BJECTIVE: To study the effect of transposition of great adductor muscular tendon pedicled vessels in repairing the medial collateral ligament defect of knee joint. METHODS: From September 1991 to September 1999, on the basis study of applied anatomy, 30 patients with the medial collateral ligament defect were repaired with great adductor muscular tendon transposition pedicled vessels. Among them, there were 28 males and 2 females, aged 26 years in average. RESULTS: Followed up for 17 to 60 months, 93.3% patients reached excellent or good grades. No case fell into the poor grade. CONCLUSION: Because the great adductor muscular tendon is adjacent to the knee joint and similar to the knee ligament, it is appropriate to repair knee ligament. Transposition of the great adductor muscular tendon pedicled vessels is effective in the reconstruction of the medial collateral ligament defect of knee joint.
There is still a controversy on the treatment of the incomplete tear of tendons.Some authors insist to suture up, and some prefer not to suture. An animal experiment was performed for this purpose. One hundred twenty tendons of chicken feet were cut transverse and oblique cuts in equal number incompletely into 25%, 50% and 75%, respectively. Sixty tendons on the left feet were sutured up with external P.P. immobilization for 3 weeks while the other 60 tendons on the right feet were not sutured but with simple dressing only. The postoperative results assessed by various methods from functional observation and histological sectionsshowed that the suture group with external immobilization had a definitely superior result than that of the nonsuture group. The tendon cut over 50% was worse than those less than 50%. There was no much difference between whether the cut was transverse or oblique.
In order to study the influence of severity of tendon injury on the morphology of collagen fibers during healing process of extensor tendons, 40 female Wistal rats were used for investigation. The rats were divided into 2 groups. Transection of the tendon of extensor digitorum longus was performed in one group, while partial section of the same tendon was performed in the other group. Morphometric analysis was undertaken on the 15th, 30th, 60th and 90th day after operation. The result was that there was no significant difference between the two groups both in distribution and diameter of collagen fibers on the 15th and 30th days (P gt; 0.05). However, there was significent difference between those on the 60th and 90th days (P lt; 0.05). It was concluded that the severity of the tendon injury could influence the morphology of collagen fibers during the late stage of tendon healing.
Seventeen cases involving 18 fingers of acute rupture of flexor tendon within the Zone Ⅱ were repaired by microsurgical technique for reconstructing the digital sheath with biological membrane since 1989. The excellent/good rate based on Eaton grading was 89%. The main procedure of the operation. the early postoperative rehabilitation and active excercises were described.
In order to compare the immunogenecity and biological properties of homologous tendon grafts after treatment from different methods of freezing, tendons from chickens received repeated freezing-thawing treatment or ultra-low-temperature treatment, and then, the post-treatment tendons were preserved in liquid nitrogen for 3 months before transplantation. The autogenous tendon transplantation was served as the control. It was found that in the group of repeated freezing-thawing treated tendons, the tendon cells all died and while in the ultra-low temperature treated tendons the active rate of tendon cells was 92.5% +/- 3.4%, and the histological observation showed that transplantation of frozen tendons would result in extensive infiltration of inflammatory cells in the grafted tendons and the peritendinous adhesion was serious than that of the autografts. The active flexion function, hydroxyproline levels and the biomechanical analysis showed no significant differences between the repeated freezing-thawing treated homografts and the ultra-low-temperature treated homografts, and that the autografts was definitely superior to the homografts. The conclusions were: (1) Transplantation of the homologous tendons from the two different methods of freezing could receive considerable success and there was no significant difference between them; (2) Transplantation of frozen homologous tendon graft might give successful result which was probably due to the preservation of the cellular activity of the tendon cells following freezing treatment and elimination of the antigen presenting cells in the tendon as well, and (3) Although the cellular components of the tendon were damaged and the antigenicity of the tendon was lowered, it did not necessarily mean that homologous tendon graft would always be successful in transplantation.
Five fresh human forearms removed from cadavers were used to study the vascular concentration of the flexor digital tendons by stereology method. The results showed: (1) The Vv is 0.45%, and Lv is 1.9; (2) The vascular concentration of the flexor digital tendons of different fingers showed no significance statistically; (3) The vascular concentration of the tendons within the digital sheath was less than that outside the digital sheath (plt;0.01); (4) The vascular concentration of the tendons were decreasing gradually form the thum dto litter finger.
Objective To make a comparison for the change of maximum tensile intensity and stiffness of a whole implant that is placed into bone tunnel with various lengths tendon, by using beagle dog’s autogenous flexor tendons to reconstruct anterior cruciate l igament (ACL). Methods Sixty male beagle dogs were included in the experiment (weighting 13-16 kg). Three dogs were used for intact flexor tendon of both knees (normal control group), 3 dogs for the intact ACL andfemur-graft-tibia complex (auto control group) and 54 dogs (108 knees) for models of reconstructed ACL (6 experimentalgroups according to different lengths of tendon: 5, 9, 13, 17, 21 and 25 mm in the bone tunnel). The tensile intensity and stiffness were measured after 45, 90 and 180 days separately after operation. Results In the normal control group, the maximum tensile intensity of the intact flexor tendon was (564.15 ± 36.18) N, the stiffness was (59.89 ± 4.28) N/ mm. In the auto control group, the maximum tensile intensity of the intact ACL was (684.75 ± 48.10) N, the stiffness was (74.34 ± 6.99) N/ mm, all ruptured through the intra-articular portion of the graft. The maximum tensile intensity of femur-graft-tibia complex in the auto control group was (301.92 ± 15.04) N, the stiffness was (31.35 ± 1.97) N/mm. After 45 days of operation, all failure occurred at the tibial or femoral insertion site. After 90 days of operation, 24 of the breakpoints were scattered in tendon-bone junction, 12 (3 in 17 mm group, 5 in 21 mm group, 4 in 25 mm group) ruptured through the intra-articular portion. After 180 days of the operation, all breakpoints were distributed inside joint of the implant. The maximum tensile intensity and the stiffness were ber in 17, 21 and 25 mm groups than in 5, 9 and 13 mm groups after operation (P lt; 0.05). Conclusion Tendon with 17 mm length, which will be implanted into bone tunnel, is an appl icable index, in reconstruction of ACL by autogenous tendons.
OBJECTIVE: The review the effect of cytokines on repair of tendon injury and the relevant mechanism. METHODS: By broadly consulting recent issues about cytokines involved in tendon repair, a variety of cytokines with effects in repairing injured tendon was made and the possible mechanisms were summarized, with unsolved problems discussed. RESULTS: There were many cytokines participated in the procedure of tendon repair, among which insulin-like growth factor (IGF-1), transforming growth-beta 1 (TGF-beta 1) played significant roles. Most of the relevant researches were limited in experimental study in vitro. CONCLUSION: Cytokines possibly can accelerate tendon repair and show great potentials in future clinical application.
Objective To study the adhesion-preventing effect of basic fibroblast growth factor(bFGF) combined slow-releasing degradable membrane.Methods The bFGF combined slow-releasing degradable membrane was made from bFGF and the reagent which could promote fibrinogen synthesize. Sixty-six SD rats were divided into groups A,B,C randomly (22 rats each group). In group A, sutured achilles tendon were encapsulated with bFGF combined slow-releasing degradable membrane;in group B, sutured achilles tendon were encapsulated with degradable membrane without any drug; in group C, achilles tendon were only sutured. Ninety days later, light-microscope, electronmicroscopoe, figureanalysing, hydroxyproline content, extent of peritendon adhesion and biomechanic test were evaluated.Results ①The amount of fibroblast and fibrinogen inside the sutured tendon in group A was larger than that inits peripheral connective tissue and in groups B and C (P＜0.05). Thecontent of hydroxyproline and the ultimate tensile strength in group A was higher than those in groups B and C(P＜0.01).② The peripheral tissue in group A almostremains the formal loose connective tissue, but it became dense connective tissue in groups B and C and grew into the tendon. Moreover, the extent of adhesion in group A was lesser than that in groups B, C according to the mensuration of peritendon adhesion.Conclusion The bFGF combined slow-releasing degradable membrane can make the intrinsic healing of tendon faster than peripheral