A Novel Strategy for Optimized Achilles Tendon Healing: DCN/Hep-Loaded Sutures

The avascular nature of tendons presents a significant challenge for postoperative healing, often resulting in complications and compromised tissue strength. This study explores a novel approach for Achilles tendon repair using a suture-based system incorporating bioactive factors. Decorin (DCN) and heparin (Hep) were selected as key biochemical factors due to their potential to modulate the tendon healing process. The optimal concentration and ratio of DCN were determined through in vitro experiments assessing their effects on tendon stem cell (TSC) proliferation and differentiation. Subsequently, Hep/DCN-loaded sutures were fabricated via electrospinning, exhibiting low immunogenicity and anti-adhesion properties. In vivo studies demonstrated enhanced collagen fibril organization and repair capacity, leading to improved tensile strength of the Achilles tendon postoperatively. These findings were confirmed through mRNA analysis and immunohistochemistry. The suture-based system established in this study not only serves as a valuable tool for investigating the molecular mechanisms underlying TSC differentiation but also holds promise as a new therapeutic strategy for clinical tendon repair applications.