Chapter 27 - Tendon and muscle responses to biomaterials

Abstract

Tendon and muscle pathologies and injuries are common across all age groups. They can cause debilitating pain, loss of function, impaired productivity, and inevitable healthcare cost. The spectrum of injury ranges, but it often involves disruption of the tendon or muscle, and the cause can be either an acute event, involving trauma and laceration, or a chronic condition from overuse and intrinsic degeneration. For tendon ruptures, various treatment modalities exist but surgical repair, augmentation, or grafts are often required, and in most cases of tendon surgery some form of biomaterial implantation is involved, either as sutures or through the use of scaffold or other implantable materials. The limited availability of autografts and allografts, as well as donor site morbidity of autografts and the risk of infection and adverse immune responses elicited by allografts, have paved the need to develop other alternative strategies which may utilize biomaterials in novel ways. For muscle injuries and surgery, standard sutures have been in use historically up to current practice, but innovative approaches applying biomaterial solutions to large muscle gaps and restoration have been explored recently. This review will look into the different treatment options available in recent years for both small and large tendon and muscle defects, with a focus on the host reactions stimulated by each therapy.