Abstract
A flexor tendon injury is acquired fast and is common for athletes, construction workers, and military personnel among others, treated in the emergency department. However, the healing of injured flexor tendons is stretched over a long period of up to 12 weeks, therefore, remaining a significant clinical problem. Postoperative complications, arising after traditional tendon repair strategies, include adhesion and tendon scar tissue formation, insufficient mechanical strength for early active mobilization, and infections. Various researchers have tried to develop innovative strategies for developing a polymer-based construct that minimalizes these postoperative complications, yet none are routinely used in clinical practice. Understanding the role such constructs play in tendon repair should enable a more targeted approach. This review mainly describes the polymer-based constructs that show promising results in solving these complications, in the hope that one day these will be used as a routine practice in flexor tendon repair, increasing the well-being of the patients. In addition, the review also focuses on the incorporation of active compounds in these constructs, to provide an enhanced healing environment for the flexor tendon.
Highlights
Polymer-Based Constructs for FlexorThe flexor digitorum superficialis, or in short, the flexor tendon, is an irreplaceable part of the human body
Several postoperative complications may occur such as infection, wear, tendon scar tissue formation, mechanical failure, and excessive adhesion formation
Most current researchers focusing on flexor tendon repair develop a construct that is equipped with both anti-inflammatory as well as antimicrobial agents, solving the most severe postoperative complications occurring during tendon healing
Summary
The flexor digitorum superficialis, or in short, the flexor tendon, is an irreplaceable part of the human body. Multiple therapeutic reconstruction techniques such as suturing, auto-, allo-, and xenograft or replacement with a synthetic prosthesis have been used [10,11] None of these traditional techniques accomplish a long-term adequate solution for postoperative complications such as infection, wear, tendon scar tissue formation, mechanical failure, and excessive adhesion formation [12]. The success and effectiveness of these traditional repair techniques are mostly linked to the degree of undesired postoperative adhesion formation between surrounding tissue and the healing site [7]. It is important to note that the original mechanical properties are never fully restored after tendon repair due to scar tissue formation around the healing site. An excessive amount of type III collagen results in loosely organized fibrils [13] These complications can be avoided by inducing a healing response that is faster than the rate of adhesion and scar tissue formation [14]. This review article acts as a literature scan to identify the current state-of-the-art research for flexor tendon repair constructs, some of which have active compounds incorporated which induce anti-inflammatory and antimicrobial properties
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