The clinical strategies for tendon repair with biomaterials: A review on rotator cuff and Achilles tendons

J Biomed Mater Res B Appl Biomater. 2020 Jul;108(5):1826-1843. doi: 10.1002/jbm.b.34525. Epub 2019 Nov 30.

Abstract

Tendon repair is a complex process due to the low tenocyte density, metabolism, and vascularization. Tears of rotator cuff (RCT) and Achilles tendons ruptures have a major impact on healthcare costs and quality of life of patients. Scaffolds are used to improve the healing rate after surgery and long-term results. A systematic search was carried out to identify the different types of scaffolds used during RCT and Achilles tendon repair surgery in the last 10 years. A higher number of clinical studies were reported on RCT ruptures. Biological scaffolds were used more than synthetic ones, for both rotator cuff and Achilles tendons. Moreover, platelet-rich plasma (PRP)-based scaffolds were the most widely used in RCT. A different type of synthetic scaffold was used in each of the five studies found. Biological scaffolds either provide variable results, in particular PRP-based ones, or poor results, such as bovine equine pericardium. All the synthetic scaffolds demonstrated a significant increase in clinical and functional scores in biomechanics, and a significant decrease in pain and re-tear rate in comparison to conventional surgery. Despite the limited number of studies, further investigation in the clinical use of synthetic scaffolds should be carried out.

Keywords: Achilles tendon; biological scaffolds; rotator cuff tendon; synthetic scaffolds; tissue repair.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Achilles Tendon / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Biocompatible Materials / chemistry
  • Biocompatible Materials / metabolism
  • Biomimetic Materials / chemistry
  • Biomimetic Materials / metabolism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plastic Surgery Procedures / methods*
  • Platelet-Rich Plasma
  • Regeneration
  • Rotator Cuff / surgery*
  • Rotator Cuff Injuries / therapy*
  • Tendon Injuries / therapy*
  • Wound Healing

Substances

  • Biocompatible Materials