The In Vivo Response of Foetal Tendons to Sutures

The in vivo response of foetal flexor digitorum profundus tendons to tendon sutures was studied macroscopically and microscopically in foetal lambs. No tendon adhesions were noted at any of the examination intervals. 4 days after injury, a mild inflammatory reaction was noted around the suture. The tendon examined at the 4-week interval showed evidence of migration of epitenon cells from the outer surface of the tendon into the suture track. The tendon examined at the 6-week interval showed normal tendon fibres surrounding the suture site. Differences between foetal skin and foetal tendon healing are discussed along with the possible role of amniotic fluid in modulating the healing process in the foetus.

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Triggering After Partial Tendon Laceration

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(93)90119-z ◽

1993 ◽

Vol 18 (2) ◽

pp. 241-246 ◽

Cited By ~ 28

Author(s):

M. M. AL-QATTAN ◽

J. C. POSNICK ◽

K. Y. LIN

Keyword(s):

Hind Limb ◽

Healing Process ◽

Scar Formation ◽

Spontaneous Resolution ◽

Flexor Digitorum Profundus ◽

Adult Sheep ◽

Flexor Digitorum ◽

Tendon Laceration

Triggering and tendon flap formation were studied after a transverse laceration of 50% of the width of the flexor digitorum profundus tendons of the hind limb of 14 adult sheep at various intervals after injury. The tendon laceration was not repaired and there was no post-operative immobilization. Triggering was not caused by bulbous scar formation but by the bunching of the tendon fibres proximal or distal to the laceration site. This bunched part of the tendon appeared to become incorporated into the healing process, with gradual spontaneous resolution of triggering. Failure of incorporation of this bunched part resulted in the formation of a flap in two tendons.

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Gross and Histological Analysis of Healing After Dog Flexor Tendon Repair with the Teno Fix™ Device

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2006.01.006 ◽

2006 ◽

Vol 31 (5) ◽

pp. 524-529 ◽

Cited By ~ 13

Author(s):

B. W. SU ◽

F. J. RAIA ◽

H. M. QUITKIN ◽

M. PARISIEN ◽

R. J. STRAUCH ◽

...

Keyword(s):

Flexor Tendon ◽

Weight Bearing ◽

Tendon Repair ◽

Tendon Healing ◽

Full Weight Bearing ◽

Cast Immobilization ◽

Flexor Tendon Repair ◽

The Common ◽

Flexor Digitorum

The purpose of this study was to examine the in vivo characteristics of the stainless-steel Teno Fix™ device used for flexor tendon repair. The common flexor digitorum superficialis tendon was transected in 16 dogs and repaired with the device. The animals were euthanized at 3, 6, or 12 weeks postoperatively. Difficulties with cast immobilization led nine of 16 animals to be full weight bearing too early, leading to rupture of their repairs. The seven tendons with successful primary repairs (gap <2 mm) underwent histological examination. This in vivo study demonstrates that use of the Teno Fix™ in “suture” of dog flexor tendons did not lead to scarring at the tendon surface, does not cause an inflammatory reaction within the tendon and does not interfere with tendon healing.

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Infiltration of synovitis into the flexor tendon: a case report

Journal of International Medical Research ◽

10.1177/0300060520936180 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052093618

Author(s):

Qianjun Jin ◽

Haiying Zhou ◽

Hui Lu

Keyword(s):

Flexor Tendon ◽

Surgical Excision ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Flexion Angle ◽

Flexor Digitorum Profundus ◽

Normal Tendon ◽

Active Flexion ◽

Flexor Digitorum ◽

Flexor Digitorum Profundus Tendon

Synovitis is a type of aseptic inflammation that occurs within joints or surrounding tendons. No previous reports have described a hypertrophic synovium eroding the tendon sheath and manifesting as synovitis within the flexor tendon. We herein report a case involving a 10-year-old girl who presented to our hospital with a 1-month history of a swollen mass and progressive inability to completely flex her left index finger. The active flexion angle of the proximal interphalangeal joint was limited to 85°. A longitudinal incision of the flexor digitorum profundus tendon was surgically performed. The synovium inside and outside the flexor digitorum profundus tendon was completely removed. After the surgical excision, normal tendon gliding returned without recurrence by the 1-year follow-up. The active flexion angle of the proximal interphalangeal joint improved to 100°. To the best of our knowledge, this is the first case of synovitis affecting the flexor tendon and leading to limited flexion of a finger. The manifestation of a double ring sign on magnetic resonance imaging is quite characteristic. Early diagnosis and monitoring of the hyperproliferation and invasiveness of the synovial tissue are required. Surgical excision can be a simple and effective tool when necessary.

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Application of a Purified Protein From Natural Latex and the Influence of Suture Type on Achilles Tendon Repair in Rats

The American Journal of Sports Medicine ◽

10.1177/0363546518822836 ◽

2019 ◽

Vol 47 (4) ◽

pp. 901-914 ◽

Cited By ~ 1

Author(s):

Diego Pulzatto Cury ◽

Bárbara Tavares Schäfer ◽

Sonia Regina Yokomizo de Almeida ◽

Marta Maria da Silva Righetti ◽

Ii-sei Watanabe

Keyword(s):

Healing Process ◽

Tendon Healing ◽

Healing Time ◽

Suture Technique ◽

Collagen Fibrils ◽

Control Group ◽

Slight Reduction ◽

Type I ◽

Sprague Dawley ◽

Normal Tendon

Background: The prolonged tendon-healing process, the high costs associated with treatment, the increase in the number of injuries over the past decades, and the lack of consensus on the optimal treatment of tendon injuries are a global problem. Restoring the normal tendon anatomy and decreasing the healing time are key factors for treatment advancement. Hypothesis: Application of a purified protein from natural latex (PPNL) accelerates the healing process, increasing collagen synthesis and decreasing metalloproteinases. PPNL associated with a simpler suture technique should decrease the healing time. Study Design: Controlled laboratory study. Methods: Injury, surgery, and treatment with PPNL were conducted with male Sprague-Dawley rats. Two suture techniques were used: U-suture, a simpler and lesser traumatic technique, and Kessler-Tajima, to avoid strangulation of the microcirculation. Achilles tendons were completely sectioned, and 100 µL of 0.1% PPNL was applied on the tendon during surgery. Tendon morphology, distribution, and quantity of collagen types I and III, as well as expression of TIMP-1, TIMP-2, MMP-2, and MMP-9 and ultrastructural aspects of cells and collagen fibrils, were assessed after 2 and 4 weeks. Results: PPNL treatment improved collagen type I synthesis and reduced MMP-2 expression. All groups showed a 6.8-times increase in tendon weight as compared with the control group after 2 weeks and a 5.2-times increase after 4 weeks. All groups showed an increase in diameter after 4 weeks, except for the ones treated with PPNL, which showed a slight reduction in diameter. The peak of concentration of collagen fibrils with a 80-nm diameter was 27.79% in the control group; all other experimental groups presented fibrils between 50 and 60 nm. However, the best results were observed with Kessler-Tajima suture associated with PPNL. Conclusion/Clinical Relevance: There are no known medicines or substances capable of aiding the tendon healing process besides surgery. The discovery of a substance able to improve this process and decrease its duration represents an important advancement in orthopaedic medicine.

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The effects of growth and differentiation factor 5 on bone marrow stromal cell transplants in an in vitro tendon healing model

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193410394521 ◽

2011 ◽

Vol 36 (4) ◽

pp. 271-279 ◽

Cited By ~ 22

Author(s):

M. Hayashi ◽

C. Zhao ◽

K.-N. An ◽

P. C. Amadio

Keyword(s):

Bone Marrow ◽

Collagen Gel ◽

Tendon Healing ◽

Culture Conditions ◽

Flexor Digitorum Profundus ◽

Maximal Strength ◽

Differentiation Factor ◽

Cell Transplants ◽

Flexor Digitorum

The effects of growth differentiation factor-5 (GDF-5) and bone marrow stromal cells (BMSCs) on tendon healing were investigated under in vitro tissue culture conditions. BMSCs and GDF-5 placed in a collagen gel were interpositioned between the cut ends of dog flexor digitorum profundus tendons. The tendons were randomly assigned into four groups: 1) repaired tendon without gel; 2) repaired tendon with BMSC-seeded gel; 3) repaired tendon with GDF-5 gel without cells; and 4) repaired tendon with GDF-5 treated BMSC-seeded gel. At 2 and 4 weeks, the maximal strength of repaired tendons with GDF-5 treated BMSCs-seeded gel was significantly higher than in tendons without gel interposition. However, neither BMSCs nor GDF-5 alone significantly increased the maximal strength of healing tendons at 2 or 4 weeks. These results suggest that the combination of BMSCs and GDF-5 accelerates tendon healing, but either BMSCs or GDF-5 alone are not effective in this model.

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Role of transforming growth factor-β1 and epidermal growth factor in the wound-healing process: an in vivo biomechanical evaluation

Wound Repair and Regeneration ◽

10.1046/j.1524-475x.1993.10109.x ◽

1993 ◽

Vol 1 (1) ◽

pp. 41-46 ◽

Cited By ~ 3

Author(s):

Amy W Connors ◽

Lynn M Matrisian ◽

Lillian B Nanney ◽

P. David Charles ◽

David P Reyes ◽

...

Keyword(s):

Wound Healing ◽

Growth Factor ◽

Transforming Growth Factor ◽

Healing Process ◽

Transforming Growth Factor Β1 ◽

Wound Healing Process ◽

Epidermal Growth ◽

Biomechanical Evaluation

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Strength Retention of a New Microbial Cellulose Scaffold and Existing Collagen-Based Scaffolds After In Vivo Implantation in a Rabbit Model

ASME 2009 Summer Bioengineering Conference, Parts A and B ◽

10.1115/sbc2009-203619 ◽

2009 ◽

Author(s):

Michael I. Dishowitz ◽

Miltiadis H. Zgonis ◽

Jeremy J. Harris ◽

Constance Ace ◽

Louis J. Soslowsky

Keyword(s):

Mechanical Behavior ◽

Healing Process ◽

Rabbit Model ◽

In Vivo Model ◽

Microbial Cellulose ◽

Poor Outcomes ◽

Over Time ◽

Pullout Loads

Rotator cuff tendon tears often require large tensions for repair [1] and these tensions are associated with poor outcomes including rerupture [2]. To address this, repairs are often augmented with collagen-based scaffolds. Microbial cellulose, produced by A. xylinum as a laminar non-woven matrix, is another candidate for repair augmentation [3]. An ideal augmentation scaffold would shield the repair site from damaging loads as they change throughout the healing process. Although the initial mechanical properties of clinically used scaffolds have been well characterized [4–6], their mechanical behavior following implantation is not known. As a result, the role of these scaffolds throughout the healing process remains unknown. Therefore, the objective of this study is to characterize the mechanical behavior of existing collagen-based scaffolds and a new, microbial cellulose scaffold over time using an in vivo model. We hypothesize that: 1) collagen-based scaffolds will show decreased stiffness (1a) and suture pullout loads (1b) over time when compared to initial values while the microbial cellulose scaffold will not; and 2) the collagen-based scaffolds will have decreased stiffness (2a) and suture pullout loads (2b) when compared to the new, microbial cellulose scaffold at all timepoints.

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