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Division of Bioengineering

Modulating tendon micromechanics for injury prevention or management

Principal investigator: Hazel SCREEN
Funding source(s): EPSRC & TRB Chemedica
 Start: 02-10-2017  /  End: 01-10-2021
 Amount: £140000
Directly incurred staff: Connor Gains
SEMS division:
Hyaluronic Acid in the rat Achilles tendon

Tendon is a multilevel fibre composite material, composed primarily of collagen, interspersed with a range of non-collagenous matrix components. The aligned structure is well suited to transferring muscle forces to the skeleton. However, some tendons are additionally able to store energy during use, to provide increased energy return and improve the efficiency of movement. Unfortunately these energy storing tendons (Achilles, patella) are frequently injured, and the chronic, long term nature of such injuries severely impacts patient quality of life.
In a series of studies, we have been investigating structure-function relationships in the tendon matrix, to identify the properties that facilitate energy storage in tendons, and to ascertain how loss of the specialist properties may lead to increased injury risk. We have identified particular specialisation of the tendon structure at one hierarchical level of the tissue - the fascicles and their surrounding matrix (the interfascicular matrix; IFM). For healthy tendon function, the IFM must be extensible and elastic to enable sliding between fascicles. These findings are exciting, as they suggest that treatments focused towards maintaining or returning IFM function may offer prophylactic or effective injury management solutions for tendinopathy.
TRB Chemedica manufacture a Sodium Hyaluronate-based injectable treatment (Ostenil Tendon™) already licensed for use in the U.K. for treating tendon injuries. Currently the treatment is injected into the sheath or paratenon surrounding a tendon, to help lubricate global tendon movement and reduce inflammation. However, we hypothesise that if Sodium Hyaluronate is injected directly into the IFM region, it might be able to more specifically lubricate IFM sliding, and improve local tendon mechanics to prevent tendon injury, or reverse the increased IFM stiffness seen in injury and facilitate recovery.
This project , in collaboration with TRB Chemedica (UK) Ltd,  will investigate how Sodium Hyaluronate (Ostenil Tendon™) influences local tendon mechanics in young and old, healthy and injured tendons, and elucidate how the use of Ostenil Tendon™ may impact on tendon injury resistance.