TY - JOUR
T1 - Intercalary flexor tendon grafts
T2 - A morphological study of intrasynovial and extrasynovial donor tendons
AU - Gelberman, Richard H.
AU - Seiler, John G.
AU - Rosenberg, Andrew E.
AU - Heyman, Philip
AU - Amiel, David
N1 - Funding Information:
This study was supported by NIH Grant 5ROI-AR22097.
PY - 1992
Y1 - 1992
N2 - Intercalary intrasynovial and extrasynovial flexor tendon graft donors were placed within the synovial sheaths of the medial and lateral forepaw digits of 22 dogs and treated with early controlled passive mobilization. Specimens were studied by light and transmission electron microscopy at 10 and 21 days. Early repair in the extrasynovial tendons occurred by an ingrowth of connective tissue from the digital sheath. Adhesions obliterated the gliding surface and occupied the space between the tendon's gliding surface and surrounding tissues. There was no epitenon response noted in the extrasynovial tendon grafts. While there was considerable new collagen fibril formation within the repair site at the ultrastructural level, there was a lack of longitudinal remodeling. In contrast, the intrasynovial tendon grafts showed early healing, with minimal adhesion formation, by a proliferation and migration of cells from the epitenon. These cells showed greater cellular activity and collagen production at 10 and 21 days compared to cells in extrasynovial tendons at the same intervals. The findings of this study suggest that the use of intrasynovial autogenous tendon graft donors, coupled with early controlled motion, stimulates an intrinsic repair process in both the tendon stump and autogenous tendon graft. These findings differ significantly from the experimental findings in which extrasynovial, paratenon-covered grafts are used.
AB - Intercalary intrasynovial and extrasynovial flexor tendon graft donors were placed within the synovial sheaths of the medial and lateral forepaw digits of 22 dogs and treated with early controlled passive mobilization. Specimens were studied by light and transmission electron microscopy at 10 and 21 days. Early repair in the extrasynovial tendons occurred by an ingrowth of connective tissue from the digital sheath. Adhesions obliterated the gliding surface and occupied the space between the tendon's gliding surface and surrounding tissues. There was no epitenon response noted in the extrasynovial tendon grafts. While there was considerable new collagen fibril formation within the repair site at the ultrastructural level, there was a lack of longitudinal remodeling. In contrast, the intrasynovial tendon grafts showed early healing, with minimal adhesion formation, by a proliferation and migration of cells from the epitenon. These cells showed greater cellular activity and collagen production at 10 and 21 days compared to cells in extrasynovial tendons at the same intervals. The findings of this study suggest that the use of intrasynovial autogenous tendon graft donors, coupled with early controlled motion, stimulates an intrinsic repair process in both the tendon stump and autogenous tendon graft. These findings differ significantly from the experimental findings in which extrasynovial, paratenon-covered grafts are used.
KW - Extrasynovial
KW - Intrasynovial
KW - Passive motion
KW - Tendon graft
UR - http://www.scopus.com/inward/record.url?scp=0027087402&partnerID=8YFLogxK
U2 - 10.3109/02844319209015268
DO - 10.3109/02844319209015268
M3 - Article
C2 - 1470872
AN - SCOPUS:0027087402
VL - 26
SP - 257
EP - 264
JO - Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery
JF - Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery
SN - 0284-4311
IS - 3
ER -