Tendon transplantation. Веrnstein (Surg., Gуnес. and Obst., XXIX)

Having worked out experimentally on animals and technically on cadavers the question of tendon transplantation - which operation can be successfully used in the operative treatment of polymyelitidis anterioris - the author recommends transplantation of tendons with their sheath and peritenonium, so that their vital connection would not be broken.

Murine patellar tendon transplantation requires transosseous cerclage augmentation — development of a transplantation model for investigation of systemic and local drivers of healing

Background Tendon injuries are common musculoskeletal injuries that heal with scar tissue formation, often achieving reduced biomechanical and functional properties. The murine patellar tendon is a research tool that holds potential for investigating tendon healing and can be useful for exploring therapeutic strategies. Since healing is a complex process that results from the collaboration between the systemic and local tissue environment, a murine tendon transplantation model that can be applied to transgenic mice and genetic mutants would allow isolation of systemic versus local tendon factors in driving effective tendon healing. Preliminary studies have shown that transplantation with simple tendon sutures results in a proximalization of the patellar bone due to the involuntary quadriceps muscle force leading to tearing of the graft and failure of the knee extensor mechanism. To avoid this elongation of the graft, two cerclage techniques for murine patellar tendon transplantation were introduced and validated. Methods Three developed surgical techniques (no-cerclage-augmentation (NCA)), transfascial suture cerclage with encirclement of the patellar tendon (TFSC), and dual-cerclage-augmentation with a transosseous bone-to-bone cerclage through the patella bone and an additional musculotendinous cerclage (DCA)) were compared at 4 and 8 weeks macroscopically in regards to graft continuity, cerclage integrity, gap formation, and radiologically by measuring the patello-tibial distance and using a patella bone position grading system. Results The NCA group showed complete failure at 5–7 days after surgery. The TFSC has led to 69% functional failure of the cerclage. In contrast, the DCA with a has led to 78% success with improvement in patellar bone position and a similar patello-tibial distance to the naïve contralateral murine knees over the time period of 8 weeks. Conclusions This study shows that a bone-to-bone cerclage is necessary to maintain a desired graft length in murine patellar tendon models. This surgery technique can serve for future graft trans- and implantations in the murine patellar tendon.

PECTORO-EPICONDYLARIS: A RARE EXTENSION OF THE PECTORALIS MAJOR MUSCLE. Pectoro-epicondilaris: Una rara extensión del músculo pectoral mayor

El músculo pectoral mayor es propenso a varias incongruencias morfológicas. Diferentes deslizamien-tos musculares son comunes entre ellos. Sin embargo, durante la disección rutinaria de un cadáver masculino de 55 años por estudiantes de pregrado, se encontró una variante rara de la extensión tendinosa del músculo pectoral mayor. Surgía de la lámina profunda del tendón muscular bilaminar cerca de su inserción en el húmero. En su camino a unirse al tabique intermuscular medial del brazo y finalmente al epicóndilo medial del húmero, cruzó todas las estructuras en la parte delantera del brazo de lateral a medial. Considerando la extensión tendinosa de forma proximal, no se observó formación muscular separada. Esta variante de deslizamiento puede ser nombrada como músculo pectoral epicondilario. El conocimiento de esta variación particular puede ser de especial interés para los radiólogos y médicos en procedimien-tos tales como transformación de músculo, trasplante de tendón y uso en los colgajos miocutáneos durante cirugías reconstructivas. The pectoralis major muscle is prone to various morphological incongruities. Variant muscular slips are common among them. However during routine dissection for undergraduate students in a 55-year-old male cadaver, a rare variation of the tendinous extension of the pectoralis major muscle was found. It was arising from the deep lamina of the muscular bilaminar tendon close to its insertion to the humerus. On its way to be attached to the medial intermuscular septum of the arm and finally to the medial epicondyle of the humerus, it crossed all the structures in the front of the arm from lateral to medial. Tracing this tendinous extension slip proximally, no separate muscular extension was observed. this variant slip may be named as pectoro-epicondylaris muscle. The know-ledge of this particular variation could be of special interest to radiologists and clinicians in procedures such as muscle transformation, tendon transplantation and use of myo-cutaneous flaps during reconstructive surgeries.

Application of Different Biomaterials in Achilles Tendon Repair for Exercise Injury

The rupture of Achilles tendon is hard to self-healing and repair and it is easily left pain and dysfunction. For a long time, the treatment of Achilles tendon defect by many scholars conducted a lot of research, from the tendon autograft, allograft tendon transplantation to the artificial tendon transplantation, tissue engineering tendon transplantation. Practice has proved that these methods have their own advantages and disadvantages. Although the research and application of scaffold materials for tendon tissue engineering has achieved some success, but the application materials or the presence of biocompatibility, degradation problems or have poor mechanical properties, machining molding defects, there is still a big gap between the ideal scaffold materials. This study evaluated the different biological materials in the repair of Achilles tendon injury in effect, provide a theoretical reference for the key to construct tissue engineered tendon is to find appropriate scaffold materials for tendon cell adhesion, growth and functional differentiation.

The Application of Cell Material in Tendon Injuries for Exercise Training with Biological Materials

Traditional tendon repair methods mainly used autogenous tendon transplantation and autogenous tendon transfer, but the development of two repair methods may be greatly limited due to the limited donor site and the added trauma. At the present time, the research on tissue-engineered tendon has made significant progress. The sources of seed cells for tendon repair cannot be limited to the autogenous tendon cells; we should make gene transformation to mechanocyte through gene chips method in order to resolve the problems related with sources of seed cells of tissue engineered tendon. The well-balanced mechanical stimulation is very important in tendon regeneration process. This stimulation on realignment of neonatal tendon collagen fibers and improve mechanical strength is necessary, which can guarantee implementation of early functional exercise, reducing tendon adhesion, and make tendon repair process into a virtuous circle.