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Objective:To observe the effect of extracorporeal shock wave therapy on tendon adhesion in late period after hand tendon repair. Methods:From July, 2017 to December, 2018, 40 patients with tendon adhesion after hand tendon repair more than three months were collected. They were randomly divided into control group (n = 20) and experimental group (n = 20). Two groups received routine therapy, and the experimental group added extracorporeal shock wave therapy. Before and two months after treatment, the total active movement (TAM) of the fingers and the grip strength were messured. Results:There was no significant difference in TAM of the fingers and the grip strength before treatment (P > 0.05). After treatment, TAM of the fingers and the grip strength significantly increased (|t| > 10.284,P < 0.001), and were higher in the experimental group than in the control group (t > 0.386,P < 0.001). Conclusion:Extracorporeal shock wave therapy could facilitate to improve the tendon slippage and hand function in patients with tendon adhesion after hand tendon repair.
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Objective: To review the research progress of medicine biomaterials in prevention and treatment of adhesion after tendon injury, and to provide reference for clinical treatment. Methods: The literature on the application of medical biomaterials in the prevention and treatment of tendon adhesions in recent years was reviewed, and the biological process, treatment methods, and current status of tendon adhesions were summarized. Results: Tendon adhesion as part of the healing process of the tendon is the biological response of the tendon to the injury and is also a common complication of joint dysfunction. Application of medical biomaterials can achieve better biological function of postoperative tendon by reducing the adhesion of peritendon tissues as far as possible without adversely affecting the tendon healing process. Conclusion: The use of medical biomaterials is conducive to reduce the adhesion of tendon after operation, and the appropriate anti-adhesion material should be selected according to the patients' condition and surgical needs.
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BACKGROUND: Strong evidence exists that tendon adhesion occurs after tendon repair. OBJECTIVE: To review the advance in research on the prevention of tendon adhesion in terms of human amniotic membrane, drugs and growth factor. METHODS: A computer-based online search of Wanfang, CNKI, and Medline databases was performed to search papers regarding prevention of adhesion after tendon injury published between January 2000 and April 2019 with the search terms “tendon injury, tendon adhesions, drug, human amniotic membrane, growth factor” in English and Chinese. Papers recently published in high-impact journals in the same research field were selected. Fifty papers were included in the final analysis. RESULTS AND CONCLUSION: Amniotic membrane and acellular amniotic membrane are effective in preventing tendon adhesion. Drugs can work in many ways to achieve the purpose of preventing adhesion, and drugs exhibit better efficacy after combined application with sustained-release carrier. Most growth factors not only promote tendon healing but also promote adhesion formation. The formation of tendon adhesion can be reduced by adjusting the concentration of growth factors in the lesion site.
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Subject(s)
Cicatrix , Collagen Type I , Collagen , Contracture , Desmin , Down-Regulation , Extracellular Matrix , Fibroblasts , Fibronectins , Fibrosis , Follistatin , Genetic Therapy , Immunohistochemistry , Myofibroblasts , Plasminogen Activator Inhibitor 1 , RNA, Messenger , Tendon Injuries , Tendons , Tissue Inhibitor of Metalloproteinase-1ABSTRACT
Objective To compare the effect of microsurgery and conventional surgery in the repair of tendon rupture and the effect of postoperative adhesion prevention. Methods From February 2011 to December 2016,seventy?two patients with finger tendon rupture treated in Dongfeng Hospital Affiliated to Hubei Medical College were selected as the research objectand then randomly divided into the observation group and the control group,36 cases in each group. The observation group was treated with microsurgery treatment,the control group was treated with the traditional surgical treatment to record postoperative prognosis and adhesion of the two groups. Results At 12 weeks after operation,the recovery rate of tendon in the observation group and the control group were 94. 4％ (34/36)and 75％(27/36),respectively,the data in the observation group was significantly higher than that in the control group (χ2=5. 552, P<0. 05 ) . At the same time, Carroll score of upper limb function in the observation group at 4 weeks and 12 weeks after the surgery were (85. 55±8. 29) and (102. 49 ±10.82),significantly higher than those in the control group ( (74.25±8.53)％,(91.44±12.49) ),the differences were statistically significant (t=6. 948,5. 323,P<0. 05). At 12 weeks after operation,the adhesion rate of tendon in the observation group was 2. 8％ ( 1/36 ) , significantly lower than that of the control group ( 16. 7％ ( 6/36) ) , ( P<0. 05 ) . Conclusion Compares with the conventional surgery, microsurgery in the treatment of tendon rupture repair can promote the repair of tendon tissue,improve the upper limb function,and reduce the occurrence of postoperative tendon adhesion.
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Tendon adhesion easily occurs after the operation.The outcome of tendon repair can be affected by adhesion, in-terfering with their normal gliding function.With increasingly deepened konwledge of the tendon healing process and continuous devel-opment of sciences related to medicine, a variety of effective approaches are provided to prevent tendon adhesion.Antioxidants are new orientations that are provided for prevention of tendon adhesion.Although most researches are only limited to animal experiments, the outcomes are positive.This paper reviews the mechanisms and relevant characteristics of tendon adhesion prevention in order to have a better understanding on the roles of antioxidants for preventing tendon adhesion.
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OBJECTIVE: To investigate the effect of Smad4 on the fibrosis of tendon derived fibroblasts (TDFs) induced by transforming growth factor β1(TGF-β1) by targeted regulation of miRNA219-5P (miR219-5P). METHODS: The tendons donated by the volunteers were harvested to isolate and culture TDFs. The 3rd generation cells were used for experiment. Chemically synthesized miR219-5P mimics, miR219-5P inhibitor, and negative control sequences were transfected into TDFs. The gene expression of miR219-5P in TDFs was detected by real-time PCR, and the protein expression of Smad4 in TDFs was detected by Western blot at 48 hours after transfection. The combining sites of miR219-5P and Smad4 in 3'UTR district were predicted by informatics software. Wild type and mutant type reporter gene expression vectors were constructed and then targeted verification was carried out by the luciferase reporter gene test. Transfected TDFs were then induced by TGF-β1. The proliferation activity of the cells were measured by the cell counting kit 8 after culturing for 24, 48, and 72 hours. The expressions of fibrosis related proteins in TDFs were detected by Western blot at 72 hours. RESULTS: After TDFs were transfected by miR219-5P mimics, miR219-5P expression was significantly up-regulated, but the expressions of Smad4 was decreased subsequently (P0.05). Cell proliferation and the fibrosis related proteins were increased in TGF-β1 induced TDFs, however, decreased in TGF-β1 induced TDFs after transfected by miR219-5P inhibitor (P<0.01). CONCLUSIONS: miR219-5P can significantly inhibit fibrosis of TDFs induced by TGF-β1 by down-regulating Smad4 expression.
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Objective To discover the best physical training way including frequency and intensity each day ,and to guide pa‐tients to get the best cure .Methods Totally 60 chicken ,which were randomly divided into 3 groups ,20 for each ,the deep flexor tendon of the third left toes were found ,repairing after cut them off .Flexor tendon proximal were found by making knees incision then indwelling long silk line .External fixation bandage were used .Their left toes were accepted physical training ,Training stand‐ards :6 pulling backs each time ,toe flexion 1/4 arc ,but less than 2 N .For group A ,exercised once a day ,twice a day for group B , three times a day for group C .Right ones were consider as control group weren′t processed after operation .28 days later ,tendon distance was recorded by using 2 N pulling forces at tendon proximal with aspiring balance .Gross specimen was observed and histo‐logical specimens using Tang Jinen classification method to classify adhesions ,and the dates were analyzed by statistics SPSS 19 .0 . Results Group A remaining of 18 ,rate of 5 .56% ,grade Ⅰ of 1 ,Ⅱ of 2 ,Ⅲ of 4 ;Ⅳ of 10 .Group B remaining of 17 ,rate of 5 .88% , grade Ⅰ of 12 ,Ⅱ of 2 ,Ⅲ of 1 ,Ⅳ of 1 .group C remaining of 16 ,15 toes broke again ,fracture rate was 93 .75 % ,grade Ⅰ of 1 ,con‐trol group were grade Ⅳ .Between group A and B there were no significant differences in degree of adhesion(P> 0 .05) .Group A and Cs′ differences were statistically tested (P α′) .Conclusion Physical training can reduce chicken′s tendon adhesion effectively .
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ObjectiveTo investigate the feasibility of preventing tendon adhesion by using bFGF/ vitamin C composite biodegradable membrane.MethodsSixty Newzerland rabbits were divided into experimental and control groups randomly.After the animal model was established, the tendon autografts were encapsulated with the bFGF/vitamin C composite biodegradable membrane in experimental group, while no tendon autografts encapsulation in control.Three weeks after surgery, regular HE staining and AgNO3 staining were performed to observe the fibroblast nuclei and vitamin C.The quantity of collagen fibrils was measured by Luzex-F Image Analyzer.Eight weeks after surgery, the peritendinous adhesion and the maximum tensile load were analyzed.Results At 3 weeks after surgery, the numbers of vitamin C granules, fibroblast nuclei and collagen fibrils in the experimental group were significantly more than those in the control group(t = 11.78 ,P ＜0.001) .At 8 weeks after surgery, the peritendinous adhesion in the experimental group was significantly slighter than that in the control group(Z =3.922,P ＜0.005) ,and the maximum tensile load in the experimental group was significantly higher than that in the control group (t = 8.39, P ＜ 0.001) .ConclusionbFGF/vitamin C composite biodegradable membrane can stimulate the proliferation of fibroblasts and synthesis of collagen fibrils,improve the biomechanical property of tendon autografts and prevent the tendon adhesion.
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[Objective]To investigate the effect of Zhenghai biological membrane in the prevention of adhesion of tendon. [Method]Eighteen chicken were divided into 2 groups.Zhenghai biological membrane was used in the experimental group,while simple Kessler suture was applied in the control group.The tendon adhesion degrees were compared between 2 groups with the methods of gross observation,adhesion criterion,histological observation and electron microscopy,et al.[Result]The adhesion degree was lower significantly in experimental group than that in control group.[Conclusion]Zhenghai biological membrane could prevent tendon adhesion effectively,without any obvious rejection reaction.It would not affect the healing of the tendon.
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Objective To investigate the effect of absorbable membrane on prevention of tendon adhesion after the ruptured tendon is repaired. Methods In our experiment, 30 12-weeks-old Leghorn cocks were divided into 2 groups randomly. Group A was the blank group, and Group B was the absorbable membrane group. Each group had 15 cocks. The flexor tendon of third phalanx was made ruptured. After repairing, histological observation, failure mode test and functional recovery test were performed regularly. Results In Group B, there was little adhesion between tendon and normal tissue under gross observation. There was no significant tissue necrosis or scar tissue under microscope. There was no difference in the failure mode test between the 2 groups 6 weeks after repairing. The functions of movement of interphalangeal and metacarpophalangeal joints in group B were better than those in group A. Conclusion The absorbable membrane can be a kind of material or method used to prevent tendon adhesion.