Seiler J G, Gelberman R H, Williams C S, Woo S L, Dickersin G R, Sofranko R, Chu C R, Rosenberg A E
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston 02114.
J Bone Joint Surg Am. 1993 Jul;75(7):1004-14. doi: 10.2106/00004623-199307000-00006.
Intrasynovial and extrasynovial donor autogenous flexor-tendon grafts were placed in the synovial sheaths of the medial and lateral digits of the forepaw in twenty dogs (forty tendons). Postoperatively, the dogs were managed with early, controlled, passive mobilization. Histological and ultrastructural evaluations were carried out at ten days, three weeks, and six weeks, and biomechanical analyses were performed at three and six weeks. The intrasynovial and extrasynovial tendon grafts showed different healing processes histologically. The extrasynovial tendon grafts healed with early ingrowth of peripheral adhesions, which appeared to become larger and more dense over time. These grafts exhibited decreased cellularity and early neovascularization at ten days, and there was evidence of progressive revascularization and cellular repopulation at three and six weeks. In contrast, the intrasynovial tendon grafts demonstrated minimum adhesions, and both cellularity and collagen organization were normal at each time-interval. The intrasynovial grafts had significantly more angular rotation at the proximal interphalangeal joint at three and six weeks than did the extrasynovial grafts (p < 0.05).
将20只犬（40条肌腱）的滑膜内和滑膜外自体屈肌腱移植物置于前爪内侧和外侧指的滑膜鞘内。术后，对犬进行早期、可控的被动活动管理。在术后10天、3周和6周进行组织学和超微结构评估，并在3周和6周进行生物力学分析。滑膜内和滑膜外肌腱移植物在组织学上显示出不同的愈合过程。滑膜外肌腱移植物早期有周围粘连长入，随着时间推移，这些粘连似乎变得更大、更致密。这些移植物在10天时细胞数量减少且早期有新生血管形成，在3周和6周时有血管逐渐再生和细胞重新填充的证据。相比之下，滑膜内肌腱移植物粘连最少，在每个时间间隔细胞数量和胶原组织均正常。滑膜内移植物在3周和6周时近端指间关节的角旋转明显多于滑膜外移植物（p<0.05）。
