During tendon injuries, the tendon sheath is also damaged. This study aims to test effectiveness of engineered tendon synovial cell biomembrane on prevention of adhesions. Forty New Zealand Rabbits enrolled into four study groups. Engineered synovial sheath was produced by culturing cell suspension on fabricated collagen matrix membrane. Study groups were: tendon repair (group A), tendon repair zone covered with plane matrix (Group B), synovial suspension injection into the zone of repair over matrix (Group C), and biomembrane application (Group D). Biomechanical evaluations of tendon excursion, metacarpophalangeal and proximal interphalangeal joints range of motion, H&E and Alcian Blue with neutral red staining, and adhesion formation graded for histological assessments were studied. Ten non-operated extremities used as control. Tendon excursions and range of motions were significantly higher and close to control group for Group D, p < 0.05. Adhesion formation was not different among Groups C, D, and Control, p > 0.005. Hyaluronic acid synthesis was demonstrated at groups C and D at the zone of injury. Application of synovial cells into the tendon repair zone either by cell suspension or within a biomembrane significantly decreases the adhesion formation. Barrier effect of collagen matrix and restoration of hyaluronic acid synthesis can explain the possible mechanism of action.

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Background:The present study aims to compare the clinical outcomes of patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction with Transtibial (TT) and Transportal Anatomical (TA) techniques with the diagnosis of ACL rupture.Methods: A total of 56 patients who underwent arthroscopic ACL repair in the Orthopedics and Traumatology Clinic of Menemen State Hospital between 2015 and 2020 were included in the study. The mean age of the patients was 25 years, and follow-up period was 31 months. Of the patients, 53 were male, 3 were female, and 43 had ACL ruptures in the right knee and 13 in the left knee. ACL reconstruction was performed using the TT technique in 29 patients and the TA technique in 27 patients. Patients were evaluated using the Lysholm Assessment score, the Modified Cincinnati Rating System Questionnaire, the Tegner Activity Level Scale, and the International Knee Documentation Committee scoring.Results: There was a significant difference in pre and postoperative controls (p<0.05) and while normal and near-normal results were obtained with the TT (89%) and TA (87%) techniques, there was no statistically significant difference between the two techniques when the postoperative data were compared (p>0.05). Conclusions:In this study, there was no significant difference between the two techniques in terms of clinical outcome and patient satisfaction. Although there are studies in the literature showing that the TA technique is superior in terms of knee stability, good results are obtained with both techniques.

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