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.
We know the risk of tendon injury increases with ageing, and we have additionally demonstrated that the IFM stiffens with ageing. 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.

In the current project, we wish to establish how IFM stiffening is associated with increased risk of tendon injury, and to subsequently develop novel materials and solutions to manipulate IFM mechanics and improve sliding between fascicles as potential treatments for the prevention and management of tendon injury.
TRB Chemedica (UK) Ltd are part of the Geneva based TRB Chemedica International Group, specialists in biosynthetic Hyaluronic Acid (HA), with a diverse portfolio of products licensed worldwide. Their sodium hyaluronate injectable OSTENIL TENDON is designed for injection into the sheath or paratenon surrounding a tendon, to help lubricate global tendon movement and reduce inflammation.
Working in collaboration, we aim to develop new formulations/combinations of Sodium Hyaluronate-based injectables such as OSTENIL TENDON - and possibly other substances with similar bio-mechanical properties (e.g. elastin, lubricin) - and investigate their utility in attaining our primary goal of improving IFM mechanics and preventing or managing tendon injury.
We will set up a model of mechanical overload in the rat Achilles tendon, to determine how ageing influences IFM composition, structure and mechanics, and how this influences overall Achilles fatigue resistance and the initiation of load-induced tendinopathy.
We will establish the most suitable preparations of biosynthetic HA and best approaches to administer these, to optimise infiltration to, and retention within, the IFM.
Having developed an appropriate preparation, we will investigate its effects on IFM mechanics and whole tendon fatigue resistance, as well as cell health and phenotype.
We aim to establish a preparation of OSTENIL TENDON that can be administered to the IFM to increase fascicle lubrication and subsequently tendon fatigue resistance, reducing the risk of tendon injury.