The Experts below are selected from a list of 8670 Experts worldwide ranked by ideXlab platform
W. Hope - One of the best experts on this subject based on the ideXlab platform.
-
Evolving concepts in ventral hernia repair and physical therapy: prehabilitation, rehabilitation, and analogies to Tendon Reconstruction
Hernia, 2020Co-Authors: J. E. Perez, M. A. Schmidt, A. Narvaez, L. K. Welsh, R. Diaz, M. Castro, K. Ansari, R. W. Cason, J. A. Bilezikian, W. HopeAbstract:Purpose The abdominal wall and musculoskeletal Tendons share many anatomic, physiologic, and functional characteristics. This review aims to highlight these similar characteristics and to present a rationale why the treatment principles of successful musculoskeletal Tendon Reconstruction, including principles of surgical technique and physical therapy, can be used in the treatment of complex abdominal wall Reconstruction or ventral hernia repair. Methods The MEDLINE/PubMed database was used to identify published literature relevant to the purpose of this review. Conclusions There are several anatomical and functional similarities between the linea alba and musculoskeletal Tendons. Because of this reason, many of the surgical principles for musculoskeletal Tendon repair and ventral hernia repair overlap. Distribution of tension is the main driving principle for both procedures. Suture material and configuration are chosen to maximize tension distribution among the tissue edges, as seen in the standard of care multistrand repairs for musculoskeletal Tendons, as well as in the small bites for laparotomy technique described in the STITCH trial. Physical therapy is also one of the mainstays of Tendon repair, but surprisingly, is not routine in ventral hernia repair. The evidence surrounding physical therapy prehabilitation and rehabilitation protocols in other disciplines is significant. This review challenges the fact that these protocols are not routinely implemented for ventral hernia repair, and presents the rationale and feasibility for the routine practice of physical therapy in ventral hernia repair.
-
Evolving concepts in ventral hernia repair and physical therapy: prehabilitation, rehabilitation, and analogies to Tendon Reconstruction
Hernia, 2020Co-Authors: J. E. Perez, M. A. Schmidt, A. Narvaez, L. K. Welsh, R. Diaz, M. Castro, K. Ansari, R. W. Cason, J. A. Bilezikian, W. HopeAbstract:Purpose The abdominal wall and musculoskeletal Tendons share many anatomic, physiologic, and functional characteristics. This review aims to highlight these similar characteristics and to present a rationale why the treatment principles of successful musculoskeletal Tendon Reconstruction, including principles of surgical technique and physical therapy, can be used in the treatment of complex abdominal wall Reconstruction or ventral hernia repair. Methods The MEDLINE/PubMed database was used to identify published literature relevant to the purpose of this review. Conclusions There are several anatomical and functional similarities between the linea alba and musculoskeletal Tendons. Because of this reason, many of the surgical principles for musculoskeletal Tendon repair and ventral hernia repair overlap. Distribution of tension is the main driving principle for both procedures. Suture material and configuration are chosen to maximize tension distribution among the tissue edges, as seen in the standard of care multistrand repairs for musculoskeletal Tendons, as well as in the small bites for laparotomy technique described in the STITCH trial. Physical therapy is also one of the mainstays of Tendon repair, but surprisingly, is not routine in ventral hernia repair. The evidence surrounding physical therapy prehabilitation and rehabilitation protocols in other disciplines is significant. This review challenges the fact that these protocols are not routinely implemented for ventral hernia repair, and presents the rationale and feasibility for the routine practice of physical therapy in ventral hernia repair.
Peter C Amadio - One of the best experts on this subject based on the ideXlab platform.
-
Comparison of Autograft and Allograft with Surface Modification for Flexor Tendon Reconstruction: A Canine in Vivo Model
The Journal of bone and joint surgery. American volume, 2018Co-Authors: Zhuang Wei, Peter C Amadio, Andrew R Thoreson, Ramona L. Reisdorf, Steven L. Moran, Gregory D. Jay, Chunfeng ZhaoAbstract:Background:Flexor Tendon injury is common, and Tendon Reconstruction is indicated clinically if the primary repair fails or cannot be performed immediately after Tendon injury. The purpose of the current study was to compare clinically standard extrasynovial autologous graft (EAG) Tendon and intrasy
-
Revitalized and synovialized allograft for intrasynovial flexor Tendon Reconstruction in an in vivo canine model
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2018Co-Authors: Tao Zhang, Peter C Amadio, Andrew R Thoreson, Ramona L. Reisdorf, Anne Gingery, Steven L. Moran, Chunfeng D ZhaoAbstract:This study was to test our hypothesis that flexor Tendon Reconstruction with an allograft revitalized with bone marrow stromal cells (BMSCs) and synovialized with carbodiimide derivatized autologous synovial fluid (cd-SYN) would result in better digit functional restoration than the conventional allograft Tendon. A total of 32 flexor digital profundus Tendons from the second and fifth digit of 16 dogs were created a repair failure model first. Then, failed-repaired Tendons were reconstructed with either a revitalized-synovialized allograft Tendon or a clinical standard autograft Tendon (control group). The allograft Tendon was seeded with autologous BMSCs in multiple slits and the graft surface was coated with cd-SYN. A 6 weeks after Tendon Reconstruction, the digits were harvested and evaluated for digit function, adhesion status, Tendon gliding resistance, attachment strength, cell viability, and histologic factors. The allograft group had significantly improved digit function compared with the control group through decreased work of flexion, increased digit range of motion under 2-Newton force, and less adhesion score (p
-
Surface Modification with Chemically Modified Synovial Fluid for Flexor Tendon Reconstruction in a Canine Model in Vivo.
The Journal of bone and joint surgery. American volume, 2015Co-Authors: Ramona L. Reisdorf, Peter C Amadio, Andrew R Thoreson, Steven L. Moran, Gregory D. Jay, Lawrence R. Berglund, Chunfeng ZhaoAbstract:Background: Functional restoration is the major concern after flexor Tendon Reconstruction in the hand. The purpose of the present study was to investigate the effects of modifying the surface of extrasynovial Tendon autografts with carbodiimide-derivatized synovial fluid with gelatin (cd-SF-G) on functional outcomes of flexor Tendon Reconstruction using a canine model. Methods: The second and fifth flexor digitorum profundus Tendons from eleven dogs were transected and repaired in zone II. The dogs then had six weeks of free activity leading to Tendon rupture and scar formation (the repair-failure phase). In the Reconstruction phase, two autologous peroneus longus Tendons from each dog were harvested; one Tendon was coated with cd-SF-G and the other, with saline solution, as a control. A non-weight-bearing rehabilitation protocol was followed for six weeks after Reconstruction. The digits were then harvested and evaluations of function, adhesion status, gliding resistance, attachment strength, cell viability, and histology were performed. Results: The Tendons coated with cd-SF-G demonstrated significantly lower values (mean and standard deviation) compared with the saline-solution group for work of flexion (0.63 ± 0.24 versus 1.34 ± 0.42 N-mm/deg), adhesion score (3.5 ± 1.6 versus 6.1 ± 1.3), proximal adhesion breaking force (8.6 ± 3.2 versus 20.2 ± 10.2 N), and gliding resistance (0.26 ± 0.08 versus 0.46 ± 0.22 N) (p 0.05) in distal attachment-site strength (56.9 ± 28.4 versus 77.2 ± 36.2 N), stiffness (19 ± 7.5 versus 24.5 ± 14.5 N/mm), and compressive modulus from indentation testing (4.37 ± 1.26 versus 3.98 ± 1.24 N/mm). Histological analysis showed that Tendons coated with cd-SF-G had smoother surfaces and demonstrated Tendon-to-bone and Tendon-to-Tendon incorporation. No significant difference in viable cell count between the two groups was observed on Tendon culture. Conclusions: Modification of the flexor Tendon surface with cd-SF-G significantly improved digital function and reduced adhesion formation without affecting graft healing and stiffness. Clinical Relevance: This study used native synovial fluid as a basic lubricating reagent to treat a Tendon graft in vivo, a novel avenue for improving clinical outcomes of flexor Tendon Reconstruction. This methodology may also apply to other surgical procedures where postoperative adhesions impair function.
-
The effects of biological lubricating molecules on flexor Tendon Reconstruction in a canine allograft model in vivo.
Plastic and reconstructive surgery, 2014Co-Authors: Chunfeng Zhao, Andrew R Thoreson, Ramona L. Reisdorf, Steven L. Moran, Zhuang Wei, Gregory D. Jay, Peter C AmadioAbstract:Background:Using allograft is an attractive alternative for flexor Tendon Reconstruction because of the lack of donor-site morbidity, and better matching to the intrasynovial environment. The purpose of this study was to use biological lubricant molecules to modify the graft surface to decrease adhe
-
Resurfacing with chemically modified hyaluronic acid and lubricin for flexor Tendon Reconstruction
Journal of Orthopaedic Research, 2013Co-Authors: Chunfeng D Zhao, Ramona L. Kirk, Steven Lawrence Moran, Andrew R Thoreson, Takahiro Hashimoto, Kai Nan An, Peter C AmadioAbstract:We assessed surface coating with carbodiimide derivatized hyaluronic acid combined with lubricin (cd-HA-Lubricin) as a way to improve extrasynovial Tendon surface quality and, consequently, the functional results in flexor Tendon Reconstruction, using a canine in vivo model. The second and fifth flexor digitorum profundus Tendons from 14 dogs were reconstructed with autologs peroneus longus (PL) Tendons 6 weeks after a failed primary repair. One digit was treated with cd-HA-Lubricin, and the other was treated with saline as the control. Six weeks following grafting, the digits and graft Tendons were functionally and histologically evaluated. Adhesion score, normalized work of flexion, graft friction in zone II, and adhesion breaking strength at the proximal repair site in zone III were all lower in the cd-HA-Lubricin treated group compared to the control group. The strength at the distal Tendon/bone interface was decreased in the cd-HA-Lubricin treated grafts compared to the control grafts. Histology showed inferior healing in the cd-HA-Lubricin group at both proximal and distal repair sites. However, cd-HA-Lubricin treatment did not result in any gap or rupture at either the proximal or distal repair sites. These results demonstrate that cd-HA-Lubricin can eliminate graft adhesions and improve digit function, but that treatment may have an adverse effect on Tendon healing.
Chunfeng Zhao - One of the best experts on this subject based on the ideXlab platform.
-
Comparison of Autograft and Allograft with Surface Modification for Flexor Tendon Reconstruction: A Canine in Vivo Model
The Journal of bone and joint surgery. American volume, 2018Co-Authors: Zhuang Wei, Peter C Amadio, Andrew R Thoreson, Ramona L. Reisdorf, Steven L. Moran, Gregory D. Jay, Chunfeng ZhaoAbstract:Background:Flexor Tendon injury is common, and Tendon Reconstruction is indicated clinically if the primary repair fails or cannot be performed immediately after Tendon injury. The purpose of the current study was to compare clinically standard extrasynovial autologous graft (EAG) Tendon and intrasy
-
Surface Modification with Chemically Modified Synovial Fluid for Flexor Tendon Reconstruction in a Canine Model in Vivo.
The Journal of bone and joint surgery. American volume, 2015Co-Authors: Ramona L. Reisdorf, Peter C Amadio, Andrew R Thoreson, Steven L. Moran, Gregory D. Jay, Lawrence R. Berglund, Chunfeng ZhaoAbstract:Background: Functional restoration is the major concern after flexor Tendon Reconstruction in the hand. The purpose of the present study was to investigate the effects of modifying the surface of extrasynovial Tendon autografts with carbodiimide-derivatized synovial fluid with gelatin (cd-SF-G) on functional outcomes of flexor Tendon Reconstruction using a canine model. Methods: The second and fifth flexor digitorum profundus Tendons from eleven dogs were transected and repaired in zone II. The dogs then had six weeks of free activity leading to Tendon rupture and scar formation (the repair-failure phase). In the Reconstruction phase, two autologous peroneus longus Tendons from each dog were harvested; one Tendon was coated with cd-SF-G and the other, with saline solution, as a control. A non-weight-bearing rehabilitation protocol was followed for six weeks after Reconstruction. The digits were then harvested and evaluations of function, adhesion status, gliding resistance, attachment strength, cell viability, and histology were performed. Results: The Tendons coated with cd-SF-G demonstrated significantly lower values (mean and standard deviation) compared with the saline-solution group for work of flexion (0.63 ± 0.24 versus 1.34 ± 0.42 N-mm/deg), adhesion score (3.5 ± 1.6 versus 6.1 ± 1.3), proximal adhesion breaking force (8.6 ± 3.2 versus 20.2 ± 10.2 N), and gliding resistance (0.26 ± 0.08 versus 0.46 ± 0.22 N) (p 0.05) in distal attachment-site strength (56.9 ± 28.4 versus 77.2 ± 36.2 N), stiffness (19 ± 7.5 versus 24.5 ± 14.5 N/mm), and compressive modulus from indentation testing (4.37 ± 1.26 versus 3.98 ± 1.24 N/mm). Histological analysis showed that Tendons coated with cd-SF-G had smoother surfaces and demonstrated Tendon-to-bone and Tendon-to-Tendon incorporation. No significant difference in viable cell count between the two groups was observed on Tendon culture. Conclusions: Modification of the flexor Tendon surface with cd-SF-G significantly improved digital function and reduced adhesion formation without affecting graft healing and stiffness. Clinical Relevance: This study used native synovial fluid as a basic lubricating reagent to treat a Tendon graft in vivo, a novel avenue for improving clinical outcomes of flexor Tendon Reconstruction. This methodology may also apply to other surgical procedures where postoperative adhesions impair function.
-
The effects of biological lubricating molecules on flexor Tendon Reconstruction in a canine allograft model in vivo.
Plastic and reconstructive surgery, 2014Co-Authors: Chunfeng Zhao, Andrew R Thoreson, Ramona L. Reisdorf, Steven L. Moran, Zhuang Wei, Gregory D. Jay, Peter C AmadioAbstract:Background:Using allograft is an attractive alternative for flexor Tendon Reconstruction because of the lack of donor-site morbidity, and better matching to the intrasynovial environment. The purpose of this study was to use biological lubricant molecules to modify the graft surface to decrease adhe
-
Improvement of flexor Tendon Reconstruction with carbodiimide-derivatized hyaluronic acid and gelatin-modified intrasynovial allografts: study of a primary repair failure model.
The Journal of bone and joint surgery. American volume, 2010Co-Authors: Chunfeng Zhao, Ramona L. Kirk, Andrew R Thoreson, Steven L. Moran, Yu Long Sun, Jun Ikeda, Peter C AmadioAbstract:Background: Tendon grafts play an important role in flexor Tendon Reconstruction. This study was an investigation of the effects of surface modification of allograft intrasynovial Tendons with carbodiimide-derivatized hyaluronic acid and gelatin in an in vivo canine model. To mimic the actual clinical situation, a novel and clinically relevant model of a failed primary flexor Tendon repair was used to evaluate the flexor Tendon grafts. Methods: Twenty-eight flexor digitorum profundus Tendons from the second and fifth digits of fourteen dogs were lacerated and repaired in zone II in a first-surgery phase. The dogs were allowed free active motion postoperatively. In a second phase, six weeks later, the Tendons were reconstructed with use of a flexor digitorum profundus allograft. In each dog, one graft was treated with carbodiimide-derivatized hyaluronic acid and gelatin (the CHG group) and the other was treated with saline solution, as a control. The dogs were restricted from free active motion, but daily therapy was performed beginning on postoperative day 5 and continued until six weeks after the operation, when the animals were killed. The outcomes were evaluated on the basis of digit work of flexion, gliding resistance, healing at the distal attachment, graft cell viability, histological findings, and findings on scanning electron microscopy. Results: In the first phase, all twenty-eight repaired Tendons ruptured, with scar and adhesion formation in the repair site. Six weeks after allograft Reconstruction, the mean work of flexion was 0.37 and 0.94 N-mm/degree in the CHG group and the saline-solution control group, respectively; these values were significantly different (p < 0.05). The gliding resistance in the CHG group was also significantly less than that in the saline-solution control group (0.18 versus 0.28 N) (p < 0.05), but no difference between groups was observed with regard to the distal Tendon-bone pullout strength. Histological analysis showed that tenocytes in the host Tendon proliferated and migrated toward the acellular allograft. Conclusions: This primary repair failure model was reproducible and reliable, with a uniform failure pattern, and provides an appropriate and clinically relevant animal model with which to study flexor Tendon Reconstruction. The surface modification of allografts with carbodiimide-derivatized hyaluronic acid and gelatin improved digital function and Tendon gliding ability.
J. E. Perez - One of the best experts on this subject based on the ideXlab platform.
-
Evolving concepts in ventral hernia repair and physical therapy: prehabilitation, rehabilitation, and analogies to Tendon Reconstruction
Hernia, 2020Co-Authors: J. E. Perez, M. A. Schmidt, A. Narvaez, L. K. Welsh, R. Diaz, M. Castro, K. Ansari, R. W. Cason, J. A. Bilezikian, W. HopeAbstract:Purpose The abdominal wall and musculoskeletal Tendons share many anatomic, physiologic, and functional characteristics. This review aims to highlight these similar characteristics and to present a rationale why the treatment principles of successful musculoskeletal Tendon Reconstruction, including principles of surgical technique and physical therapy, can be used in the treatment of complex abdominal wall Reconstruction or ventral hernia repair. Methods The MEDLINE/PubMed database was used to identify published literature relevant to the purpose of this review. Conclusions There are several anatomical and functional similarities between the linea alba and musculoskeletal Tendons. Because of this reason, many of the surgical principles for musculoskeletal Tendon repair and ventral hernia repair overlap. Distribution of tension is the main driving principle for both procedures. Suture material and configuration are chosen to maximize tension distribution among the tissue edges, as seen in the standard of care multistrand repairs for musculoskeletal Tendons, as well as in the small bites for laparotomy technique described in the STITCH trial. Physical therapy is also one of the mainstays of Tendon repair, but surprisingly, is not routine in ventral hernia repair. The evidence surrounding physical therapy prehabilitation and rehabilitation protocols in other disciplines is significant. This review challenges the fact that these protocols are not routinely implemented for ventral hernia repair, and presents the rationale and feasibility for the routine practice of physical therapy in ventral hernia repair.
-
Evolving concepts in ventral hernia repair and physical therapy: prehabilitation, rehabilitation, and analogies to Tendon Reconstruction
Hernia, 2020Co-Authors: J. E. Perez, M. A. Schmidt, A. Narvaez, L. K. Welsh, R. Diaz, M. Castro, K. Ansari, R. W. Cason, J. A. Bilezikian, W. HopeAbstract:Purpose The abdominal wall and musculoskeletal Tendons share many anatomic, physiologic, and functional characteristics. This review aims to highlight these similar characteristics and to present a rationale why the treatment principles of successful musculoskeletal Tendon Reconstruction, including principles of surgical technique and physical therapy, can be used in the treatment of complex abdominal wall Reconstruction or ventral hernia repair. Methods The MEDLINE/PubMed database was used to identify published literature relevant to the purpose of this review. Conclusions There are several anatomical and functional similarities between the linea alba and musculoskeletal Tendons. Because of this reason, many of the surgical principles for musculoskeletal Tendon repair and ventral hernia repair overlap. Distribution of tension is the main driving principle for both procedures. Suture material and configuration are chosen to maximize tension distribution among the tissue edges, as seen in the standard of care multistrand repairs for musculoskeletal Tendons, as well as in the small bites for laparotomy technique described in the STITCH trial. Physical therapy is also one of the mainstays of Tendon repair, but surprisingly, is not routine in ventral hernia repair. The evidence surrounding physical therapy prehabilitation and rehabilitation protocols in other disciplines is significant. This review challenges the fact that these protocols are not routinely implemented for ventral hernia repair, and presents the rationale and feasibility for the routine practice of physical therapy in ventral hernia repair.
Andrew R Thoreson - One of the best experts on this subject based on the ideXlab platform.
-
Comparison of Autograft and Allograft with Surface Modification for Flexor Tendon Reconstruction: A Canine in Vivo Model
The Journal of bone and joint surgery. American volume, 2018Co-Authors: Zhuang Wei, Peter C Amadio, Andrew R Thoreson, Ramona L. Reisdorf, Steven L. Moran, Gregory D. Jay, Chunfeng ZhaoAbstract:Background:Flexor Tendon injury is common, and Tendon Reconstruction is indicated clinically if the primary repair fails or cannot be performed immediately after Tendon injury. The purpose of the current study was to compare clinically standard extrasynovial autologous graft (EAG) Tendon and intrasy
-
Revitalized and synovialized allograft for intrasynovial flexor Tendon Reconstruction in an in vivo canine model
Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 2018Co-Authors: Tao Zhang, Peter C Amadio, Andrew R Thoreson, Ramona L. Reisdorf, Anne Gingery, Steven L. Moran, Chunfeng D ZhaoAbstract:This study was to test our hypothesis that flexor Tendon Reconstruction with an allograft revitalized with bone marrow stromal cells (BMSCs) and synovialized with carbodiimide derivatized autologous synovial fluid (cd-SYN) would result in better digit functional restoration than the conventional allograft Tendon. A total of 32 flexor digital profundus Tendons from the second and fifth digit of 16 dogs were created a repair failure model first. Then, failed-repaired Tendons were reconstructed with either a revitalized-synovialized allograft Tendon or a clinical standard autograft Tendon (control group). The allograft Tendon was seeded with autologous BMSCs in multiple slits and the graft surface was coated with cd-SYN. A 6 weeks after Tendon Reconstruction, the digits were harvested and evaluated for digit function, adhesion status, Tendon gliding resistance, attachment strength, cell viability, and histologic factors. The allograft group had significantly improved digit function compared with the control group through decreased work of flexion, increased digit range of motion under 2-Newton force, and less adhesion score (p
-
Surface Modification with Chemically Modified Synovial Fluid for Flexor Tendon Reconstruction in a Canine Model in Vivo.
The Journal of bone and joint surgery. American volume, 2015Co-Authors: Ramona L. Reisdorf, Peter C Amadio, Andrew R Thoreson, Steven L. Moran, Gregory D. Jay, Lawrence R. Berglund, Chunfeng ZhaoAbstract:Background: Functional restoration is the major concern after flexor Tendon Reconstruction in the hand. The purpose of the present study was to investigate the effects of modifying the surface of extrasynovial Tendon autografts with carbodiimide-derivatized synovial fluid with gelatin (cd-SF-G) on functional outcomes of flexor Tendon Reconstruction using a canine model. Methods: The second and fifth flexor digitorum profundus Tendons from eleven dogs were transected and repaired in zone II. The dogs then had six weeks of free activity leading to Tendon rupture and scar formation (the repair-failure phase). In the Reconstruction phase, two autologous peroneus longus Tendons from each dog were harvested; one Tendon was coated with cd-SF-G and the other, with saline solution, as a control. A non-weight-bearing rehabilitation protocol was followed for six weeks after Reconstruction. The digits were then harvested and evaluations of function, adhesion status, gliding resistance, attachment strength, cell viability, and histology were performed. Results: The Tendons coated with cd-SF-G demonstrated significantly lower values (mean and standard deviation) compared with the saline-solution group for work of flexion (0.63 ± 0.24 versus 1.34 ± 0.42 N-mm/deg), adhesion score (3.5 ± 1.6 versus 6.1 ± 1.3), proximal adhesion breaking force (8.6 ± 3.2 versus 20.2 ± 10.2 N), and gliding resistance (0.26 ± 0.08 versus 0.46 ± 0.22 N) (p 0.05) in distal attachment-site strength (56.9 ± 28.4 versus 77.2 ± 36.2 N), stiffness (19 ± 7.5 versus 24.5 ± 14.5 N/mm), and compressive modulus from indentation testing (4.37 ± 1.26 versus 3.98 ± 1.24 N/mm). Histological analysis showed that Tendons coated with cd-SF-G had smoother surfaces and demonstrated Tendon-to-bone and Tendon-to-Tendon incorporation. No significant difference in viable cell count between the two groups was observed on Tendon culture. Conclusions: Modification of the flexor Tendon surface with cd-SF-G significantly improved digital function and reduced adhesion formation without affecting graft healing and stiffness. Clinical Relevance: This study used native synovial fluid as a basic lubricating reagent to treat a Tendon graft in vivo, a novel avenue for improving clinical outcomes of flexor Tendon Reconstruction. This methodology may also apply to other surgical procedures where postoperative adhesions impair function.
-
The effects of biological lubricating molecules on flexor Tendon Reconstruction in a canine allograft model in vivo.
Plastic and reconstructive surgery, 2014Co-Authors: Chunfeng Zhao, Andrew R Thoreson, Ramona L. Reisdorf, Steven L. Moran, Zhuang Wei, Gregory D. Jay, Peter C AmadioAbstract:Background:Using allograft is an attractive alternative for flexor Tendon Reconstruction because of the lack of donor-site morbidity, and better matching to the intrasynovial environment. The purpose of this study was to use biological lubricant molecules to modify the graft surface to decrease adhe
-
Resurfacing with chemically modified hyaluronic acid and lubricin for flexor Tendon Reconstruction
Journal of Orthopaedic Research, 2013Co-Authors: Chunfeng D Zhao, Ramona L. Kirk, Steven Lawrence Moran, Andrew R Thoreson, Takahiro Hashimoto, Kai Nan An, Peter C AmadioAbstract:We assessed surface coating with carbodiimide derivatized hyaluronic acid combined with lubricin (cd-HA-Lubricin) as a way to improve extrasynovial Tendon surface quality and, consequently, the functional results in flexor Tendon Reconstruction, using a canine in vivo model. The second and fifth flexor digitorum profundus Tendons from 14 dogs were reconstructed with autologs peroneus longus (PL) Tendons 6 weeks after a failed primary repair. One digit was treated with cd-HA-Lubricin, and the other was treated with saline as the control. Six weeks following grafting, the digits and graft Tendons were functionally and histologically evaluated. Adhesion score, normalized work of flexion, graft friction in zone II, and adhesion breaking strength at the proximal repair site in zone III were all lower in the cd-HA-Lubricin treated group compared to the control group. The strength at the distal Tendon/bone interface was decreased in the cd-HA-Lubricin treated grafts compared to the control grafts. Histology showed inferior healing in the cd-HA-Lubricin group at both proximal and distal repair sites. However, cd-HA-Lubricin treatment did not result in any gap or rupture at either the proximal or distal repair sites. These results demonstrate that cd-HA-Lubricin can eliminate graft adhesions and improve digit function, but that treatment may have an adverse effect on Tendon healing.
