Advances in the Development of Anti-Adhesive Biomaterials for Tendon Repair Treatment

Abstract

Background: Peritendinous adhesion that simultaneous with tendon healing link the healing tendon to the surrounding tissue. It results in functional disability, and has a significant adverse impact on health as well as social and economic development.

Methods: Based on a search in the PubMed and Web of Science database, the research articles were screened by their time, main idea, impact factor index, while the ones with no credibility were excluded. Afterwards, we go through the analysis of the reliability and characteristics of the results were further screened from selected articles.

Results: A total of 17 biomaterials used to evaluate the adhesion mechanism and the properties of the material were found. All of these biomaterials contained randomized controlled studies and detailed descriptions of surgical treatment that support the reliability of their results which indicates that biomaterials act as barriers to prevent the formation of adhesion, and most of them exhibit satisfactory biocompatibility, biodegradability or selective permeability. Moreover, a few had certain mechanical strength, anti-inflammatory, or carrier capacities. However, there still existed some defects, such as time, technology, clinical trials, material targeting and different measurement standards which also lowered the reliability of their results.

Conclusion: In future, anti-adhesion biomaterials should focus on affordable raw materials with wide sources, and the production process should be simplified, in this way, the versatility and targeting of materials will be improved.

Keywords: Biocompatible materials; Electrospun fiber membrane; Hydrogels; Tendon injuries; Tissue adhesion.

Fig. 1

Tendon hierarchy: collagen fibers dominate, tenocytes, nerves and blood vessels are scattered. Adapted with permission from Yang et al. [9]

Fig. 2

The process of hydrogel formation. Adapted with permission from Thoniyot P, Tan MJ, Karim AA, Young DJ, Loh XJ. Nanoparticle-hydrogel composites: concept, design, and applications of these promising, multi-functional materials. Adv Sci (Weinh). 2015;2(1–2):1400010

Fig. 3

The electrospinning process: First, high voltage static electricity accelerates charged polymer droplets in a capillary Taylor cone vortex and eventually form a jet trickle. The solvent then evaporates in the trickle jet process, and the polymers solidify in the receiving device to form a nonwoven fabric similar to the fiber film. Adapted with permission from Cheng F, Ou Y, Liu G, Zhao L, Dong B, Wang S, et al. Novel quasi-solid-state electrolytes based on electrospun poly(vinylidene fluoride) fiber membranes for highly efficient and stable dye-sensitized solar cells. Nanomaterials (Basel). 2019;9(5)

Fig. 4

After formation of the HA/PCL membrane, it was applied to tendon. Adapted with permission from Liu et al. [40]