Akasaka Toshiki, Nishida Jun, Imaeda Toshihiko, Shimamura Tadashi, Amadio Peter C, An Kai-Nan
Department of Orthopaedic Surgery, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan.
Clin Biomech (Bristol). 2006 Oct;21(8):810-5. doi: 10.1016/j.clinbiomech.2006.04.007. Epub 2006 Jun 9.
Adhesion between the tendon and tendon sheath after flexor tendon graft inhibits restoration of excursion and strength of the grafted tendons, so post-operative finger function is occasionally unsatisfactory. Early setting rehabilitation is one important factor to prevent the adhesion, and another factor may be a lubricant. We considered the possibility of utilizing hyaluronic acid as a lubricant. The goal of this study is to investigate the in vitro effect of hyaluronic acid on tendon excursion resistance against a digital pulley in a modified human model.
The excursion resistance between grafted intrasynovial and extrasynovial tendons and A2 pulley were evaluated, and compared before and after soaking in 10 mg/ml hyaluronic acid.
The resistance increased after extrasynovial tendon graft, and then it decreased after soaking hyaluronic acid solution.
The evidence we collected suggests that some style of administration of the hyaluronic acid might reduce the excursion resistance in the tendon-pulley unit, facilitating post-operative rehabilitation and limiting adhesion, after tendon graft and possibly improve the clinical outcome of flexor tendon graft.
屈肌腱移植术后肌腱与腱鞘之间的粘连会抑制移植肌腱的滑动恢复和力量恢复，因此术后手指功能有时不尽人意。早期进行康复训练是预防粘连的一个重要因素，另一个因素可能是润滑剂。我们考虑了利用透明质酸作为润滑剂的可能性。本研究的目的是在改良的人体模型中研究透明质酸对肌腱通过指滑车时的滑动阻力的体外影响。
评估滑膜内和滑膜外移植肌腱与A2滑车之间的滑动阻力，并在浸泡于10mg/ml透明质酸前后进行比较。
滑膜外肌腱移植后阻力增加，浸泡透明质酸溶液后阻力降低。
我们收集的证据表明，某种方式给予透明质酸可能会降低肌腱-滑车单元的滑动阻力，促进肌腱移植术后的康复并限制粘连，并可能改善屈肌腱移植的临床效果。
