Surface modification counteracts adverse effects associated with immobilization after flexor tendon repair.
Although post-rehabilitation is routinely performed following flexor tendon repair, in some clinical scenarios post-rehabilitation must be delayed. We investigated modification of the tendon surface using carbodiimide derivatized hyaluronic acid and lubricin (cd-HA-Lub) to maintain gliding function following flexor tendon repair with postoperative immobilization in a in vivo canine model. Flexor digitorum profundus tendons from the 2nd and 5th digits of one forepaw of six dogs were transected and repaired. One tendon in each paw was treated with cd-HA-Lub; the other repaired tendon was not treated. Following tendon repair, a forearm cast was applied to fully immobilize the operated forelimb for 10 days, after which the animals were euthanized. Digit normalized work of flexion (nWOF) and tendon gliding resistance were assessed. The nWOF of the FDP tendons treated with cd-HA-Lub was significantly lower than the nWOF of the untreated tendons (p < 0.01). The gliding resistance of cd-HA-Lub treated tendons was also significantly lower than that of the untreated tendons (p < 0.05). Surface treatment with cd-HA-Lub following flexor tendon repair provides an opportunity to improve outcomes for patients in whom the post-operative therapy must be delayed after flexor tendon repair.
Biomechanics Laboratory, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, USA.
Chunfeng
C
Zhao
Yu-Long
YL
Sun
Gregory D
GD
Jay
Steven L
SL
Moran
Kai-Nan
KN
An
Peter C
PC
Amadio
D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry; D002234:Carbodiimides / Q000737:chemistry*; D004285:Dogs; D005552:Forelimb / Q000473:pathology; D017276:Friction; D006023:Glycoproteins / Q000737:chemistry*; D006820:Hyaluronic Acid / Q000737:chemistry*; D007103:Immobilization; D019637:Orthopedic Procedures / Q000379:methods; D013499:Surface Properties; D013708:Tendon Injuries / Q000628:therapy*; D013710:Tendons / Q000473:pathology* / Q000601:surgery; D013718:Tensile Strength; D000099158:Proteoglycan 4
D001672:Biocompatible Materials; D002234:Carbodiimides; D006023:Glycoproteins; D006820:Hyaluronic Acid; D000099158:Proteoglycan 4