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Article
Adhesive-Based Tendon-To-Bone Repair: Failure Modelling and Materials Selection
Journal of the Royal Society Interface
  • Evangelos I. Avgoulas
  • Michael P. F. Sutcliffe
  • Stephen W. Linderman
  • Victor Birman, Missouri University of Science and Technology
  • Stavros Thomopoulos
  • Guy M. Genin
Abstract

Surgical reattachment of tendon to bone is a procedure marked by high failure rates. For example, nearly all rotator cuff repairs performed on elderly patients with massive tears ultimately result in recurrence of tearing. These high failure rates have been attributed to stress concentrations that arise due to the mechanical mismatch between tendon and bone. Although recent studies have identified potential adhesives with mechanical properties tuned to alleviate these stress concentrations, and thereby delay the onset of failure, resistance to the progression of failure has not been studied. Here, we refined the space of adhesive material properties that can improve surgical attachment by considering the fracture process. Using cohesive zone modelling and physiologically relevant values of mode I and mode II adhesive fracture toughnesses, we predicted the maximum displacement and strength at failure of idealized, adhesively bonded tendon-to-bone repairs. Repair failure occurred due to excessive relative displacement of the tendon and bone tissues for strong and compliant adhesives. The failure mechanism shifted to rupture of the entire repair for stiffer adhesives below a critical shear strength. Results identified a narrow range of materials on an Ashby chart that are suitable for adhesive repair of tendon to bone, including a range of elastomers and porous solids.

Department(s)
Mechanical and Aerospace Engineering
Keywords and Phrases
  • Cohesive zone model,
  • Enthesis,
  • Rotator cuff
Document Type
Article - Journal
Document Version
Citation
File Type
text
Language(s)
English
Rights
© 2019 The Author(s), All rights reserved.
Publication Date
4-1-2019
Publication Date
01 Apr 2019
PubMed ID
30966948
Citation Information
Evangelos I. Avgoulas, Michael P. F. Sutcliffe, Stephen W. Linderman, Victor Birman, et al.. "Adhesive-Based Tendon-To-Bone Repair: Failure Modelling and Materials Selection" Journal of the Royal Society Interface Vol. 16 Iss. 153 (2019) ISSN: 1742-5662
Available at: http://works.bepress.com/victor-birman/210/