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Functionally Graded,Bone‐ and Tendon‐Like Polyurethane for Rotator Cuff Repair
Authors:Dai Fei Elmer Ker  Dan Wang  Anthony William Behn  Evelyna Tsi Hsin Wang  Xu Zhang  Benjamin Yamin Zhou  Ángel Enrique Mercado‐Pagán  Sungwoo Kim  John Kleimeyer  Burhan Gharaibeh  Yaser Shanjani  Drew Nelson  Marc Safran  Emilie Cheung  Phil Campbell  Yunzhi Peter Yang
Affiliation:1. Department of Orthopaedic Surgery, Stanford University, Stanford, CA, USA;2. Institute for Tissue Engineering and Regenerative Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR;3. School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR;4. Tenth People's Hospital of Tongji University, Shanghai, China;5. Department of Material Science and Engineering, Stanford University, Stanford, CA, USA;6. Department of Mathematics, Stanford University, Stanford, CA, USA;7. Department of Biological Sciences, University of Pittsburgh, Pittsburgh, PA, USA;8. Engineering Research Accelerator, Carnegie Mellon University, Pittsburgh, PA, USA;9. Department of Mechanical Engineering, Stanford University, Stanford, CA, USA;10. Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA;11. Department of Bioengineering, Stanford University, Stanford, CA, USA
Abstract:Critical considerations in engineering biomaterials for rotator cuff repair include bone‐tendon‐like mechanical properties to support physiological loading and biophysicochemical attributes that stabilize the repair site over the long‐term. In this study, UV‐crosslinkable polyurethane based on quadrol (Q), hexamethylene diisocyante (H), and methacrylic anhydride (M; QHM polymers), which are free of solvent, catalyst, and photoinitiator, is developed. Mechanical characterization studies demonstrate that QHM polymers possesses phototunable bone‐ and tendon‐like tensile and compressive properties (12–74 MPa tensile strength, 0.6–2.7 GPa tensile modulus, 58–121 MPa compressive strength, and 1.5–3.0 GPa compressive modulus), including the capability to withstand 10 000 cycles of physiological tensile loading and reduce stress concentrations via stiffness gradients. Biophysicochemical studies demonstrate that QHM polymers have clinically favorable attributes vital to rotator cuff repair stability, including slow degradation profiles (5–30% mass loss after 8 weeks) with little‐to‐no cytotoxicity in vitro, exceptional suture retention ex vivo (2.79–3.56‐fold less suture migration relative to a clinically available graft), and competent tensile properties (similar ultimate load but higher normalized tensile stiffness relative to a clinically available graft) as well as good biocompatibility for augmenting rat supraspinatus tendon repair in vivo. This work demonstrates functionally graded, bone‐tendon‐like biomaterials for interfacial tissue engineering.
Keywords:biomedical applications  biomimetics  polymeric materials  rotator cuff repair  tissue engineering
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