[Analysis of histological changes of tendinous grafts in reconstruction of the dorsal wrist ligament].
The reconstruction of the dorsal aspect of the triangular fibrocartilage complex in the distal radioulnar joint with an autologous ligament graft has been an optimal treatment for instability of this joint. Tendinous grafts for ligament reconstruction have been studied in ACL reconstruction finding a metaplasia of the tendinous tissue into ligament like tissue. These studies have been performed in humans without making an important lesion to the reconstructed ligament. The purpose of this study is to evaluate the integration and adaptation of a tendon graft into an intraarticular environment with a different mechanical demand. We enrolled 3 patients that underwent reconstruction of the dorsal aspect of the triangular fibrocartilaginous complex in the distal radio ulnar joint, with an evolution between 6 to 48 months, and studied specimens with electronic microscope. In all specimens we found revascularization, reorientation of collagen fibers into a longitudinal pattern at 6 months after surgery, very similar to ligament. Patients did not require further immobilization after biopsy, rehabilitation of range of movement at home, returning to their normal daily activities. We conclude that tendinous grafts for ligamentous instability of distal radioulnar joint undergo histologic changes that make them similar to original ligaments.
Espinosa Gutiérrez
Alejandro
A
Servicio de Cirugía de la Mano y Microcirugía INR.
Villegas Castrejón
Hilda
H
Sánchez Gutiérrez
Luis Enrique
LE
D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008854:Microscopy, Electron; D019637:Orthopedic Procedures / Q000379:methods; D011446:Prospective Studies; D013710:Tendons / Q000033:anatomy & histology* / Q000637:transplantation*; D014955:Wrist Joint / Q000601:surgery*