FLEXOR TENDON--RESTORATION OF THE GLIDING SURFACE

屈肌腱——滑动面的恢复

• 批准号: 3156504
• 负责人: RICHARD H GELBERMAN
• 金额: $ 27.58万
• 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/3156504
• 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 组织受到物理力的显着影响。 一个特别 指屈肌腱具有显着的功能反应。 我们实验室的研究显示了各种有利的反应 主要修复指屈肌腱的早期动员，包括 增加强度和偏移、数字角旋转、腱周 血管重塑、修复位点和鞘 DNA 含量与 延迟动员和固定控制。 贫困现象频发 一阶段和两阶段屈肌腱移植后的数字功能 激发了人们对术后受保护的早期运动的新兴趣。 我们的 假设是自体屈肌腱移植愈合，与 随着滑膜粘连向内生长，受到早期受控运动的刺激。 此外，愈合反应是供体组织特异性的 滑膜内屈肌腱供体表现出更高的细胞存活率 与滑膜外伸肌腱供体相比，胶原蛋白合成增加。 我们 建议通过重新安置相关的肌腱来治疗自体肌腱 肌腱的功能绕过自体移植物转化阶段（无血管 坏死、血运重建、细胞增殖和重塑）。 粘连血运重建，仅适用于固定自体 与移植物相比，导致结构上较差的修复 移植物早期动员。 内在的愈合过程依赖于细胞 自体移植物存活和增殖鞘反应 不动了。 本提案的目的是确定具体的 在没有滑膜的情况下屈肌腱自体移植物愈合的方式 早期被动运动条件下鞘膜粘连向内生长。 这 自体屈肌腱的滑动面和滑膜鞘将被 使用形态学、生物化学和生物力学进行表征 技术。