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

      Affiliations

    • Research Associate, Colorado State University, Veterinary Medical Center, Fort Collins, CO
    • ,
  • Hali Wang, PhD, MS

      Affiliations

    • Staff Scientist, Biologics R&D, Zimmer Orthobiologics, Inc., Warsaw, In
    • Corresponding Author InformationAddress correspondence to: Hali Wang, PhD, Zimmer Orthobiologics, Inc., 9301 Amberglen Blvd, Ste 100, Austin, TX 78729.
    • ,
  • Eileen S. Hackett, DVM, MS

      Affiliations

    • Assistant Professor, Colorado State University, Veterinary Medical Center, Fort Collins, CO
    • ,
  • Jian Q. Yao, PhD, MBA

      Affiliations

    • Senior Director, Biologics R&D, Zimmer Orthobiologics, Inc., Warsaw, In
    • ,
  • Mei-Shu Shih, DVM, PhD

      Affiliations

    • Director, Orthopaedics, MDS Pharma Services, Bothell, WA
    • ,
  • Heather L. Ramsay, PhD

      Affiliations

    • Study Director, Surgery, MDS Pharma Services, Bothell, WA
    • ,
  • A. Simon Turner, BVSc, MS

      Affiliations

    • Professor, Colorado State University, Veterinary Medical Center, Fort Collins, CO

References 

  1. Maffulli N. Rupture of the Achilles tendon. J Bone Joint Surg (Am). 1999;81-A:1019–1036
  2. Popovic N, Lemaire R. Diagnosis and treatment of acute ruptures of the Achilles tendon. Current concepts review. Acta Orthop Belg. 1999;65:458–471
  3. Leppilahti J, Orava S. Total Achilles tendon rupture. A review. Sports Med. 1998;25:79–100
  4. Valentin JE, Badylak JS, McCabe GP, Badylak SF. Extracellular matrix bioscaffolds for orthopaedic applications. A comparative histologic study. J Bone Joint Surg (Am). 2006;88-A:2673–2686
  5. Provencher MT, Mazzocca A, Romeo AA. Biologics in rotator cuff surgery: management of rotator cuff tears with an extracellular matrix patch. Tech Orthop. 2007;22:43–54
  6. Coons DA, Alan Barber F. Tendon graft substitutes—rotator cuff patches. Sports Med Arthrosc. 2006;14:185–190
  7. Malcarney HL, Bonar F, Murrell GA. Early inflammatory reaction after rotator cuff repair with a porcine small intestine submucosal implant: a report of 4 cases. Am J Sports Med. 2005;33:907–911
  8. Zheng MH, Chen J, Kirilak Y, Willers C, Xu J, Wood D. Porcine small intestine submucosa (SIS) is not an acellular collagenous matrix and contains porcine DNA: possible implications in human implantation. J Biomed Mater Res B Appl Biomater. 2005;73:61–67
  9. Grove JR, Hardy MA. Autograft, allograft and xenograft options in the treatment of neglected Achilles tendon ruptures: a historical review with illustration of surgical repair. Foot Ankle J 1(5):1, 2008. Available at http://faoj.wordpress.com/2008/05/01. Accessed July 13, 2009.
  10. Turner TM, Urban RM, Hall DJ, Dahlmeier EL. Achilles tendon repair augmented with a decellularized porcine dermal graft compared to two other collagen xenografts. Society For Biomaterials Annual Meeting and Exposition 2009, April 22–25, Abstract 147.
  11. Nicholson GP, Breur GJ, Van Sickle D, Yao JQ, Kim J, Blanchard CR. Evaluation of a cross-linked acellular porcine dermal patch for rotator cuff repair augmentation in an ovine model. J Shoulder Elbow Surg. 2007;16:S184–S190
  12. Badhe SP, Lawrence TM, Smith FD, Lunn PG. An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears. J Shoulder Elbow Surg. 2008;17:35S–39S
  13. Roukis TS, Zgonis T, Tiernan B. Autologous platelet-rich plasma for wound and osseous healing: a review of the literature and commercially available products. Adv Ther. 2006;23:218–237
  14. Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62:489–496
  15. Rodeo SA. Biologic augmentation of rotator cuff tendon repair. J Shoulder Elbow Surg. 2007;16:S191–S197
  16. Iannotti JP, Codsi MJ, Kwon YW, Derwin K, Ciccone J, Brems JJ. Porcine small intestine submucosa augmentation of surgical repair of chronic two-tendon rotator cuff tears. A randomized, controlled trial. J Bone Joint Surg (Am). 2006;88-A:1238–1244
  17. Belcher HJ, Zic R. Adverse effect of porcine collagen interposition after trapeziectomy: a comparative study. J Hand Surg (Br). 2001;26-B:159–164
  18. Jarman-Smith ML, Bodamyali T, Stevens C, Howell JA, Horrocks M, Chaudhuri JB. Porcine collagen crosslinking, degradation and its capability for fibroblast adhesion and proliferation. J Mater Sci Mater Med. 2004;15:925–932
  19. Sclamberg SG, Tibone JE, Itamura JM, Kasraeian S. Six-month magnetic resonance imaging follow-up of large and massive rotator cuff repairs reinforced with porcine small intestinal submucosa. J Shoulder Elbow Surg. 2004;13:538–541
  20. Durselen L, Dauner M, Hierlemann H, Planck H, Ignatius A, Claes LE. Control of material stiffness during degradation for constructs made of absorbable polymer fibers. J Biomed Mater Res B Appl Biomater. 2003;67:697–701
  21. Van Kampen CL. Biomechanics of synthetic augmentation of ligament reconstructions. Clin Mater. 1994;15:23–27
  22. Adams JE, Zobitz ME, Reach JS, An KN, Steinmann SP. Rotator cuff repair using an acellular dermal matrix graft: an in vivo study in a canine model. Arthroscopy. 2006;22:700–709
  23. Barber FA, Herbert MA, Boothby MH. Ultimate tensile failure loads of a human dermal allograft rotator cuff augmentation. Arthroscopy. 2008;24:20–24
  24. Omae H, Steinmann SP, Zobitz ME, Wongtriratanachai P, Sperling JW, An K. Biomechanical effect of rotator cuff augmentation with acellular dermal matrix graft: a cadaver study. Proceedings of the 54th Orthopedic Research Society Meeting, San Francisco, 2008, Abstract 1526.
  25. Turner T, Urban RM, Romeo AA, Hall DJ, Inoue N. Repair of a rotator cuff tendon defect using an acellular human dermal graft in a large primate model. Proceedings of the 54th Orthopedic Research Society Meeting, San Francisco, 2008, Abstract 1528.
  26. Lee DK. A preliminary study on the effects of acellular tissue graft augmentation in acute Achilles tendon ruptures. J Foot Ankle Surg. 2008;47:8–12
  27. Lee MS. GraftJacket augmentation of chronic Achilles tendon ruptures. Orthopedics. 2004;27:s151–s153
  28. Dejardin LM, Arnoczky SP, Ewers BJ, Haut RC, Clarke RB. Tissue-engineered rotator cuff tendon using porcine small intestine submucosa. Histologic and mechanical evaluation in dogs. Am J Sports Med. 2001;29:175–184
  29. Schlegel TF, Hawkins RJ, Lewis CW, Motta T, Turner AS. The effects of augmentation with swine small intestine submucosa on tendon healing under tension: histologic and mechanical evaluations in sheep. Am J Sports Med. 2006;34:275–280
  30. Lansdaal JR, Goslings JC, Reichart M, Govaert GAM, van Scherpenzeel KM, Haverlag R, et al. The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment. Injury. 2007;38:839–844
  31. de Mos M, van der Windt AE, Jahr H, van Schie HT, Weinans H, Verhaar JA, et al. Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med. 2008;36:1171–1178
  32. Anitua E, Sanchez M, Nurden AT, Nurden P, Orive G, Andia I. New insights into and novel applications for platelet-rich fibrin therapies. Trends Biotechnol. 2006;24:227–234
  33. Magra M, Maffulli N. Matrix metalloproteases: a role in overuse tendinopathies. Br J Sports Med. 2005;39:789–791
  34. Sanchez M, Anitua E, Azofra J, Andia I, Padilla S, Mujika I. Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med. 2007;35:245–251
  35. Hohendorff B, Siepen W, Spiering L, Staub L, Schmuck T, Boss A. Long-term results after operatively treated Achilles tendon rupture: fibrin glue versus suture. J Foot Ankle Surg. 2008;47:392–399

 Financial Disclosure: Zimmer Orthobiologics, Inc., provided a research grant that funded this investigation.

 Conflict of Interest: Hali Wang, PhD, is employed by Zimmer Orthobiologics, Inc., 9301 Amberglen Blvd., Suite 100, Austin, TX 78729.

 This study was approved by the Animal Care and Use Committee at Colorado State University (CSU).

PII: S1067-2516(09)00513-4

doi: 10.1053/j.jfas.2009.12.005

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

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