Enhanced flexor tendon healing through controlled delivery of PDGF-BB

Stavros Thomopoulos, Rosalina Das, Matthew J. Silva, Shelly Sakiyama-Elbert, Frederick L. Harwood, Emmanouil Zampiakis, H. Mike Kim, David Amiel, Richard H. Gelberman

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96 Scopus citations


Afibrin/heparin-based delivery system was used to provide controlled delivery of platelet derived growth factor BB (PDGF-BB) in an animal model of intrasynovial flexor tendon repair. We hypothesized that PDGF-BB, administered in this manner, would stimulate cell proliferation and matrix remodeling, leading to improvements in the sutured tendon's functional and structural properties. Fifty-six flexor digitorum profundus tendons were injured and repaired in 28 dogs. Three groups were compared: (1) controlled delivery of PDGF-BB using a fibrin/heparin-based delivery system; (2) delivery system carrier control; and (3) repair- only control. The operated forelimbs were treated with controlled passive motion rehabilitation. The animals were euthanized at 7, 14, and 42 days, at which time the tendons were assessed using histologic (hyaluronic acid content, cellularity, and inflammation), biochemical (total DNA and reducible collagen crosslink levels), and biomechanical (gliding and tensile properties) assays. We found that cell activity (as determined by total DNA, collagen crosslink analyses, and hyaluronic acid content) was accelerated due to PDGF-BB at 14 days. Proximal interphalangeal joint rotation and tendon excursion (i.e., tendon gliding properties) were significantly higher for the PDGF-BB-treated tendons compared to the repair-alone tendons at 42 days. Improvements in tensile properties were not achieved, possibly due to suboptimal release kinetics or other factors. In conclusion, PDGF-BB treatment consistently improved the functional but not the structural properties of sutured intrasynovial tendons through 42 days following repair.

Original languageEnglish
Pages (from-to)1209-1215
Number of pages7
JournalJournal of Orthopaedic Research
Issue number9
StatePublished - Sep 2009


  • Controlled delivery
  • Delivery system
  • Flexor tendon
  • Growth factor
  • Tendon healing


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