Long-Term Follow-up of Achilles Tendon Repair with an Absorbable Polymer Carbon Fiber Composite

Abstract

In this cooperative multicenter study for surgical repair of Achilles tendon rupture using a composite implant, 48 patients underwent 52 procedures. This implant is composed of filamentous uniaxially aligned carbon fibers coated with an absorbable polymer. This highly biocompatible implant acts as a scaffold for regrowth of collagenous tissue. The early strength of this repair is provided by the composite implant and by the rapid ingrowth and attachment of new tissue, which allows for an earlier and more vigorous rehabilitation program. Patients with a minimum follow-up of 1 year form the basis of this article. The overall average follow-up is 2.1 years. Three cohort groups were observed on a temporal basis and quantitatively evaluated at 1 year (N = 29), 18 months (N = 22), and 2 years (N = 20), respectively. These three groups demonstrated continuous improvement during the first postoperative year. A high level of function was maintained throughout the second year. Repair of chronic injuries (N = 15) was compared with repair of acute injuries (N = 12) at 1 year following surgery. Both groups greatly improved. However, the acute group had more serious preoperative deficits but improved to a slightly better overall level. Of the patients having at least 1 year follow-up, 86% had a good or excellent result. There was no increased morbidity associated with the use of the carbon implant.

The past, present and future in scaffold-based tendon treatments

“…Carbon fibres have exhibited clinically acceptable mechanical and structural properties, promoted extrinsic and intrinsic cellular activity and ultimately a functional neotissue formation, leading to long-term tissue integration and healing [399,400]. However, the potential side effects of carbon have limited their further development [401][402][403]. These results gave rise to degradable-based substitutes for tendon repair.…”

Biomaterialien in der Sportmedizin – Anwendungen bei Knorpel-, Knochen-, und Bandverletzungen

“…Synthetische Polymere werden bei der Therapie von Sehnen-und Bandschäden oft in Form von relativ stabilen und reißfesten, oftmals mehrlagigen Netzen eingesetzt, die den Defekt überbrücken und primäre Stabilität verleihen können. [58]. Auch Ozaki zeigte, dass durch den Einbau von Polyethylenimplantaten in chronischen Achillessehnenrupturen gute klinische Resultate zu erreichen sind [56].…”

Multigram Solution‐Phase Synthesis of Three Diastereomeric Tripeptidic Second‐Generation Dendrons Based on (2S,4S)‐, (2S,4R)‐, and (2R,4S)‐4‐Aminoprolines

“…The application of carbon fibers to biomaterials has been expected because they are strong and flexible 30. Actually, carbon fibers have been used for tendon repair in clinical settings,31, 32 but they are too thick for use in cell or cytokine therapy for tissue regeneration. If creation of a 3D web consisting of carbon fibers with a nanoscale structure is possible, it may serve as a promising new scaffold biomaterial for tissue regeneration.…”