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Monday, January 30, 2023

The Scaffolding That Helps Torn Tendons Heal Faster

Tendon tears are common, painful injuries that can keep you out of action for months — but a breakthrough promises to allow you to recover faster and end long periods of “rest” while the wound heals.

Tendons are strong, flexible cords of tissue that connect muscles to bones. As they age, they can become damaged from trauma or wear and tear.

Although there are approximately 4,000 tendons in the body, the most commonly injured are the Achilles tendon, which runs along the back of the calf, the patellar tendon in the knee, and the rotator cuff in the shoulder, because they are under the greatest stress during exercise.

While torn tendons can heal on their own, it often takes a long time because their blood supply is poor, which means they only get limited amounts of nutrients and growth factors. Resting while the wound repairs itself can make it worse because it causes stiffness and slows down the healing process.

Tendons are strong, flexible cords of tissue that connect muscles to bones.As we age, they can become damaged from trauma or wear and tear

The surgery involves stitching the ends of the tendon together and it can take up to six months to regain full range of motion.

Another option is to use tissue taken from another part of the patient’s body (or a donor) for the repair, usually from the patellar tendon or hamstring muscle that connects the large thigh muscle to the bone.

But now scientists in China have developed a brace that allows the tendon to repair itself while keeping the patient active.

When elastic scaffolds made of engineered living tissue were implanted into rats with damaged tendons, they were able to walk normally after two weeks, according to research from Beihang University published in the journal Matter.

This quick recovery is thanks to a new structure that is both resilient and strong.

First, the scientists sandwiched an elastic material made of tiny collagen fibers between other biocompatible materials.

They then twisted this thin strip into yarn to create a spiral rope, creating a material that mimics natural tendons.

In laboratory studies, this “rope” was stretched to 1.5 times its length more than 40,000 times without failure. This scaffold is designed to support the tissue, which is then implanted with rat stem cells (the master cells that form all other cells) to help the injury heal.

Mark Wilkinson, professor of orthopedics at the University of Sheffield, said: “The main finding of the Chinese study is that the technology allows for such rapid movement.” However, he cautioned that it may be years before humans benefit from the technology.

While torn tendons can heal on their own, it often takes a long time because their blood supply is poor, which means they only get limited amounts of nutrients and growth factors.Resting while the injury repairs itself can make it worse as it causes stiffness and slows down the healing process

While torn tendons can heal on their own, it often takes a long time because their blood supply is poor, which means they only get limited amounts of nutrients and growth factors.Resting while the injury repairs itself can make it worse as it causes stiffness and slows down the healing process

This isn’t the only trial focused on braces to address the problem of repairing damaged tendons. Scientists around the world are working on a variety of different approaches, including scaffolds made of synthetic materials and even silk.

“Furthermore, different types of cells were implanted on the scaffold in the hope that they would initiate tissue regeneration,” Professor Wilkinson said.

‘Stem cells are widely used because of their ability to replicate themselves, or develop into different types of cells. They have anti-inflammatory properties as well as the ability to regenerate damaged tissue and promote the growth of collagen, a protein that gives tendons and other connective tissues their structure, firmness and texture.

Some are using scaffolds seeded with tenocytes bathed in growth factors to boost their activity.

For the past decade, a team at the University of Manchester has been working with fibrous scaffolds (rather than twisted ones).

“We have developed a scaffold that provides a bridge to the healing tendon, allowing cells to rapidly close the wound gap,” said Sarah Cartmell, a professor of bioengineering who led the research.

This has several advantages over the current procedure, which only requires one operation, she said; it’s less likely to cause scar tissue that could cause the tendon to rupture again and require more surgery.

Infection occurs in one in 20 tendon repair surgeries, leading to longer recovery times, the need for repeat surgeries, and the risk of rejection if a donor tendon is used.

But using a scaffold significantly reduces the risk of rejection because the material breaks down in the body as new tendon tissue forms.

“Our device allows the tendon to rebuild more naturally and potentially heal faster and stronger,” said Professor Cartmel. “This will reduce reoperation costs as well as time spent on recovery and vacation for patients.”

This is important, Professor Wilkinson explained, because these types of injuries are likely to become more common as “life expectancy increases and more people engage in high-intensity exercise”.

Ideally, of course, you don’t injure the tendon in the first place.

Maintaining a healthy weight and exercising regularly can help, says Daniel Richards, senior clinical tutor in sports physiotherapy at Liverpool Hope University, who has worked with Premier League footballers.

“Tendons don’t like sudden changes in load or exercise intensity, and a common problem is when people go from a relatively low activity level to a very high activity level very quickly—for example, training for a charity run,” he explained. “You need to build up slowly, allowing the tendons to rest and recover between training activities.”

Low-impact activities such as cycling, rowing, and swimming are less likely to cause problems, and warming up and gentle stretches are also important.

“Fit footwear is also key, especially for runners, and seeing a qualified podiatrist every two years is invaluable, as insoles and trainers that fit you personally may help,” he said. Say.

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