Synthetic Graft Augmentation (Polyurethane Urea) for Reconstruction of Peroneal Tendon Injury



Biomaterials such as polyurethane urea can be utilized for augmentation and reconstruction of peroneal tendon tears. They provide mechanical strength during the acute healing phase while permitting anatomical mechanical loading and remodeling into organized functional tissue.


Artelon Polyurethane urea Biomaterials Synthetic graft 


  1. 1.
    Weiler A, Peters G, Mäurer J, Unterhauser FN, Südkamp NP. Biomechanical properties and vascularity of an anterior cruciate ligament graft can be predicted by contrast-enhanced magnetic resonance imaging. A two-year study in sheep. Am J Sports Med. 2001;29(6):751–61.CrossRefGoogle Scholar
  2. 2.
    Clancy WG Jr, Narechama RG, Rosenberg RD, Gmeiner JG, Wisnefske DD, Lange TA. Anterior and posterior cruciate ligament reconstruction in rhesus monkeys. J Bone Joint Surg Am. 1981;63(8):1270–84.CrossRefGoogle Scholar
  3. 3.
    Fu F, Bennett CH, Lattermann C, Benjamin C. Current trends in anterior cruciate ligament reconstruction. Part 1: Biology and biomechanics of reconstruction. Am J Sports Med. 1999;27(6):821–30.CrossRefGoogle Scholar
  4. 4.
    Rading J, Peterson L. Clinical experience with the Leeds-Keio artificial ligament in anterior cruciate ligament reconstruction. A prospective two-year follow-up study. Am J Sports Med. 1995;23(3):316–9.CrossRefGoogle Scholar
  5. 5.
    Wredmark T, Engstrom B. Five-year results of anterior cruciate ligament reconstruction with the Stryker Dacron high-strength ligament. Knee Surg Sports Traumatol Arthrosc. 1993;1(2):71–5.CrossRefGoogle Scholar
  6. 6.
    Engström B, Wredmark T, Westblad P. Patellar tendon or Leeds-Keio graft in the surgical treatment of anterior cruciate ligament ruptures. Intermediate results. Clin Orthop Relat Res. 1993;295:190–7.Google Scholar
  7. 7.
    Denti M, Bigoni M, Dodaro G, Monteleone M, Arosio A. Long-term results of the Leeds-Keio anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 1995;3(2):75–7.CrossRefGoogle Scholar
  8. 8.
    Pattee GA, Friedman M. A review of autogenous intraarticular reconstruction of the anterior cruciate ligament. In: Friedman MJ, Ferkel RD, editors. Prosthetic ligament reconstruction of the knee. Philadelphia: WB Saunders; 1988. p. 22–8.Google Scholar
  9. 9.
    Puddu G, Cipolla M, Cerullo G, Franco V, Giannì E. Anterior cruciate ligament reconstruction and augmentation with PDS graft. Clin Sports Med. 1993 Jan;12(1):13–24.CrossRefGoogle Scholar
  10. 10.
    Gretzer C, Emanuelsson L, Liljensten E, Thomsen P. The inflammatory cell influx and cytokines changes during transition from acute inflammation to fibrous repair around implanted materials. J Biomater Sci Polym Ed. 2006;17(6):669–87.CrossRefGoogle Scholar
  11. 11.
    Giza E, Frizzell L, Farac R, Williams J, Kim S. Augmented tendon Achilles repair using a tissue reinforcement scaffold: a biomechanical study. Foot Ankle Int. 2011 May;32(5):S545–9.CrossRefGoogle Scholar
  12. 12.
    Gisselfält K, Edberg B, Flodin P. Synthesis and properties of degradable poly(urethane urea)s to be used for ligament reconstructions. Biomacromolecules. 2002 Sep-Oct;3(5):951–8.CrossRefGoogle Scholar
  13. 13.
    Liljensten E, Gisselfält K, Edberg B, Bertilsson H, Flodin P, Nilsson A, Lindahl A, Peterson L. Studies of polyurethane urea bands for ACL reconstruction. J Mater Sci Mater Med. 2002 Apr;13(4):351–9.CrossRefGoogle Scholar
  14. 14.
    Peterson L, Eklund U, Engström B, Forssblad M, Saartok T, Valentin A. Long-term results of a randomized study on anterior cruciate ligament reconstruction with or without a synthetic degradable augmentation device to support the autograft. Knee Surg Sports Traumatol Arthrosc. 2014;22(9):2109–20.CrossRefGoogle Scholar
  15. 15.
    Coughlin MJ, Saltzman CL, Anderson RB. Mann’s surgery of the foot and ankle. Philadelphia: Saunders/Elsevier; 2014.Google Scholar
  16. 16.
    Ogawa BK, Thordarson DB. Current concepts review: peroneal tendon subluxation and dislocation. Foot Ankle Int. 2007;28(9):1034–40.CrossRefGoogle Scholar
  17. 17.
    Gersoff WK, Bozynski CC, Cook CR, Pfeiffer FM, Kuroki K, Cook JL. Evaluation of a novel degradable synthetic biomaterial patch for augmentation of tendon healing in a large animal model. J Knee Surg. 2019;32(5):434–40.CrossRefGoogle Scholar
  18. 18.
    Pellegrini MJ, et al. Effectiveness of allograft reconstruction for irreparable peroneal brevis tears: a cadaveric model. Foot Ankle Int. 2016;37(8):803–8.CrossRefGoogle Scholar
  19. 19.
    Shoaib A, Mishra V. Surgical repair of symptomatic chronic Achilles tendon rupture using synthetic graft augmentation. Foot Ankle Surg. 2017;23:179–82.CrossRefGoogle Scholar
  20. 20.
    Sanders TH, Neufeld SK, Cuttica DJ. Anterior tibial tendon repair with polycaprolactone-based polyurethane urea based graft. Am Orthop Foot Ankle Soc. 33rd Annual Meeting, July 11-14, 2018, Boston, MA.Google Scholar
  21. 21.
    McKenna BJ, et al. Lateral Ankle Stabilization: Anatomic reconstruction for chronic lateral ankle instability utilizing degradable synthetic graft – a case series. Am Coll Foot Ankle Surg Scientific Conference, February 19–22, 2020, San Antonio, TX.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.The Orthopaedic Foot and Ankle CenterCenter for Advanced OrthopedicsFalls ChurchUSA
  2. 2.Wake OrthopaedicsRaleighUSA

Personalised recommendations