Standard of care
Currently there a few ways that VML is managed. The standard of care from a surgical perspective involves autologous tissue transfer. This involves blah blah blah. However, because of the highly technical procedures involved in the surgery, these method is associated with significant donor site morbidity, especially in the lower leg muscles. (Khouri, Roger, et al., 711-721). Nonsurgical options include use of a lower limb orthosis such as an ankle-foot orthosis, but this method is typically limited to lower-limb VML. Many times these methods are paired with physical therapy designed to induce muscle hypertrophy.
State of the art
Figure 1: Different scaffold designs currently used in SMTE (Koning et al., 407-415).
Currently, we are able to develop both synthetic and natural scaffolds. Synthetic biodegradable three dimensional (3D) scaffolds that show great promise form SMTE are polymers ...
... middle of paper ...
Figure 2: (Left): Experimental setup to measure contractile strength of muscle tissue in vivo (Right): Light microscopy of neural cells and myotubes following 1 week co-culture (Larkin et al., 75-82)
To ensure that the results are statistically significant I would create five strands of skeletal muscle tissue from each group: 5 grown from tibialis anterior satellite cells and 5 grown from gastrocnemius satellite cells. These would be tested against corresponding muscle tissue harvested from the rats.
In conclusion, this approach would hopefully produce engineered skeletal muscle tissue that has its own vascularization, has proper neural innervation, and can incorporate itself in vitro without biocompatibility or functional issues. This would provide a great solution to patients undergoing any sort of volumetric muscle loss.
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