title: Treatment of Tendon Injuries of the Lower Limb with Growth Factors Associated with Autologous Fibrin Scaffold or Collagenous Scaffold.
abstract: Tendon injuries are an increasing problem in orthopedics as we are faced with a growing demand in sports and recreation and an aging population. Tendons have poor spontaneous regenerative capacity, and often, complete recovery after injury is not achieved. Once injured, tendons do not completely re-acquire the biological and biomechanical properties of normal tendons due to the formation of adhesions and scarring, and often these abnormalities in the arrangement and structure are risk factors for re-injury. These problems associated with the healing of tendon injuries are a challenge for clinicians and surgeons. This study examined 9 cases of subcutaneous injuries including quadriceps tendon (2 cases), patellar tendon (1 case), and Achilles tendon (6 cases), incomplete and complete, treated consecutively. The surgical technique has provided, as appropriate, the termino-terminal tenorraphy, techniques of plastics of rotation flap, reinsertion with suture anchors, and in one case tendon augmentation with cadaver tissue. In cases where we needed mechanical support to the suture, we used preloaded growth factors on porcine collagen scaffold; in cases where we needed only one biological support, we used fibrin scaffold.
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Giannotti
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Dell'Osso
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Vanna
authors.initials: V
authors.lastname: Bottai
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ghilardi
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bugelli
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Lazzerini
authors.affiliation: IInd Orthopaedic and Traumatologic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Guido
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D015331:Cohort Studies; D003094:Collagen / Q000008:administration & dosage*; D005260:Female; D005337:Fibrin / Q000008:administration & dosage*; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D013552:Swine; D013708:Tendon Injuries / Q000188:drug therapy* / Q000601:surgery*; D013710:Tendons / Q000601:surgery; D054457:Tissue Scaffolds
chemical_list: D036341:Intercellular Signaling Peptides and Proteins; D005337:Fibrin; D003094:Collagen