title: Effects of lubricant and autologous bone marrow stromal cell augmentation on immobilized flexor tendon repairs.
abstract: The purpose of the study was to test a novel treatment that carbodiimide-derivatized-hyaluronic acid-lubricin (cd-HA-lubricin) combined cell-based therapy in an immobilized flexor tendon repair in a canine model. Seventy-eight flexor tendons from 39 dogs were transected. One tendon was treated with cd-HA-lubricin plus an interpositional graft of 8 × 10(5) BMSCs and GDF-5. The other tendon was repaired without treatment. After 21 day of immobilization, 19 dogs were sacrificed; the remaining 20 dogs underwent a 21-day rehabilitation protocol before euthanasia. The work of flexion, tendon gliding resistance, and adhesion score in treated tendons were significantly less than the untreated tendons (p < 0.05). The failure strength of the untreated tendons was higher than the treated tendons at 21 and 42 days (p < 0.05). However, there is no significant difference in stiffness between two groups at day 42. Histologic analysis of treated tendons showed a smooth surface and viable transplanted cells 42 days after the repair, whereas untreated tendons showed severe adhesion formation around the repair site. The combination of lubricant and cell treatment resulted in significantly improved digit function, reduced adhesion formation. This novel treatment can address the unmet needs of patients who are unable to commence an early mobilization protocol after flexor tendon repair.
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ozasa
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Shimura
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Ramona L
authors.initials: RL
authors.lastname: Reisdorf
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Thoreson
authors.affiliation: Department of Emergency Medicine, Brown University, Providence, Rhode Island.
authors.forename: Gregory
authors.initials: G
authors.lastname: Jay
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Moran
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Kai-Nan
authors.initials: KN
authors.lastname: An
authors.affiliation: Division of Orthopedic Research Mayo Clinic, Biomechanics Laboratory and the Tendon & Soft Tissue Biology Laboratory, Rochester, Minnesota.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Amadio
mesh_terms: D000818:Animals; D016026:Bone Marrow Transplantation; D004285:Dogs; D004353:Drug Evaluation, Preclinical; D006023:Glycoproteins / Q000627:therapeutic use*; D055428:Growth Differentiation Factor 5 / Q000627:therapeutic use*; D006230:Hand Injuries / Q000188:drug therapy / Q000601:surgery*; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011897:Random Allocation; D013708:Tendon Injuries / Q000188:drug therapy / Q000601:surgery*; D014182:Transplantation, Autologous
chemical_list: D006023:Glycoproteins; D055428:Growth Differentiation Factor 5; C581641:cd-HA-lubricin; D006820:Hyaluronic Acid
keywords: bone marrow stromal cells; flexor tendon; hyaluronic acid; immobilization; lubricin; tendon repair