro tools and primary tendon-derived cells, showing exceptional biocompatibility despite rapid degradation, improved cell attachment and that cells could migrate across the patch towards a chemoattractant. Finally, we showed the feasibility of detecting the patch using ultrasound and injecting liquid into the confinement ex vivo. There is a potential for using this scaffold in the surgical repair of interfaces such as the tendon insertion in the rotator cuff, in conjunction with beneficial factors.

Micropatterning Electrospun Scaffolds to Create Intrinsic Vascular Networks

“…This is close to commonly sutured electrospun poly(caprolactone) (PCL) (164 N · mm −2 ) and several times greater than poly(ether urethane urea) (PEUU) blends (35–59 N · mm −2 ) which were sutured for in vivo fixation . PDO is a FDA‐approved material used for sutures that resorb within 6 months or faster for fibers with high surface area . In vitro culture of HUVECs on electrospun PDO fibers also demonstrate good attachment as indicated by sprawled morphology (Figure c and f).…”

Role of tissue engineering in tendon reconstructive surgery and regenerative medicine: Current concepts, approaches and concerns

“…Generally, they can be divided into three major groups including biological (natural), synthetic and hybrid materials 12,41,42 . Biological materials such as collagen, elastin, gelatin, chitosan, albumin, alginate, fibrin and chondroitin sulphate have been shown to be effective in tendon healing 36,40,43,44 .…”

“…In these types of scaffolds, alignment of the newly regenerated tissue is not a major concern because of the nature of the tissue that should be reconstructed 56 . Electrospinning is another but highly expensive and timeconsuming technological approach 2,42,54 . By this technology, it is possible to align the polymerised fibres of the scaffold (Fig.…”

A comparative evaluation of the effect of polymer chemistry and fiber orientation on mesenchymal stem cell differentiation

“…12 Previous studies have shown that electrospun scaffolds made of polymers such as PLGA and Polydioxanone (PDO) exhibit excellent cellular response and biocompatibility. 13,14 It has also been reported that multilineage differentiation into osteoblasts, adipocytes, and chondrocytes is fully supported by an electrospun tissue scaffold. 15 Electrospun PLGA scaffolds have previously been shown to support successful differentiation of mesenchymal stem cells (MSCs) in vitro for the generation of bone, cartilage and dermal tissue.…”

“…It has also been demonstrated that electrospun materials cause a lower immune response in vivo compare to the same material in plain sheets . Previous studies have shown that electrospun scaffolds made of polymers such as PLGA and Polydioxanone (PDO) exhibit excellent cellular response and biocompatibility . It has also been reported that multilineage differentiation into osteoblasts, adipocytes, and chondrocytes is fully supported by an electrospun tissue scaffold …”