Preventing peritendinous adhesions using lubricious supramolecular hydrogels.

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Orthopedic Surgery

Background:

• Peritendinous adhesions significantly limit range of motion (ROM) after hand flexor tendon injuries, affecting over 30-40% of 1.5 million annual cases in the US.
• Current treatments lack effective adhesion prevention methods that allow for rapid, full ROM restoration post-surgery in the delicate digital space.

Purpose of the Study:

• To develop and evaluate dynamically crosslinked, bioresorbable supramolecular hydrogels as injectable barriers for preventing peritendinous adhesions.
• To assess the hydrogels' safety, efficacy, and potential for improving functional recovery after tendon injury.

Main Methods:

• Development of injectable, stable supramolecular hydrogels with tunable viscoelastic properties.
• In vitro assessment of hydrogel-tissue interface interactions and lubricity.
• Ex vivo biomechanical testing of cadaveric tendons treated with hydrogels.
• In vivo evaluation in a preclinical rat tendon injury model to assess retention, healing, and functional recovery (ROM, dorsiflexion).

Main Results:

• Hydrogels demonstrated long-term stability, injectability, and maintained a lubricious barrier between tissues.
• Ex vivo studies confirmed unimpaired tendon biomechanics.
• Preclinical trials showed prolonged hydrogel retention and significant improvements in functional recovery, including ROM and maximal dorsiflexion.
• Hydrogels were found to be safe and did not impede tendon healing.

Conclusions:

• Dynamically crosslinked supramolecular hydrogels represent a promising, easy-to-apply solution for preventing peritendinous adhesions after hand tendon injuries.
• These hydrogels facilitate improved functional recovery and ROM, offering a scalable intervention with significant translational potential for clinical use.