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Home/Large Joints and Extremities/$1.7 Million to Case Western Engineer for Growing Tissue
Large Joints and Extremities

$1.7 Million to Case Western Engineer for Growing Tissue

June 25, 2014 2 min read Premium comments

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$1.7 Million to Case Western Engineer for Growing Tissue
Source: Case Western Reserve University
Secondary

Ozan Akkus, Ph.D., a professor of mechanical and aerospace engineering at Case Western Reserve University, has been awarded a $1.7 million grant from the National Institutes of Health (NIH) to grow replacement rotator cuffs and other large tendon groups. His work will impact injured soldiers and athletes, accident victims and the wider population.

Dr. Akkus, who created a way to reconstitute collagen into tough fibers and induce adult stem cells to grow into tendons on those fibers, will be focusing on basic science and translational work over the next five years.

According to the June 16, 2014 news release, “His lab uses electrical currents to align collagen threads, mimicking the natural tendon and making the threads dense and strong as a tendon. And his team can make threads in bulk, which would enable manufacturers to make spools of the material—enough to accommodate hundreds of thousands of surgeries.”

“Woven threads are sufficiently strong to be surgically handled and sutured in place and be fully load-bearing, ” Dr. Akkus said. “This would enable a patient to begin physical therapy and remobilization quickly, ” he added. “The threads alone could be used as sutures to repair simple tears. But when more tendon material is needed, adult mesenchymal stem cells placed on the aligned collagen differentiate toward tendon cells without highly regulated growth factors, which also carry undesirable side effects or other chemicals.”

Dr. Akkus told OTW, “The most striking feature of this product is its ability to induce growth-factor free differentiation of adult stem cells into tendon cells by mimicking the topography of the natural tendon. This is probably the first time a fully-load bearing pure collagen repair scaffold is fabricated as a woven biotextile for bulk-repair of tendon. Unlike ‘collagen rich’ decellularized xenografts, the 100% pure collagen nature of this scaffold will have consistent performance.”

Regarding his most important message for orthopedic surgeons, Dr. Akkus stated, “The complication rates in rotator cuff repairs are still unacceptably high. Furthermore, the number of solutions for functional repair of advanced stage rotator cuff degenerations is limited.”

Asked about the challenges of this work, Dr. Akkus noted, “Like any biomaterial based repair strategy, patient to patient variations in the regenerative capacity of stem cells is one of the biggest challenges in the regenerative medicine. Some stem cells thrive magnificiently in the body whereas other sources may not.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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