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Comparative Study
. 2010 Jul;35(7):1153-9.
doi: 10.1016/j.jhsa.2010.03.023. Epub 2010 Jun 11.

Effects of synovial interposition on healing in a canine tendon explant culture model

Jun Ikeda  1 , Chunfeng Zhao, Steven L Moran, Kai-Nan An, Peter C Amadio
Affiliations
Comparative Study

Effects of synovial interposition on healing in a canine tendon explant culture model

Jun Ikeda et al. J Hand Surg Am. 2010 Jul.

Abstract

Purpose: To investigate whether synovium interposition between repaired tendon ends can integrate into the tendon repair and improve tendon healing strength in a canine tendon explant culture model.

Methods: We used 80 flexor digitorum profundus tendons from 10 mixed-breed dogs for this study. The flexor digitorum profundus tendons were assigned to 2 groups: repaired tendons with synovium implanted between the cut tendon ends and repaired tendons without any implantation between the tendon ends. The repaired tendons were cultured for either 2 or 4 weeks and then assessed mechanically for rupture strength and histology.

Results: The strength of the repaired tendons with the synovium interposition was significantly higher (p < .001) than the repaired tendons without interposition at both 2 and 4 weeks. The strength of the repaired tendons at 4 weeks was significantly higher than that at 2 weeks in both groups.

Conclusions: Interpositional synovial grafts have the potential to accelerate tendon healing when they are implanted at the repair site. The exact mechanism of this effect remains to be elucidated.

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Figures

Figure 1
Figure 1
Placement of holding suture at the transection site.
Figure 2
Figure 2
The custom-made frame used to hold specimens straight alignment in tissue culture.
Figure 3
Figure 3. Test Setup
To the left is the transducer, to the right side the motor, which distracted at a rate of 0.1 mm/second. The data from the load transducer was recorded to measure the maximum failure load of the tendon repair site.
Figure 4
Figure 4. Sample Data
The force increased gradually until failure of the repair site
Figure 5
Figure 5. Load to Failure
cont. = Without Synovium syn. = Synovium Interposition 2w = 2 Weeks 4w = 4 Weeks
Figure 6
Figure 6. Histology of the suture site after 4 weeks tissue culture in control group
T: tendon end, S: synovium, *: tendon to tendon apposition site (A) With the suture cut, the end to end healing strength of the tendon is very low. We have no examples, therefore, of specimens in which the cut ends did not separate during sectioning. (×20) (B) Suture site of a control group specimen. (×40) The synovium cannot be seen on this section. Note limited cellularity as compared to Figure 7.
Figure 6
Figure 6. Histology of the suture site after 4 weeks tissue culture in control group
T: tendon end, S: synovium, *: tendon to tendon apposition site (A) With the suture cut, the end to end healing strength of the tendon is very low. We have no examples, therefore, of specimens in which the cut ends did not separate during sectioning. (×20) (B) Suture site of a control group specimen. (×40) The synovium cannot be seen on this section. Note limited cellularity as compared to Figure 7.
Figure 7
Figure 7. Histology of the suture site after 4 weeks in tissue culture with synovium implantation
T: tendon end, S: synovium, *: tendon to tendon apposition site (A) Suture site specimen in the synovium interposition group. Note fibroblast-like cells were around the interposed synovium and migrating into the tendon ends. (×20) (B) Higher magnification view (X200) of area with the box in Figure 7(A).
Figure 7
Figure 7. Histology of the suture site after 4 weeks in tissue culture with synovium implantation
T: tendon end, S: synovium, *: tendon to tendon apposition site (A) Suture site specimen in the synovium interposition group. Note fibroblast-like cells were around the interposed synovium and migrating into the tendon ends. (×20) (B) Higher magnification view (X200) of area with the box in Figure 7(A).
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References

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