Tensile Strength of Nerve Bridging Models Using Collagen Nerve Conduits

Yusuke Hattori; Shinsuke Takeda; Takuya Usami; Ryutaro Shibata; Hiroshi Takahashi; Yuji Joyo; Yohei Kawaguchi; Hideki Okamoto; Hideki Murakami; Permsak Paholpak; Hideyuki Ota

doi:10.1055/a-2387-3282

Journal of Reconstructive Microsurgery, Inhaltsverzeichnis

J Reconstr Microsurg 2025; 41(05): 383-389
DOI: 10.1055/a-2387-3282

Original Article

Tensile Strength of Nerve Bridging Models Using Collagen Nerve Conduits

Yusuke Hattori‡^†

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

²Department of Orthopedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan

,

Shinsuke Takeda‡^†

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

,

Takuya Usami

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

,

Ryutaro Shibata

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

,

Hiroshi Takahashi

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

,

Yuji Joyo

²Department of Orthopedic Surgery, Nagoya City University East Medical Center, Nagoya, Japan

,

Yohei Kawaguchi

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

,

Hideki Okamoto

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

,

Hideki Murakami

¹Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

,

Permsak Paholpak

³Department of Orthopedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

,

Hideyuki Ota

⁴Department of Orthopedic Surgery and Hand Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan

› Institutsangaben

Abstract

Background In the treatment of peripheral nerve injuries with nerve defects, second-generation collagen-based conduits, such as Renerve® (Nipro, Osaka, Japan), have shown the potential for promoting nerve regeneration. However, there is concern related to the weak material properties. No previous studies have addressed the strength of the bridging model using collagen conduits. This study aimed to investigate the tensile strength and failure patterns in nerve defect models bridged with Renerve® conduits through biomechanical research.

Methods Using fresh chicken sciatic nerves, we examined the maximum failure load of four groups: bridging models using Renerve® with one suture (group A), with two sutures (group B), with three sutures (group C), and end-to-end neurorrhaphy models with two sutures (group N). Each group had eight specimens. We also evaluated failure patterns of the specimens.

Results Group N showed a significantly higher maximum failure load (0.96 ± 0.13 N) compared to groups A (0.23 ± 0.06 N, p < 0.0001), B (0.29 ± 0.05 N, p < 0.0001), and C (0.40 ± 0.10 N, p < 0.0001). Regarding failure patterns, all specimens in group A showed nerve-end dislocation from the conduit. Two specimens in group B and three specimens in group C failed due to circumferential cracks in the conduit. Six specimens in group B and five specimens in group C exhibited cutting out of sutures from the conduit.

Conclusion This study suggests that the number of sutures in synthetic collagen nerve conduits has little effect on the maximum failure load. To take advantage of its biomaterial benefits, a period of postoperative range of motion restriction may be required.

Keywords

synthetic nerve conduits - tensile strength - collagen conduit - postoperative ROM restriction

Volltext

Referenzen

References
1 Houshyar S, Bhattacharyya A, Shanks R. Peripheral nerve conduit: materials and structures. ACS Chem Neurosci 2019; 10 (08) 3349-3365
2 Ichihara S, Inada Y, Nakamura T. Artificial nerve tubes and their application for repair of peripheral nerve injury: an update of current concepts. Injury 2008; 39 (Suppl. 04) 29-39
3 Okamoto H, Hata K, Kagami H. et al. Recovery process of sciatic nerve defect with novel bioabsorbable collagen tubes packed with collagen filaments in dogs. J Biomed Mater Res A 2010; 92 (03) 859-868
4 Saeki M, Tanaka K, Imatani J. et al. Efficacy and safety of novel collagen conduits filled with collagen filaments to treat patients with peripheral nerve injury: a multicenter, controlled, open-label clinical trial. Injury 2018; 49 (04) 766-774
5 Peng Y, Li KY, Chen YF. et al. Beagle sciatic nerve regeneration across a 30 mm defect bridged by chitosan/PGA artificial nerve grafts. Injury 2018; 49 (08) 1477-1484
6 Lohmeyer JA, Siemers F, Machens HG, Mailänder P. The clinical use of artificial nerve conduits for digital nerve repair: a prospective cohort study and literature review. J Reconstr Microsurg 2009; 25 (01) 55-61
7 Mackinnon SE, Dellon AL. Clinical nerve reconstruction with a bioabsorbable polyglycolic acid tube. Plast Reconstr Surg 1990; 85 (03) 419-424
8 Mankavi F, Ibrahim R, Wang H. Advances in biomimetic nerve guidance conduits for peripheral nerve regeneration. Nanomaterials (Basel) 2023; 13 (18) 2528
9 Takeda S, Kurimoto S, Tanaka Y. et al. Mid-term outcomes of digital nerve injuries treated with Renerve® synthetic collagen nerve conduits: a retrospective single-center study. J Orthop Sci 2024; 29 (03) 809-816
10 Huang DX, Yang MX, Jiang ZM. et al. Nerve trunk healing and neuroma formation after nerve transection injury. Front Neurol 2023; 14: 1184246
11 Goldberg SH, Jobin CM, Hayes AG, Gardner T, Rosenwasser MP, Strauch RJ. Biomechanics and histology of intact and repaired digital nerves: an in vitro study. J Hand Surg Am 2007; 32 (04) 474-482
12 Strojny MM, Kozlowska K, Brodowska S, Różczka K, Siemionow M. Assessment of human epineural conduit of different size diameters on efficacy of nerve regeneration and functional outcomes. J Reconstr Microsurg 2023; 39 (05) 392-404
13 Babovic N, Klaus D, Schessler MJ. et al. Assessment of conduit-assisted primary nerve repair strength with varying suture size, number, and location. Hand (N Y) 2019; 14 (06) 735-740
14 Rasappan K, Rajaratnam V, Wong YR. Conduit-based nerve repairs provide greater resistance to tension compared with primary repairs: a biomechanical analysis on large animal samples. Plast Reconstr Surg Glob Open 2018; 6 (12) e1981
15 Weber RA, Breidenbach WC, Brown RE, Jabaley ME, Mass DP. A randomized prospective study of polyglycolic acid conduits for digital nerve reconstruction in humans. Plast Reconstr Surg 2000; 106 (05) 1036-1045 , discussion 1046–1048
16 Duncan SF, Kakinoki R, Rizzo M, Kang W. Extrusion of a NeuroTube: a case report. Ochsner J 2015; 15 (02) 191-192
17 Tanaka H, Kurimoto S, Hirata H. Efficacy of collagen conduit wrapping with collagen fibers on nerve regeneration in sciatic nerve injury with partial transection: an experimental study in the rat model. J Biomed Mater Res B Appl Biomater 2024; 112 (01) e35369
18 Yamamoto M, Endo N, Ito M. et al. Novel polysaccharide-derived hydrogel prevents perineural adhesions in a rat model of sciatic nerve adhesion. J Orthop Res 2010; 28 (03) 284-288
19 Brogan DM, Dy CJ, Rioux-Forker D, Wever J, Leversedge FJ. Influences of repair site tension and conduit splinting on peripheral nerve reconstruction. Hand (N Y) 2022; 17 (06) 1048-1054
20 Brogan DM, Dy CJ, Lee TY, Rioux-Forker D, Wever J, Leversedge FJ. Histologic and functional outcomes of conduit wrapping for peripheral nerve repair: early results in a rat model. J Reconstr Microsurg 2021; 37 (07) 559-565
21 Wolfe EM, Mathis SA, Ovadia SA, Panthaki ZJ. Comparison of collagen and human amniotic membrane nerve wraps and conduits for peripheral nerve repair in preclinical models: a systematic review of the literature. J Reconstr Microsurg 2023; 39 (04) 245-253
22 Uemura T, Onode E, Yokoi T. et al. Nerve capping technique with nerve conduit for treating painful digital neuroma: a case report. J Orthop Sci 2022; 27 (01) 284-287
23 Lohmeyer JA, Kern Y, Schmauss D. et al. Prospective clinical study on digital nerve repair with collagen nerve conduits and review of literature. J Reconstr Microsurg 2014; 30 (04) 227-234
24 Schultz GS, Chin GA, Moldawer L. et al. Principles of Wound Healing. In: Fitridge R, Thompson M. eds. Mechanisms of Vascular Disease: A Reference Book for Vascular Specialists [Internet]. Adelaide (AU): University of Adelaide Press; 2011: 23