Collagen Implants Research Articles

Designing and testing anti‐scarring and anti‐inflammatory biomaterials for corneal implants: A promising alternative to human donors.

Purpose: Corneal blindness is mainly treated by cornea transplantation. However, there is a shortage of cornea donors for surgeries in many countries. Even with accessible donors, patients suffering from severe pathologies causing inflammation may not benefit as they are at high risk for graft rejection. The Griffith laboratory is the first to use acellular human collagen implants to regenerate high‐risk corneas in a group of patients. For broader clinical applications, scalable collagen‐like peptide (CLP) synthetic hydrogels are being developed. It is important to identify design patterns to ensure the implants do not cause inflammation.Methods: The growth of stromal fibroblasts cultured on CLP hydrogels with and without RGD groups are compared, with collagen gels and tissue culture plastic as controls. Cellular growth and viability on the different substrates were compared using the AmarBlue assay. Next, TGF‐β was added to the media to stimulate fibroblast differentiation into myofibroblasts. The latter has been linked to corneal scarring. The proportion of resulting myofibroblasts was determined by immunostaining using anti‐smooth muscle actin (SMA) antibody. Stromal cells seeded onto the hydrogels were also stained against fibronectin to study its implication due to RGD. Furthermore, the CLP‐based hydrogel was tested in vivo on alkali burnt BALB/c mice to investigate their practical biocompatibility and efficacy.Results: α‐SMA expression was observed in cells grown on CLP‐RGD containing hydrogels but not on tissue culture plastic or CLP‐only control. There was a positive fibronectin expression by cells cultured on CLP‐RGD hydrogels, on 5% collagen hydrogels and on the issue culture control. The CLP‐RGD hydrogel is a smooth and soft gel with desirable water content. The in vivo test showed that there was no sign of inflammation or angiogenesis in the cornea after three months, which can prove the great biocompatibility of the prepared CLP‐based hydrogel.Conclusions: This project allowed for the testing of cell growth on RGD‐containing CLP hydrogels, which has not been done before. Early results suggest that RGD groups within CLPs induced myofibroblast differentiation and potential pro‐inflammatory responses.

IMPLANTATION OF CHONDROFILLER LIQUID® AS A SCAFFOLD MATERIAL FOR THE TREATMENT OF CHONDRAL LESIONS OF THE KNEE JOINT

Introduction: Trauma, sports, or the normal aging degenerative process may damage the articular cartilage. Surgical methods that are most often used to manage cartilage defects include autologous chondrocyte implantation, mosaicplasty, microfractures, perforations, and joint arthroplasty in cases of severe damage. Another approach is to use collagen gel for cartilage defect reconstruction. Its biocompatibility, high tensile strength, and minimal invasiveness make it an attractive solution. ChondroFiller gel is a two-component collagen implant that could be used in the treatment of traumatic or degenerative chondral lesions. After application, it forms a protective cover for the damaged chondral area and provides structural support for the stem cells that migrate to its collagen matrix. Thus, with ChondroFiller, we aim to restore articular cartilage, prevent further degenerative processes, and return to normal joint function. In this research, we have investigated the application of ChondroFiller during knee arthroscopy to treat knee articular cartilage lesions. Methods: The clinical study was conducted at the University Hospital - Pleven Clinic of Orthopedics and Traumatology between 2012 and 2023. Seventeen patients (ten males and seven females) with a mean age of 31 years underwent knee chondroplasty with ChondroFiller gel, and their data was analyzed. Knee function was assessed using the Lysholm scale and IKDC score. The follow-up period was twelve months. Results: Statistical analysis has shown a significant difference between pre-operative Lysholm and pre-operative IKDC score and 3rd month, 6th and 12 months. Significant difference is detected between the 3rd month and 6th and 12th months Lysholm and IKDC scores (p < 0.05). No statistical difference was found between 6 and 12 month (p > 0.05). Conclusion: Restoring joint congruity is challenging. Overall, we have found encouraging results by employing ChondroFiller to restore articular cartilage. We believe that Chondrofiller provides an excellent surgical solution to younger patients with chondral defects less than 2cm2. In our opinion, further research in the field of collagen implants is needed to discover long-term effect.

Augmentation With A Bioinductive Collagen Implant Of A Posterosuperior Cuff Repair Decreases Failures At Two-Year Follow-Up. A Randomized Controlled Trial

Augmentation With A Bioinductive Collagen Implant Of A Posterosuperior Cuff Repair Decreases Failures At Two-Year Follow-Up. A Randomized Controlled Trial

Treatment of Partial-Thickness Rotator Cuff Tears with Bio-Inductive Collagen Implant for Paraplegic Tennis Player: A Case Report

In patient with lower limb disability, rotator cuff disorders are prevalent, with partial thickness tears occurring at nearly twice the rate of full thickness tears. For those with acromion spurs unresponsive to conservative treatment, rotator cuff repair via the take-down method poses a retear risk and requires extensive rehabilitation. Conversely, surgery utilizing bio-inductive collagen implants shows a lower retear risk and enables faster recovery, making it an appealing option for wheelchair athletes. Thus, the authors aim to present favorable outcomes from isolated bio-inductive collagen implant repair in a 45-year-old female wheelchair tennis player with a bursal side partial thickness tear, alongside a literature review.

Quantitative Assessment of New Frontiers in Dermatochalasis and Periorbital Hyperpigmentation Treatment: The Role of Cross-Linked Porcine Collagen.

Collagen dermal fillers have shown efficacy in addressing age-related changes in facial appearance. However, their potential in rejuvenating the periorbital region remains unexplored. The aim of this study was to evaluate the effectiveness, clinical safety, and patient satisfaction associated with the utilization of collagen dermal fillers in individuals with dermatochalasis and periorbital hyperpigmentation. This study was reviewed and approved by the institutional review board of China Medical University Hospital (IRB No. CMUH107-REC2-157). Adults diagnosed with dermatochalasis or periorbital hyperpigmentation received periorbital injections of a sterile cross-linked highly-purified specific antigen free porcine dermal collagen (FACIALGAIN® Collagen Implant with Lidocaine, Sunmax Biotechnology Co. Ltd., Taipei, Taiwan) and were assessed for hydration, elasticity, pigmentation index, redness index, lightness value, and density with the DermaLab® Combo Multiparameter Skin Analysis System (Cortex Technology, Hadsund, Denmark) and Cutometer® Dual MPA 580 (Courage+Khazaka electronic GmbH, Köln, Germany). Data was collected prior to injection and at 1 week, 4 weeks, and 12 weeks after injection. Patient satisfaction on volume augmentation, decrease in hyperpigmentation, persistence, and overall satisfaction were also recorded. A total of 12 samples each were recruited for dermatochalasis and periorbital hyperpigmentation. For dermatochalasis subjects, hydration of the periorbital tissue significantly increased at week 1 and 4 (p = 0.011 and p = 0.015). Elasticity decreased by week 4 and persisted until week 12 (p = 0.001 and 0.014). For periorbital hyperpigmentation patients, lightness value increased significantly starting week 1 (p = 0.016), tapering off at week 12. Elasticity decreased by week 4 and persisted until week 12 (p = 0.002 and p = 0.002). Median overall patient satisfaction was 4 out of 5 for the dermatochalasis group and 4.5 out of 5 for the periorbital hyperpigmentation group, with a mild but insignificant decrease by week 12. DermaLab® Combo and Cutometer® Dual MPA 580 are considered effective methods for evaluating patients undergoing dermal filler injections. The utilization of cross-linked porcine collagen dermal filler injections can serve as a minimally invasive approach to enhance skin laxity in dermatochalasis and address discoloration in periorbital hyperpigmentation. However, it is important to note that regular treatments may be necessary to sustain the desired outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/0026 .

CORR Insights®: No Short-term Clinical Benefit to Bovine Collagen Implant Augmentation in Primary Rotator Cuff Repair: A Matched Retrospective Study.

CORR Insights®: No Short-term Clinical Benefit to Bovine Collagen Implant Augmentation in Primary Rotator Cuff Repair: A Matched Retrospective Study.

Arthroscopic management of isolated partial-thickness rotator cuff tears.

The aim of the present study is to provide a comprehensive review on the surgical outcomes following arthroscopic treatments of partial-thickness rotator cuff tears (PT-RCTs) and to compare the postoperative American Shoulder and Elbow Surgeons(ASES)score following in situ transtendon repair and tear completion, followed by repair. Medline, EMBASE, Scopus, CINAHL and CENTRAL bibliographic databases were searched. Papers including patients with PT-RCTs of any grade who underwent treatment using debridement, in situ transtendon repair, tear completion and repair or bioinductive collagen implants were reviewed. Primary PT-RCTs were the sole indication for surgery. Primary postoperative outcomes assessed included the ASESscore,the Absolute Constant-Murley score, the Simple Shoulder Test, the Visual Analogue Scale, the University of California-Los Angeles Shoulder Scale, the Western Ontario Rotator Cuff Score, range of motion, complications and revisions. A meta-analysis of comparative studies compared the postoperative ASES score between patients treated with in situ transtendon repair versus tear completion repair. Twenty-eight studies were included. The ASES score was reported by four comparative studies with contrasting results. The heterogeneity was high (I2 = 86%), and effect sizes ranged from -0.49 in favour of the tear completion and repair technique to an effect size of +1.07 favouring in situ transtendon repair. The overall effect size of 0.02 suggests an equivalence between the two techniques in terms of the ASES score. Two studies with a total sample size of 111 patients reported on debridement, and four studies with a total sample size of 155 patients reported on bioinductive collagen implants. Debridement alone is suitable for Ellman grades I-II PT-RCTs. In situ transtendon and tear completion repair techniques yield similar postoperative outcomes. Bioinductive collagen implants hold promise but lack long-term efficacy data. High-quality comparative studies are needed to determine the best treatment for PT-RCTs. Level IV.

A highly durable and biocompatible bionic collagen implant with exceptional anti-calcification and collagen regeneration capabilities for improved skin rejuvenation

Skin aging, a complex and inevitable biological process, considerably impacts an individual’s physical appearance and overall well-being. While collagen-based implants hold potential for skin rejuvenation, their clinical application is limited by the poor durability of non-crosslinked implants and the negative impacts of crosslinking agents, such as cytotoxicity and calcification. Herein, we report a highly durable and biocompatible bionic collagen implant for superior skin rejuvenation with advanced anti-calcification characteristics and enhanced collagen regeneration. Utilizing biomimetic self-assembly and covalent crosslinking approach, we successfully created long-lasting and biomimetic collagen implants with densely-packed collagen fibers. Crosslinking of collagen fibers with a low concentration of N-hydroxysuccinimide activated suberic acid (NHS-SA) was highly efficient, resulting in complete crosslinking and thicker collagen fiber formation with a uniform network structure. Compared with glutaraldehyde-crosslinked collagen fibers, NHS-SA-crosslinked assembled collagen fibers (NACF) demonstrated considerably improved thermal stability and durability. Furthermore, the NACF implant exhibited superior biocompatibility, establishing NHS-SA crosslinked collagen fibers as a safer and more bioactive choice for implant applications. In mouse subcutaneous implant models, the NACF implant outperformed other collagen implants, demonstrating exceptional biocompatibility, effective collagen regeneration, and excellent anti-calcification potential. The NACF implant shows immense promise in collagen regeneration, offering considerable potential to advance skin rejuvenation therapies.

MORPHOLOGICAL AND RADIOLOGICAL ASPECTS OF POST-TRAUMATIC REMODELING OF THE MANDIBULAR BONE AFTER TRANSPLANTATION OF NATURAL COLLAGEN WITH LINCOMYCIN

This article presents the research results of the morphological, radiological, and lectin-histochemical characteristics of bone-ceramic regenerate after the transplantation of natural collagen combined with lincomycin into an experimental defect in the rabbit mandible. Aim. To study in an experiment the dynamics of changes in the mandible bone after its traumatic injury with subsequent replacement of the defect with an osteoplastic material based on natural collagen in combination with lincomycin. Materials and Methods. Experiments were conducted on 45 male rabbits aged 6-7 months, weighing 2.5-3.0 kg. 20 animals constituted the control group, and 20 the experimental group. Another 5 intact animals were used to study the normal structure of the bone tissue of the studied area of the mandible. The control group included animals with a bone tissue defect that healed under a blood clot. The experimental group consisted of rabbits where the bone defect was filled with natural collagen, with simultaneous intramuscular injection of Lincomycin at a dose of 12 mg/kg of animal weight once daily for 6 days (Col-C-L). Post-traumatic bone tissue status within the defect area was monitored for 84 days. The following methods were employed: bone defect modeling, assessment of jaw macrostructure, radiographic examination, radiovisiography, examination of bone sections under a microscope, and lectin-histochemical analysis of decalcified bone sections. Results and Discussion. Examination of the macrostructure of the experimental bone defect in the rabbit mandible after implantation of natural collagen in combination with lincomycin revealed numerous regenerative changes that occurred after the injury and correlated with the data of radiographic and radiovisiographic examinations. Microscopic examination of bone sections allowed us to establish the phased nature of the dynamics of the studied regenerative changes and the composition of the regenerate. Conclusions. It was established that in the experimental group of animals where defect repair was performed using Col-C osteoplastic material with simultaneous prophylactic administration of Lincomycin in the early stages of the experiment, it positively affected the course of the inflammatory process, followed by the formation of new bone tissue.

New suture probe canaloplasty combined with suprachoroidal collagen implantation.

To present the modified surgery technique of new suture probe canaloplasty with a specially prepared monofilament 4.0 polypropylene suture combined with suprachoroidal drainage (ScD) and collagen sheet implantation for non-penetrating glaucoma surgery. Prospective study with a twelve months follow-up. A standard 4/0 polypropylene suture (ProleneTM by Ethicon; thickness: approximately 250m) is cut and shaped with an ophthalmic knife (MANI® Crescent Knife, Mani Inc 8-3 Kiyohara Industrial Park, Utsunomiya, Tochigi 321-3231, Japan) to create a blunt end without sharp or compressed edges. This improves suture probe canaloplasty by providing a more stable and smoother probing device. Schlemm's canal is prepared using the standard technique of canaloplasty with suprachoroidal drainage. Then, instead of using the canaloplasty microcatheter or the previously published 6/0 double-helix suture, Schlemm's canal is probed with the blunt ending of the 4/0 Prolene suture. After successful 360-degree probing, a doubled 10/0 polypropylene tension suture is threaded through the tip of the 4/0 suture. The 4/0 suture is then pulled back and the 10/0 tension sutures are tied at both ends to tension Schlemm's canal. A special collagen sheet (Ologen®) is placed in suprachoroidal space, and the scleral flap is firmly sewed. 115 eyes were included in this prospective study. In 113 cases the Schlemm's canal could completely be probed with the suture probe and canaloplasty with ScD and collagen sheet implantation succeeded. In two cases the intervention was transformed to 360-degree suture trabeculotomy due to an intraoperative cheese-wiring. Twelve months after successful new suture probe canaloplasty with ScD and Collagen Implantation the IOP had decreased by 37.1% (from 21.6 ± 6.0mmHg with 3.3 different IOP lowering eye drops to 13.5 ± 3.5mmHg with 1.0 eye drops). 16 Patients did not achieve sufficient IOP levels and underwent 360-degree suture trabeculotomy during the follow-up. One patient had to be treated with further glaucoma surgery to achieve a sufficient IOP level. Complications were hyphema, postoperative IOP elevation and transient hypotony. No serious or sight-threatening complications occurred. New suture probe canaloplasty with ScD and collagen sheet implantation yields the opportunity to conduct a cost-effective canaloplasty easier and less complicated than with the previously described method with the twisted 6/0 suture. The safety profile and IOP lowering effect is comparable. In cases where complete probing fails, there is still the opportunity to switch to suture trabeculotomy over the majorly probed part of Schlemm's canal. The pressure lowering effect of the deep sclerectomy with ScD and suprachoroidal collagen sheet implant seems to have an additional impact on the sufficient pressure lowering procedure.

Результаты лечения хронической боли в области плечевого пояса с применением препаратов на основе полинуклеотидов и коллагена

Aim: to evaluate the efficacy and safety of intra- and peri-articular administration of injectable gel implant containing polynucleotides and collagen implants in patients with adhesive capsulitis / impingement syndrome / cervical spondylosis (uncovertebral arthrosis, spondylosis) with clinical reflex and reflex compression signs and orthopedic conditions. Patients and Methods: this prospective multicenter longitudinal 6-month study included 100 men and women (mean age 45 years). The patients were divided into 4 groups (25 patients in each group) based on the diagnosis. Treatment strategy (intra- and peri-articular administration of injectable gel implant containing polynucleotides and collagen implants) was determined by diagnosis and joint inflammation. Before and after treatment, the functional state of the shoulder and pain severity were assessed using questionnaires and laboratory and instrumental tests. Efficacy was assessed by pain relief, improvement in the functional activity of the shoulder joint, and changes in the range of movements in the shoulder joint and cervical spine. Treatment safety was assessed by the adverse effects. Results: after treatment, most patients reported an increase in the range of movements in the cervical spine and shoulder joint, a decrease in pain severity in the cervical spine and shoulder joint, and improvement in the functionality of the shoulder joint. After treatment, a decrease in the CRP levels and ESR was observed. No severe adverse effects were detected. Conclusion: intra- and peri-articular administration of gel implant containing poly-nucleotides and collagen implants for upper shoulder girdle disorders is effective and safe. KEYWORDS: upper shoulder girdle, cervical spine, shoulder joint, chronic pain, polynucleotides, collagen, collagen implant, intraarticular injection, periarticular injection. FOR CITATION: Shcherbakov G.I., Kovtun S.N., Potkina T.N. Outcomes of treatment for chronic shoulder pain using drugs containing polynucleotides and collagen. Russian Medical Inquiry. 2024;8(2):102–109 (in Russ.). DOI: 10.32364/2587-6821-2024-8-2-8.

Semitendinosus Autograft Transplant for Medial Meniscus

Treatment of meniscal tears has evolved over the last few decades, and preservation has now become the gold standard of treatment. Advancements in repair technique have extended the indication of repair. However, meniscectomy has to be performed in some situations. In these situations, meniscal allograft transplantation is considered the gold standard. But allografts are not available in every part of the world. Collagen implants and synthetic polymers are also advocated. But again, its limited research, availability, and high cost have restricted its widespread use. Many authors have advocated autograft transplantation, but there are no long-term results, and there is a lack of uniform surgical techniques. There is a technique described for lateral meniscus, but a medial meniscus autograft transplant technique is not very well elaborated. In this report, we aimed to describe a medial meniscus replacement technique using a hamstring autograft.

Augmentation of a Transosseous-Equivalent Repair in Posterosuperior Nonacute Rotator Cuff Tears With a Bioinductive Collagen Implant Decreases the Retear Rate at 1 Year: A Randomized Controlled Trial

To determine whether the addition of a bioinductive collagen implant (BCI) over a transosseous equivalent (TOE) repair of medium-to-large posterosuperior rotator cuff tears improves the healing rate determined by magnetic resonance imaging (MRI) at 12-month follow-up. A Level I randomized controlled trial was performed in 124 subjects with isolated, symptomatic, reparable, full-thickness, medium-to-large posterosuperior nonacute rotator cuff tears, with fatty infiltration ≤2. These were randomized to 2 groups in which an arthroscopic posterosuperior rotator cuff tear TOE repair was performed alone (Control group) or with BCI applied over the TOE repair (BCI group). The primary outcome was the retear rate (defined as Sugaya 4-5) determined by MRI at 12 months of follow-up. Secondary outcomes were characteristics of the tendon (Sugaya grade and thickness of the healed tendon) and clinical outcomes (pain levels, EQ-5D-5L, American Shoulder and Elbow Surgeons, and Constant-Murley scores) at 12 months of follow-up. Of the 124 randomized patients, 122 (60 in the BCI group and 62 in the Control group) were available for MRI evaluation 12.2 ± 1.02 months after the intervention. There were no relevant differences in preoperative characteristics. Adding the BCI reduced the retear rate (8.3% [5/60] in the BCI group vs 25.8% [16/62] in the Control group, P= .010; relative risk of retear of 0.32 [95% confidence interval 0.13-0.83]). Sugaya grade was also better in the BCI group (P=.030). There were no differences between groups in the percentage of subjects who reached the MCID for CMS (76.7% vs 81.7%, P= .654) or American Shoulder and Elbow Surgeons (75% vs 80%, P= .829), in other clinical outcomes or in complication rates at 12.4 ± 0.73 (range 11.5-17) months of follow-up. Augmentation with a BCI of a TOE repair in a medium-to-large posterosuperior rotator cuff tear reduces the retear rate at 12-month follow-up by two-thirds, yielding similar improvements in clinical outcomes and without increased complication rates. Level I, randomized controlled trial.

Trabeculectomy with collagen implant for the treatment of glaucoma

The goal is to assess the effectiveness and safety of trabeculectomy with collagen implants for glaucoma patients who cannot be managed medically. This research is a case series that intervenes without randomization and focuses on potential outcomes. The study consisted of 76 treated eyes of 76 patients with uncontrollable glaucoma. A thorough examination of the eyes was performed on all patients, and the results were documented. Each patient underwent conventional trabeculectomy surgery using the fornix-based approach. Additionally, a subconjunctival collagen implant known as Ologen was also utilized. We recorded preoperative data such as age, gender, best-corrected visual acuity, intraocular pressure, glaucoma type, and a few preoperative antiglaucoma medications. We recorded the intraocular pressure after surgery, the number of glaucoma medications given after surgery, and any complications that occurred during the postoperative period. Each patient was monitored for a minimum of six months. Before the operation, the average intraocular pressure (IOP) was 34.21 ± 12.5, and the patient took at least two IOP-lowering medications (average 2.3). The postoperative IOP was measured after three months and found to be 13.85±5.42mm Hg, with a p-value of 0.060. On average, the blood pressure decreased by 16.42±6.42 mmHg after six months, with a p-value of 0.056. After six months, it was observed that the medication significantly reduced 1.22 in intraocular pressure (P=<0.001), leading to a notable decrease of 17.79 mmHg. The success rate stood at a commendable 97.36% at the three-month mark, but it reduced to an alarming 88.15% by the last visit. Within just one month after the operation, several complications arose, including three cases of hyphaema, one case of the shallow anterior chamber, and two cases of wound leak. All patients showed gradual improvement with conservative management. However, three of them developed cataracts within three months. For patients who have not responded to topical antiglaucoma medications, to manage intraocular pressure is a dependable and safe surgical procedure that offers an efficient treatment option.

РОЛЬ КОЛЛАГЕНА И ГИДРОКСИАПАТИТА В СОСТАВЕ КОМПОЗИЦИОННЫХ КОСТНОПЛАСТИЧЕСКИХ МАТЕРИАЛОВ, ИСПОЛЬЗУЕМЫХ В ЧЕЛЮСТНО-ЛИЦЕВОЙ ХИРУРГИИ (обзор литературы)

Abstract. Introduction. Bone tissue reconstruction is one of the most challenging problems of maxillofacial surgery. This paper provides a review of studies related to the use of hydroxyapatite- and collagen-based osteoplastic materials for jawbone defects. Aim of our study is the review of the latest information on how essential collagen and hydroxyapatite as part of osteoplastic composites used in maxillofacial surgery. Materials and Methods. The published topical studies are reviewed, dealing with the study of collagen and hydroxyapatite as part of osteoplastic composites. Results and Discussion. Collagen implants promote fibroblast proliferation, vascularization of nearby tissues and induce the formation of new bone tissue with its subsequent restructuring. Collagen was also used as a rapidly biodegrading material in form of a gel for the restoration of bone defects. Conclusions. Currently, considering the positive qualities of collagen and hydroxyapatite, we see their widespread use as part of composite bone plastic materials as promising.

Arthroscopic Repair of Retracted Large and Massive Rotator Cuff Tears With and Without Augmentation With a Bio-Inductive Collagen Implant Reveals Substantial and Comparable Clinical Improvement

PurposeThe study objective was to compare clinical and imaging results following repair of retracted large and massive full thickness rotator cuff tears, including revision repairs, with and without augmentation with a bio-inductive collagen implant. MethodsThe study group comprised 24 patients (17 males) with retracted 2-3 tendon rotator cuff tears undergoing arthroscopic repair followed by on-lay augmentation with a bio-inductive collagen implant. The control group comprised 24 patients (19 males) matched by tear size undergoing repair without augmentation. Mean patient age at repair in both groups was 61 years. Active range of motion (ROM) and patient-reported outcomes (PROs) were recorded pre- and post-operatively. Non-contrast high-field MRI was obtained in 20/24 collagen implant patients and 17/24 control patients at minimum 6 months follow-up to assess tendon healing. ResultsASES scores and SST improved from 35 to 86 and 3.6 to 9.3, respectively, in the collagen implant group and from 39 to 87 and 3.9 to 9.7 in the control group. VAS-pain improved from 6.0 to 0.9 and from 5.9 to 0.9 in the collagen implant and control groups, respectively (p<0.001 for all). Overall improvements in ROM and PROs were similar in both groups. MRI revealed intact repairs in 11/20 (55%) patients in the patch group and 9/17 (53%) in the control group. Two patients in each group were revised to reverse shoulder arthroplasty. ConclusionsArthroscopic repair of retracted large and massive rotator cuff tears, including revision repairs, with and without augmentation using a bio-inductive collagen implant results in substantial and comparable early clinical improvement, although predictable healing remains elusive. Further work is needed to optimize patient selection for massive rotator cuff repair and define more precisely the indications for augmentation of these repairs using the collagen implant.

An experimental study of the vascular embolism caused by recombinant type III collagen implants and hyaluronic acid.

There are significant differences in the reported incidence of vascular complications that result from the injection of different soft tissue fillers. This study aimed to compare the risk of vascular embolism after recombinant type III collagen implants and hyaluronic acid (HA) injection into arteries. Different concentrations of recombinant type III collagen and Restylane were injected into the central ear artery of rabbits, to construct an immediate embolization model. We screened for vascular recanalization and tissue necrosis at 30 min, 1 day, and 7 days after injection, and histopathology examination was processed on Day 7. At 30 min after injection, complete recanalization of the central ear artery was observed in 17 rabbits in the C1 group while none in the HA group. On Day 1 after injection, complete recanalization of the CEA main trunk was observed in all rabbits in the collagen group while 50% in the HA group. There was a significant difference between the C1 group and the HA group in terms of vascular recanalization and skin necrosis. Under the present experimental conditions, the risk of causing vascular embolism was much lower with collagen than with Restylane. Different doses of collagen at different injection rates have the same safety profile.

A randomized, double-blind, placebo-controlled study to evaluate the efficacy and safety of a bupivacaine hydrochloride implant in patients undergoing abdominoplasty

IntroductionSurgical site infiltration with bupivacaine hydrochloride (HCl) is a standard element of postoperative analgesia for soft tissue surgeries, but results in short-lived analgesia. A novel bupivacaine implant, XARACOLL (bupivacaine HCl),...

MP60-17 OFF-THE-SHELF IMPLANT TO BRIDGE A URETHRA, MULTICENTRE 8-YEAR JOURNEY FROM BENCH TO BED

MP60-17 OFF-THE-SHELF IMPLANT TO BRIDGE A URETHRA, MULTICENTRE 8-YEAR JOURNEY FROM BENCH TO BED

Finite Element Analysis of Different Osseocartilaginous Reconstruction Techniques in Animal Model Knees.

Lesions of the articular cartilage are frequent in all age populations and lead to functional impairment. Multiple surgical techniques have failed to provide an effective method for cartilage repair. The aim of our research was to evaluate the effect of two different compression forces on three types of cartilage repair using finite element analysis (FEA). Initially, an in vivo study was performed on sheep. The in vivo study was prepared as following: Case 0-control group, without cartilage lesion; Case 1-cartilage lesion treated with macro-porous collagen implants; Case 2-cartilage lesion treated with collagen implants impregnated with bone marrow concentrate (BMC); Case 3-cartilage lesion treated with collagen implants impregnated with adipose-derived stem cells (ASC). Using the computed tomography (CT) data, virtual femur-cartilage-tibia joints were created for each Case. The study showed better results in bone changes when using porous collagen implants impregnated with BMC or ASC stem cells for the treatment of osseocartilaginous defects compared with untreated macro-porous implant. After 7 months postoperative, the presence of un-resorbed collagen influences the von Mises stress distribution, total deformation, and displacement on the Z axis. The BMC treatment was superior to ASC cells in bone tissue morphology, resembling the biomechanics of the control group in all FEA simulations.