TY - JOUR
T1 - The effect of muscle loading on flexor tendon-to-bone healing in a canine model
AU - Thomopoulos, Stavros
AU - Zampiakis, Emmanouil
AU - Das, Rosalina
AU - Silva, Matthew J.
AU - Gelberman, Richard H.
PY - 2008/12
Y1 - 2008/12
N2 - Previous tendon and ligament studies have demonstrated a role for mechanical loading in tissue homeostasis and healing. In uninjured musculoskeletal tissues, increased loading leads to an increase in mechanical properties, whereas decreased loading leads to a decrease in mechanical properties. The role of loading on healing tissues is less clear. We studied tendon-to-bone healing in a canine flexor tendon-to-bone injury and repair model. To examine the effect of muscle loading on tendon-to-bone healing, repaired tendons were either cut proximally (unloaded group) to remove all load from the distal phalanx repair site or left intact proximally (loaded group). All paws were casted postoperatively and subjected to daily passive motion rehabilitation. Specimens were tested to determine functional properties, biomechanical properties, repair-site gapping, and bone mineral density. Loading across the repair site led to improved functional and biomechanical properties (e.g., stiffness for the loaded group was 8.2 ± 3.9 versus 5.1 ± 2.5 N/mm for the unloaded group). Loading did not affect bone mineral density or gapping. The formation of a gap between the healing tendon and bone correlated with failure properties. Using a clinically relevant model of flexor tendon injury and repair, we found that muscle loading was beneficial to healing. Complete removal of load by proximal transection resulted in tendon-to-bone repairs with less range of motion and lower biomechanical properties compared to repairs in which the muscle-tendon-bone unit was left intact.
AB - Previous tendon and ligament studies have demonstrated a role for mechanical loading in tissue homeostasis and healing. In uninjured musculoskeletal tissues, increased loading leads to an increase in mechanical properties, whereas decreased loading leads to a decrease in mechanical properties. The role of loading on healing tissues is less clear. We studied tendon-to-bone healing in a canine flexor tendon-to-bone injury and repair model. To examine the effect of muscle loading on tendon-to-bone healing, repaired tendons were either cut proximally (unloaded group) to remove all load from the distal phalanx repair site or left intact proximally (loaded group). All paws were casted postoperatively and subjected to daily passive motion rehabilitation. Specimens were tested to determine functional properties, biomechanical properties, repair-site gapping, and bone mineral density. Loading across the repair site led to improved functional and biomechanical properties (e.g., stiffness for the loaded group was 8.2 ± 3.9 versus 5.1 ± 2.5 N/mm for the unloaded group). Loading did not affect bone mineral density or gapping. The formation of a gap between the healing tendon and bone correlated with failure properties. Using a clinically relevant model of flexor tendon injury and repair, we found that muscle loading was beneficial to healing. Complete removal of load by proximal transection resulted in tendon-to-bone repairs with less range of motion and lower biomechanical properties compared to repairs in which the muscle-tendon-bone unit was left intact.
KW - Animal model
KW - Enthesis
KW - Flexor tendon
KW - Hand
KW - Insertion site
UR - http://www.scopus.com/inward/record.url?scp=56749175180&partnerID=8YFLogxK
U2 - 10.1002/jor.20689
DO - 10.1002/jor.20689
M3 - Article
C2 - 18524009
AN - SCOPUS:56749175180
SN - 0736-0266
VL - 26
SP - 1611
EP - 1617
JO - Journal of Orthopaedic Research
JF - Journal of Orthopaedic Research
IS - 12
ER -