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Title: Investigating tendon mechanobiology and the potential of high frequency low magnitude loads for tendon repair and remodelling using a novel in vitro loading system
Author: Adekanmbi, Isaiah
Awarding Body: University of Oxford
Current Institution: University of Oxford
Date of Award: 2013
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Tendon injuries are ubiquitous in the sporting and occupational environment. Clinically they present a challenge to Orthopaedic surgeons as they account for up to half of all sports injuries and almost half of reported work related ailments. The capacity for tendons to heal subsequent to injury is restricted due to their poor blood supply. Moreover, healed tendon tissue may be inferior to the intact tendon, having diminished biochemical and biomechanical properties and this brings about an ever increasing need for optimized treatment methods for tendon repair. Mechanobiology is concerned with how mechanical forces influence physiological and pathological aspects of the living tissue. However, the complex and poorly controlled loading environment in living organisms prevent the establishment of direct relationships between mechanical stimuli and tissue response. By developing a novel in vitro loading system (IVLS), the work in this thesis investigates the potential of a new and exciting biophysical loading intervention, High Frequency Low Magnitude (HFLM) mechanical loading, for stimulation of tendon repair and remodelling. Following a pre-defined stimulation period, healthy rat tail tendon fascicles (RTTFs) were evaluated for tissue viability and metabolism, Glycosaminoglycan (GAG) content, collagen arrangement and tangent modulus, using staining and biochemical assays, together with microscopy techniques, and mechanical testing. HFLM mechanically loaded tendons showed a trend for a higher tangent modulus than fresh tissue, and significantly higher modulus than unloaded. Further, when varying mechanical loading parameters of frequencies and dosages over clinically relevant ranges, a frequency dependent response was observed with increased tangent modulus and GAG content with increasing frequency. An association between high tendon crimp pattern and elevated tendon modulus as a result of HFLM mechanical loading was also demonstrated. Concomitantly, an injury model was developed to evaluate the effects of in vitro static, low frequency cyclic and HFLM mechanical loading conditions on the biochemical and biomechanical properties of in vitro damaged tendons. HFLM mechanically loaded damaged tendons again demonstrated significantly higher modulus and metabolism than unloaded tissue, although these were reduced below those of fresh damaged tissue. The findings in this thesis together with the newly developed IVLS reveal the potential for an exciting and unique biophysical therapeutic loading intervention for treatment of tendon injuries, and provide a scientific platform for further investigation of the effects of HFLM mechanical loads, potentially leading to an application within the clinic for enhanced connective tissue repair and remodelling.
Supervisor: Thompson, M. S. Sponsor: Engineering and Physical Sciences Research Council
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Biomedical engineering ; Tendon ; High Frequency ; mechanical load ; repair ; tissue ; Biophysics ; novel ; in vitro ; Medicine