Experimental and clinical evaluation of an absorbable biomaterial inducing an anti-adhesive barrier (Divide®)

7Citations
Citations of this article
10Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

We evaluated the efficacy of a biomaterial composed of oxidised regenerated cellulose (Divide) in decreasing the formation of peri-tendinous adhesions in an experimental and clinical study. The experimental study was carried out in 47 New Zealand white rabbits whose Achilles tendons were subjected to a crush injury. The left Achilles tendon served as a control, while the right tendon was wrapped in a sheet of Divide®. Six weeks later the range of motion at the ankle was measured, the tendons were histologically analysed for peri-tendinous adhesions, the tendon sheath was examined using a scanning electron microscope for determining resorption of the biomaterial and the mechanical properties evaluated. The clinical study was performed on 22 patients; 16 requiring post-traumatic extensor tenolysis and six who underwent dorsal synovectomy for rheumatoid arthritis. A sheet of Divide® was placed either between the periosteum and the tendon or around the tendon in all patients. Total active motion and grip strength was evaluated in all patients pre-operatively and at regular intervals post-operatively. The experimental study showed that ankle range of motion was similar between the control and Divide® treated groups in two rabbits, better in the Divide® group in seven rabbits and better in the control group in two rabbits. The results were not statistically significant (P ≤ 0.262) since the numbers were quite low. Histological analysis showed that the treated tendon had a better gliding surface and minimal inflammation/reaction compared to the control group. Scanning electron microscopy on the 10th post-operative day revealed the formation of a new tendon sheath in the Divide® group. The mechanical properties of both the control and experimental Achilles tendon were similar and comparable to a human tendon. The clinical study demonstrated that Divide® was completely resorbed, perfectly biocompatible and non-allergenic. The mean T.A.M. improved from 159.4° to 187.3° (P ≤ 0.074) and grip strength from -26.7 kgF to 10.7 kgF on the 84th post-op day in the extensor tenolysis group (16 digits), while mean return of function to pre-operation level was achieved at 42nd post-operative day and grip strength increased from -3.4 kgF in the immediate, post-operative period to +5.7 kgF at the 84th day in the rheumatoid arthritis group. © 2008 The Author(s).

Cite

CITATION STYLE

APA

Merle, M., Lallemand, B., Lim, A., & Gantois, G. (2008). Experimental and clinical evaluation of an absorbable biomaterial inducing an anti-adhesive barrier (Divide®). European Journal of Orthopaedic Surgery and Traumatology, 18(4), 255–263. https://doi.org/10.1007/s00590-008-0294-9

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free