Can An Emerging Synthetic Graft Have An Impact In Soft Tissue Repair?
- Volume 26 - Issue 3 - March 2013
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With the high incidence of degenerative and traumatic soft tissue injuries, biomaterial support is favorable. Synthetic scaffolds can provide excellent biocompatibility and predictable degradation. Scaffolds may augment soft tissue repairs in which weakness exists or even facilitate an earlier return to activity. Artelon allows for revascularization and supports repair through remodeling with satisfactory clinical outcomes. The use of synthetic graft to augment tendon and ligament repairs is showing promising results in our experience and further randomized prospective trials may yield further support of its applications.
As always, one should employ caution when using any orthobiologic until there are more level 1 studies to support more universal use as the additional cost of these products should be justified by evidence-based studies. It is important, however, for the foot and ankle surgeon to be aware of what options are available should complications arise. Historically, if a patient has had sensitivity to allografts or xenografts in prior surgical procedures, the surgeon’s only choice in the past may have been an autograft harvest. With this synthetic graft’s ease of use and current safety profile, the need for host donor tendon/ligament harvests may be reduced.
Dr. Miller is a partner of the Pennsylvania Orthopaedic Center and an Adjunct Associate Professor in the Department of Surgery at the Temple University School of Podiatric Medicine in Philadelphia. He is currently the Director of the Pennsylvania Intensive Lower Extremity Fellowship Program in Malvern, Pa. Dr. Miller is a Diplomate of the American Board of Podiatric Surgery. He is a Founding Fellow of the American Professional Wound Care Association.
Dr. Chen is a Fellow with the Pennsylvania Intensive Lower Extremity Fellowship. He is an Associate of the American College of Foot and Ankle Surgeons.
1. Rees JD, Wills AM, Wolman RL. Current concepts in the management of tendon disorders. Rheumatology. 2006; 45(5):508-521.
2. Decarbo W, Feldner, B, Hyer, C. Inflammatory reaction to implanted equine pericardium xenograft. J Foot Ankle Surg. 2010; 49(2):155-58.
3. Chen J, Xu J, Wang A, Zheng M. Scaffolds for tendon and ligament repair: review of the efficacy of commercial products. Expert Rev Med Devices. 2009; 6(1):61-73.
4. Basiglini L, Iorio R, Vadala R, et al. Achilles tendon surgical revision with synthetic augmentation. Knee Surg Sports Traumatol Arthrosc. 2010; 18(5):644–647.
5. 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(12):2673-2686.
6. Giza E, Frizzell L, Farac R, et al. Augmented tendon Achilles repair using a tissue reinforcement scaffold: A biomechanical study. Foot Ankle Int. 2011; 32(5):S545-549.
7. Artimplant product monograph and company correspondence, 2013. Available at http://www.artimplant.com/ .