Tanaka Toshikazu, Zhao Chunfeng, Sun Yu-Long, Zobitz Mark E, An Kai-Nan, Amadio Peter C
Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
J Hand Surg Am. 2007 Jul-Aug;32(6):876-81. doi: 10.1016/j.jhsa.2007.03.007.
We have recently reported that application of carbodiimide-derivatized hyaluronic acid and gelatin (cd-HA gelatin) to a peroneus longus tendon graft increased tendon graft gliding ability and decreased work of flexion compared with untreated grafts in a canine model in vivo. In this study, we investigated the effect of this modification on adhesions, stiffness, strength of the distal attachment, and fibroblast count.
A total of 24 dogs were used for this study. The peroneus longus tendons of each hind leg were grafted into the 2nd and 5th digits of one forepaw in each dog. One peroneus longus tendon was treated with cd-HA gelatin prior to grafting, and the other one was immersed in 0.9% saline solution as a control. Animals were killed 1, 3, or 6 weeks postoperatively.
The adhesion score of cd-HA gelatin-treated tendons was significantly less than that in the saline-treated tendons at all time points. There was no significant difference in the indentation stiffness between HA- and saline-treated grafts at any time point. For the ultimate force at the distal attachment, there was a significant difference among the time points, with a steady increase over time, but no significant difference between treated and control tendons at any time point. There was no significant difference in fibroblast count between treated and control tendons at any time point.
Although gross adhesion formation was less, there was no significant difference in strength at the distal tendon-bone interface, cellularity, or tendon graft stiffness when comparing saline-treated and cd-HA gelatin-treated tendon grafts in vivo.
我们最近报道,在体内犬模型中,与未处理的移植物相比,将碳二亚胺衍生化透明质酸和明胶(cd-HA明胶)应用于腓骨长肌腱移植物可提高肌腱移植物的滑动能力并减少屈曲功。在本研究中,我们调查了这种修饰对粘连、刚度、远端附着强度和成纤维细胞计数的影响。
本研究共使用24只犬。将每只后腿的腓骨长肌腱移植到每只犬一只前爪的第2和第5趾中。一条腓骨长肌腱在移植前用cd-HA明胶处理,另一条浸入0.9%盐溶液中作为对照。术后1、3或6周处死动物。
在所有时间点,cd-HA明胶处理的肌腱的粘连评分均显著低于盐水处理的肌腱。在任何时间点,HA处理和盐水处理的移植物之间的压痕刚度均无显著差异。对于远端附着处的极限力,各时间点之间存在显著差异,随时间稳步增加,但在任何时间点,处理组和对照组肌腱之间均无显著差异。在任何时间点,处理组和对照组肌腱之间的成纤维细胞计数均无显著差异。
在体内比较盐水处理和cd-HA明胶处理的肌腱移植物时,虽然总的粘连形成较少,但在远端肌腱-骨界面的强度、细胞密度或肌腱移植物刚度方面没有显著差异。