PDF(Pubmed)
Abstract：
Rotator cuff repair surgeries fail frequently, with 20 to 94% of the 600,000 repairs performed annually in the United States resulting in retearing of the rotator cuff. The most common cause of failure is sutures tearing through tendons at grasping points. To address this issue, we drew inspiration from the specialized teeth of snakes of the Pythonoidea superfamily, which grasp soft tissues without tearing. To apply this nondamaging gripping approach to the surgical repair of tendon, we developed and optimized a python tooth-inspired device as an adjunct to current rotator cuff suture repair and found that it nearly doubled repair strength. Integrated simulations, 3D printing, and ex vivo experiments revealed a relationship between tooth shape and grasping mechanics, enabling optimization of the clinically relevant device that substantially enhances rotator cuff repair by distributing stresses over the attachment footprint. This approach suggests an alternative to traditional suturing paradigms and may reduce the risk of tendon retearing after rotator cuff repair.
摘要：
肩袖修复手术经常失败，在美国每年进行的600,000次维修中，有20％至94％导致了肩袖的撕开。失败的最常见原因是缝合线在抓握点处通过肌腱撕裂。为了解决这个问题，我们从Pythonoidea超家族的蛇的特殊牙齿中汲取灵感，抓住软组织而不撕裂。为了将这种无损的夹持方法应用于肌腱的手术修复，我们开发并优化了一种蟒蛇牙启发装置,作为目前肩袖缝合修复的辅助手段,发现其修复强度几乎提高了一倍.综合模拟,3D打印,离体实验揭示了牙齿形状和抓握力学之间的关系，通过将应力分布在附件覆盖区上,使得能够优化临床相关装置,从而显著增强肩袖修复。这种方法建议了传统缝合范例的替代方法，并且可以降低肩袖修复后肌腱再撕裂的风险。
