Comparison of Achilles Tendon Repair Techniques in a Sheep Model Using a Cross-linked Acellular Porcine Dermal Patch and Platelet-rich Plasma Fibrin Matrix for Augmentation

Sarrafian, Tiffany L.; Wang, Hali; Hackett, Eileen S.; Yao, Jian Q.; Shih, Mei-Shu; Ramsay, Heather L.; Turner, A. Simon

doi:10.1053/j.jfas.2009.12.005

« Previous Next »Journal of Foot and Ankle Surgery
Volume 49, Issue 2 , Pages 128-134, March 2010

Comparison of Achilles Tendon Repair Techniques in a Sheep Model Using a Cross-linked Acellular Porcine Dermal Patch and Platelet-rich Plasma Fibrin Matrix for Augmentation

Presented at the 54th Annual Meeting of the Orthopedic Research Society, San Francisco, CA, March 2008.

Tiffany L. Sarrafian, DVM
- Research Associate, Colorado State University, Veterinary Medical Center, Fort Collins, CO
Hali Wang, PhD, MS
- Staff Scientist, Biologics R&D, Zimmer Orthobiologics, Inc., Warsaw, In
- Address correspondence to: Hali Wang, PhD, Zimmer Orthobiologics, Inc., 9301 Amberglen Blvd, Ste 100, Austin, TX 78729.
Eileen S. Hackett, DVM, MS
- Assistant Professor, Colorado State University, Veterinary Medical Center, Fort Collins, CO
Jian Q. Yao, PhD, MBA
- Senior Director, Biologics R&D, Zimmer Orthobiologics, Inc., Warsaw, In
Mei-Shu Shih, DVM, PhD
- Director, Orthopaedics, MDS Pharma Services, Bothell, WA
Heather L. Ramsay, PhD
- Study Director, Surgery, MDS Pharma Services, Bothell, WA
A. Simon Turner, BVSc, MS
- Professor, Colorado State University, Veterinary Medical Center, Fort Collins, CO

published online 05 February 2010.

Abstract

The primary goal of this study was to evaluate a cross-linked acellular porcine dermal patch (APD), as well as platelet-rich plasma fibrin matrix (PRPFM), for repair of acute Achilles tendon rupture in a sheep model. The 2 surgically transected tendon ends were reapproximated in groups 1 and 2, whereas a gap was left between the tendon ends in group 3. APD was used to reinforce the repair in group 2, and autologous PRPFM was used to fill the gap, which was also reinforced with APD, in group 3. All sheep were humanely euthanized at 24 weeks after the repair, and biomechanical and histological testing were performed. Tensile strength testing showed a statistically significant difference in elongation between the operated limb and the unoperated contralateral limb in groups 1 and 3, but not in group 2. All operated tendons appeared healed with no apparent fibrosis under light and polarized microscopy. In group 1, all surgical separation sites were identifiable, and healing occurred via increasing tendon thickness. In group 2, healing occurred with new tendon fibers across the separation, without increasing tendon thickness in 2 out of 6 animals. Group 3 showed complete bridging of the gap, with no change in tendon thickness in 2 out of 6 animals. In groups 2 and 3, peripheral integration of the APD to tendon fibers was observed. These findings support the use of APD, alone or with PRPFM, to augment Achilles tendon repair in a sheep model.

Level of Clinical Evidence: 5

Keywords: bioscaffold, collagen patch, surgery, tissue engineering, trauma