Advanced robotics to address translational gap in tendon engineering

A review paper by Oxford University scientists discussed the potential benefits of using human musculoskeletal robots and soft robotic systems as bioreactor platforms in the production of clinically useful tendon structures.

New review paper published on 15 September 2022 in the Journal Cyborg and Bionic Systems, summarizes current trends in tendon tissue engineering and discusses how conventional bioreactors are unable to provide physiologically relevant mechanical stimulation given that they are largely dependent on uniaxial tensile phases. The paper then highlights musculoskeletal robots and soft robotic systems as platforms to provide physiologically relevant mechanical stimulation that can overcome this translation gap.

Tendon and soft tissue injuries are a growing social and economic problem, with the tendon repair market in the United States estimated at US$1.5 billion. Tendon repair surgeries have a high rate of revision, with over 40% of rotator cuff repairs failing after surgery. Producing engineered tendon grafts for clinical use is a potential solution to this challenge. Conventional tendon bioreactors primarily provide uniaxial tensile stimulation. There are no summary systems in vivo Hypotenuse loading is a big gap in translation.

“The human body provides tendons with 3D mechanical stress in the form of tension, compression, twisting and shearing. Current research indicates that healthy native tendon tissue requires multiple types and directions of stress. Promising platforms for robotics may be able to mimic it. in vivo Tendon loading,” explained author Ian Sander, a researcher at the University of Oxford with the Soft Tissue Engineering Research Group.

Musculoskeletal robotics were initially designed for applications such as crash test dummies, prosthetics, and sports augmentations. They try to imitate human anatomy by having similar body proportions, skeletal structure, muscle arrangement, and joint structure. Musculoskeletal hominids like Roboy and Kenshiro use tendon-driven systems with muscle actuators that mimic human neuromuscular tissue. Myorobotic units consist of a brushless DC motor that generates tension like a human muscle, accessory cables that act as a tendon unit, and a motorized dashboard with a spring encoder, which acts as a nervous system by sensing variables including tension, pressure, muscle length, and temperature. Suggested advantages of skeletal muscle include the ability to provide multiaxial loading, the potential for loading to take into account human movement patterns, and the provision of loading volumes similar to in vivo forces. One recent study demonstrated the feasibility of culturing human tissue on a musculoskeletal robot for tendon engineering.

Biohybrid Soft Robotics is focused on developing biomimetic-compatible robotic systems that allow flexible and adaptive interactions with unpredictable environments. These automated systems are operated by a number of methods, including temperature, pneumatic and hydraulic pressure, and light. They are made of soft materials including hydrogels, rubber, and even human skeletal muscle tissue. These systems are already used to provide mechanical stimulation to smooth muscle tissue and have been implemented in vivo In the pig model. These systems are attractive for tendon tissue engineering given that: 1) their flexible and compliant properties allow them to wrap around anatomical structures, mimicking native tendon formation 2) they are able to provide multi-axis operation and 3) a number of techniques used in soft robotics intertwine with engineering practices. Existing tendon tissues, and looking to the future, the team envisions advanced robotic systems as platforms that provide a physiologically appropriate mechanical stimulus for tendon grafting prior to clinical use. There are a number of challenges to consider when implementing advanced robotic systems. First, it will be important for future experiments to compare the technologies proposed in this review with conventional bioreactors. With the development of systems capable of providing multi-axis loading, it will be important to find ways to measure stress in a 3D image. Finally, advanced robotic systems will need to be affordable and widely accessible.

“An increasing number of research groups are showing that it is possible to use advanced robotics with living cells and tissues for bioengineering and tissue engineering applications. We are now at an exciting stage where we can explore the various possibilities for incorporating these technologies into tissue engineering,” said Pierre Alexis Mathuy, senior author of the review article. tendons and examining whether they can really help improve the quality of engineered tendon grafts.In the long term, these technologies have the potential to improve the quality of life for individuals, by reducing pain and the risk of tendon repair failure, and healthcare systems, by reducing the number of revision surgeries, and for The economy, by improving workplace productivity and reducing healthcare costs.

The paper’s authors include Ian Sander, Nicole Dvorak, Julie Stebbins, Andrew J. Carr, and Pierre Alexis Mathuy.

This work was completed with financial support from the UK Engineering and Physical Sciences Research Council (project number: 17 P/S003509/1), and the Rhodes Fund.


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