The five-year research programme, which starts this December 2018, brings together musculoskeletal research and engineering sciences to deliver better and more cost-effective care for patients with shoulder tendon problems.
Rotator cuff tendon tears are a leading cause of prolonged periods of disability and absence from work worldwide. With an aging population, these injuries represent an important and increasing societal and economic burden. With 40% of the surgical repairs failing due to poor tissue healing and with tendon autograft transplantation being limited due to donor site morbidity, it is urgent to identify new solutions for these patients. Tissue engineering is a promising strategy, but more advanced bioreactors are needed to provide clinically relevant engineered grafts.
“Our research programme aims to develop a novel platform in tissue engineering that makes use of human-like robots for enabling the provision of physiological mechanical stimulation to tendon tissue grafts. We hope that this will improve the functionality and the clinical relevance of engineered tendons. The ultimate goal is to deliver better care for patients”, says lead investigator Dr Mouthuy.
Bringing together medicine, life sciences, engineering and mathematics, Dr Mouthuy’s programme will explore the potential of this approach by adapting an anthropomorphic robotic shoulder developed at the Technical University of Munich. Using 3D printing and textile technologies, the team will design and test novel bioreactor chambers that can be combined with the robot for the engineering of rotator cuff tendons.
“If this approach works, we could see safer and more cost-effective repairs for not only torn shoulder tendons, but crucially this could have wider applications in the repair of other musculoskeletal tissues, like other tendons, ligaments, and so on. This may also provide a more realistic platform for further in vitro work, such as for the testing of new drugs and implants”, says Dr Mouthuy.
And he adds: “This is a pioneering research programme that will allow us to make the most of recent advances in technology to deliver truly innovative medical solutions for the benefit of patients. My co-investigators and I would like to thank the EPSRC for the opportunity to work on a exciting solution which could tackle a growing medical problem”.
Tissue engineering typically involves the development of bioreactors to generate pre-conditioned tissue grafts in vitro using the patient's cells and a biomaterial used as a supportive matrix. Bioreactors are basically culture chambers that control the environmental conditions necessary for maintaining and for stimulating tissue constructs, including temperature, pH, nutrient concentrations, biochemical and mechanical stimuli, etc. Despite the recent progress, tendon bioreactors are still rudimentary with regard to their ability to provide mechanical stimulation, which is crucial for tendon growth. Most of them only provide uniaxial cyclic loadings, which poorly mimic the multiaxial mechanical stresses experienced by tendons in vivo.
