FLEXOR TENDON: RESTORATION OF THE GLIDING SURFACE

屈肌腱：滑动面的恢复

• 批准号: 3156503
• 负责人: RICHARD H GELBERMAN
• 金额: $ 26.79万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-05-01 至 1995-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3156503
• 关键词: autologous transplantation; biomechanics; cell adhesion; dogs; limb movement; musculoskeletal regeneration; tendon injury; wound healing

Recent studies have demonstrated that the healing response of connective tissue is influenced dramatically by physical forces. A particularly striking functional response has been noted in digital flexor tendons. Studies in our laboratories have shown a variety of favorable responses to early mobilization of digital flexor tendons repaired primarily, including increased strength and excursion, digital angular rotation, peritendinous vascular remodeling, and repair site and sheath DNA content compared to delayed mobilized and immobilized controls. The frequent incidence of poor digital function following one- and two-stage flexor tendon grafts has stimulated a new interest in postoperative protected early motion. Our hypothesis is that autogenous flexor tendon graft healing, not associated with synovial adhesion ingrowth, is stimulated by early controlled motion. In addition, the healing response is donor tissue specific with intrasynovial flexor tendon donors exhibiting greater cellular survival and increased collagen synthesis than extrasynovial extensor tendon donors. We propose that tendon autografts treated by reinstitution of the relevant function of tendon bypass the stages of autograft transformation (avascular necrosis, revascularization, cellular proliferation, and remodeling). Revascularization by adhesions, applicable only to immobilized autogenous grafts, leads to repair that is structurally inferior when compared to grafts mobilized early. The intrinsic healing process, relying on cellular survival and proliferative sheath response when the autograft is immobilized. The objective of this proposal is to determine the specific manner by which flexor tendon autografts heal in the absence of synovial sheath adhesion ingrowth under conditions of early passive motion. The flexor tendon autografts' gliding surface and synovial sheath will be characterized using morphological, biochemical, and biomechanical techniques.

最近的研究表明，结缔组织的愈合反应 组织受到物理力的巨大影响。 特别 在数字屈肌腱中注意到了引人注目的功能响应。 我们实验室的研究表明了对 主要修复数字屈肌的早期动员，包括 增加强度和游览，数字角旋转，脑倾斜 相比 延迟动员和固定的对照。 贫穷的频繁发生 在一阶段和两个阶段屈肌肌腱移植物具有的数字功能具有 激发了对术后保护的早期运动的新兴趣。 我们的 假设是自体屈肌肌腱移植物愈合，无关 与滑膜粘附的内向，可以通过早期控制运动刺激。 另外，愈合反应是特定于供体组织 鞘内屈肌肌腱供体表现出更大的细胞存活和 胶原蛋白合成比外延伸延伸肌腱供体增加。 我们 提出通过恢复相关的肌腱自体移植 肌腱绕过自体移植阶段的功能（无血管 坏死，血运重建，细胞增殖和重塑）。 通过粘连进行血运重建，仅适用于固定的自动源 移植物，导致修复，与 嫁接提早动员。 依赖细胞的固有愈合过程 自体移植时生存和增殖鞘反应 固定。 该提议的目的是确定特定 在没有滑膜的情况下，屈肌肌腱自体愈合的方式 在早期被动运动条件下，护套粘附的内向。 这 屈肌肌腱自体的滑动表面和滑膜将是 使用形态，生化和生物力学的特征 技术。