Model for microneurovascular muscle transplantation in the dog.

Previous studies have suggested that successful transplantation of skeletal muscle to replace previously lost function depends on the mass of the transplanted tissue. In the present experiment, the possibility that careful microneurovascular surgical technique substantially improves the chances of successful transplantation of large-sized muscle was tested using dog gracilis muscle averaging 75 gm in weight. Gracilis muscles were completely excised ipsilaterally and were implanted into their original location (orthotopic) by reattaching tendons of insertion and origin. In addition, neurorrhaphies of nerve stumps were performed along with repair of the vascular pedicle using microsurgery techniques. After approximately 1 year, orthotopic transplants weighed about 70 percent of contralateral sham-operated gracilis muscles. Although average tension output of transplants declined to about 60 percent of control values, three of the most successfully transplanted muscles produced between 73 and 88 percent of control force. A significant increase in the number of slow-twitch-oxidative fibers was correlated with a slight but significant reduction in the maximal velocity of shortening of transplanted muscles. The ability of transplants to resist fatigue when repetitively stimulated was similar to the endurance capacity of control muscles. These results suggest that microneurovascular surgery may enhance the more complete restoration of function of transplanted skeletal muscles of relatively large size.