Ark J W, Gelberman R H, Abrahamsson S O, Seiler J G, Amiel D
Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston 02114.
J Hand Surg Am. 1994 Mar;19(2):249-58. doi: 10.1016/0363-5023(94)90015-9.
In order to investigate fibroblast survival and proliferation in autogenous flexor tendon grafts, hindlimb intrasynovial and extrasynovial donor tendons were placed within the synovial sheaths of the medial and lateral forepaw digits of 21 dogs (42 tendons) and treated with controlled early passive motion. Intravital histologic evaluations with confocal microscopy and biochemical determinations of total DNA content and DNA synthesis were carried out at 10 days, 3 weeks, and 6 weeks. Intravital staining of the extrasynovial tendon grafts demonstrated variable degrees of cellular necrosis at the earliest intervals followed by cellular repopulation with fibroblasts and neovascularization from surface vessels. In contrast, intrasynovial tendon grafts were populated predominantly by viable cells at each interval, with occasional patches of cell necrosis and fibroblast ingrowth. Total DNA content and DNA synthesis values in the intrasynovial donor tendons were significantly lower than those seen in the extrasynovial tendon grafts at each interval. Extrasynovial tendons appear to act as scaffolds, undergoing extensive cellular death followed by a rapid repair response. Findings that intrasynovial tendon fibroblasts survive the tendon grafting process suggest that the nutritional supplies and metabolic requirements of intrasynovial and extrasynovial donor tendons differ largely.
为了研究自体屈肌腱移植中成纤维细胞的存活和增殖情况，将后肢滑膜内和滑膜外供体肌腱置于21只犬（42条肌腱）前爪内侧和外侧指的滑膜鞘内，并进行早期被动活动控制。在术后10天、3周和6周，采用共聚焦显微镜进行活体组织学评估，并对总DNA含量和DNA合成进行生化测定。滑膜外肌腱移植的活体染色显示，在最早的时间间隔内出现不同程度的细胞坏死，随后成纤维细胞重新填充，表面血管出现新生血管。相比之下，滑膜内肌腱移植在每个时间间隔主要由存活细胞组成，偶尔有细胞坏死和成纤维细胞长入区域。在每个时间间隔，滑膜内供体肌腱的总DNA含量和DNA合成值均显著低于滑膜外肌腱移植。滑膜外肌腱似乎起到支架作用，经历广泛的细胞死亡，随后迅速发生修复反应。滑膜内肌腱成纤维细胞在肌腱移植过程中存活的结果表明，滑膜内和滑膜外供体肌腱的营养供应和代谢需求有很大差异。
