title: Surface treatment of flexor tendon autograft and allograft decreases adhesion without an effect of graft cellularity: a pilot study.
abstract: BACKGROUND
  Flexor tendon grafting is often required to reconstruct a failed tendon repair. Previous reports have demonstrated flexor grafts coated with lubricants such as carbodiimide derivatized hyaluronic acid (cd-HA) decrease adhesion formation and improve digit function. However, whether this surface modification would affect graft adhesion and cellularity is unknown.
  
  
  OBJECTIVE
  Adhesion score and the cellularity of the graft of untreated and cd-HA surface-modified autograft and allograft tendons were studied using a canine forepaw in vivo model.
  
  
  METHODS
  The peroneus longus tendons (n = 6) and flexor digitorum profundus tendons (n = 8) were used as extrasynovial autograft and intrasynovial allograft, respectively. The flexor digitorum profundus (FDP) tendons in the second and fifth digits in each dog were reconstructed with one digit treated with cd-HA and the other treated with saline as a control. Six weeks after surgery, the grafted tendons were harvested for histological evaluation with hematoxylin and eosin staining. During dissection, the adhesions were observed and scored.
  
  
  RESULTS
  The adhesion score was greatest in the extrasynovial autograft without surface modification and the least in the intrasynovial allograft with surface modification. Autograft tendons had a higher cell density than the allografts regardless of surface treatment. Cd-HA graft treatment did not affect cellularity when compared with controls.
  
  
  CONCLUSIONS
  Our observations suggest surface modification of a tendon graft with cd-HA decreased the adhesion formation without altering the cellularity in either autologous or allograft tendon. We therefore presume this surface modification would not adversely affect graft healing.
authors: Biomechanics Laboratory, Department of Orthopedic Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
authors: Furkan E
authors: FE
authors: Karabekmez
authors: Chunfeng
authors: C
authors: Zhao
mesh_terms: D000818:Animals; D020099:Coated Materials, Biocompatible; D004285:Dogs; D005022:Ethyldimethylaminopropyl Carbodiimide / Q000031:analogs & derivatives / Q000737:chemistry*; D006614:Hindlimb; D006820:Hyaluronic Acid / Q000031:analogs & derivatives / Q000737:chemistry*; D023421:Models, Animal; D010865:Pilot Projects; D013499:Surface Properties; D013710:Tendons / Q000473:pathology / Q000637:transplantation*; D013997:Time Factors; D000267:Tissue Adhesions; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D014945:Wound Healing
chemical_list: D020099:Coated Materials, Biocompatible; D006820:Hyaluronic Acid; D005022:Ethyldimethylaminopropyl Carbodiimide