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Polymer-Assisted Repair and Sutured Collagen Conduits: Comparative Evaluation of Peripheral Nerve Functional Recovery and Histology in a Rat Sciatic Nerve Repair Model
Diep Nguyen, PhD
1, Laura McCrum, MSc
1, Angelo R Dacus, MD
2, Tyler S. Pidgeon, MD
3; Maria Pereira, PhD
1(1)TISSIUM, Paris, France, (2)University of Virginia, Charlottesville, VA, (3)Duke University Medical Center, Durham, NC
IntroductionPeripheral nerve repair (PNR) often results in incomplete and/or unsatisfactory recovery. Current PNR techniques typically rely on sutures alone or in combination with conduit devices. This requires penetration of the epineurium by the suture resulting in an inflammatory response that may interfere with axonal regeneration and functional recovery. To overcome these limitations, this study evaluates the efficacy of a sutureless and atraumatic polymer-assisted repair device compared to a commercial collagen conduit in promoting functional nerve regeneration in a rat sciatic nerve repair model.
Materials & MethodsA sciatic nerve transection model in Wistar-han rats was utilized for this study. Animals were randomized with either an atraumatic polymer-assisted repair device (n=50) or commercial sutured collagen conduit (n=49). The nerve ends were transected and realigned at the repair site within the device. Non-operated sham animals were also evaluated (n=20). Animals were monitored in-life using a Functional Observation Battery assessment as well as Von Frey, grip strength, and measurement of toe-out angle. Histological staining (NF200 and Periaxin immunolabelling) was conducted at 7-days, 30-days, 90-days, and 180-days post implantation to evaluate axonal growth and myelin maturation of the repaired nerve.
ResultsThe Functional Observational Battery demonstrated progressive improvements in gait and normalization of toe pinch reflexes in both treatment groups. Gait impairment scoring indicated that animals implanted with the Polymer-Assisted repair device demonstrated faster recovery, with a greater proportion showing reduced gait deficits compared to sutured collagen conduit repairs. Results of Von Frey and Grip strength showed that animals treated with the polymer-assisted repair device demonstrated improved functional recovery earlier than animals treated with the sutured collage conduits. Analysis of toe-out angle during locomotion indicated convergence toward non-operative (sham) values by the end of the study in both groups, suggesting favorable restoration of coordinated motor function. Histopathology at 30-days, 90-days, and 180-days in the animals treated with the polymer-assisted repair device, revealed efficient nerve repair and had a trend of enhanced axonal growth and myelination relative to the sutured collagen conduit group.
ConclusionsThe atraumatic Polymer-Assisted Repair Device promotes enhanced functional recovery following nerve repair, demonstrated by improved early outcomes for gait, sensory response, and motor strength, and further supported by histopathological evidence. The atraumatic approach may offer a therapeutic advantage in peripheral nerve repairs as compared to standard treatment options.
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