title: Cell and Biologic-Based Treatment of Flexor Tendon Injuries.
abstract: The two primary factors leading to poor clinical results after intrasynovial tendon repair are adhesion formation within the digital sheath and repair-site elongation and rupture. As the outcomes following modern tendon multi-strand repair and controlled rehabilitation techniques are often unsatisfactory, alternative approaches, such as the application of growth factors and mesenchymal stem cells (MSCs), have become increasingly attractive treatment options. Successful biological therapies require carefully controlled spatiotemporal delivery of cells, growth factors, and biocompatible scaffold matrices in order to simultaneously (1) promote matrix synthesis at the tendon repair site leading to increased biomechanical strength and stiffness and (2) suppress matrix synthesis along the tendon surface and synovial sheath preventing adhesion formation. This review summarizes recent cell and biologic-based experimental treatments for flexor tendon injury, with an emphasis on large animal translational studies.
authors.affiliation: Department of Orthopaedic Surgery, Washington University, St. Louis, MO, United States; Department of Biomedical Engineering, Washington University, St. Louis, MO, United States.
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Linderman
authors.affiliation: Department of Orthopaedic Surgery, Washington University, St. Louis, MO, United States.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Gelberman
authors.affiliation: Department of Orthopaedic Surgery, Columbia University, New York, NY, United States; Department of Biomedical Engineering, Columbia University, New York, NY, United States.
authors.forename: Stavros
authors.initials: S
authors.lastname: Thomopoulos
authors.affiliation: Department of Orthopaedic Surgery, Washington University, St. Louis, MO, United States.
authors.forename: Hua
authors.initials: H
authors.lastname: Shen
keywords: cell; flexor tendon repair; growth factor; tissue engineering