Comparative study of vascularized and nonvascularized tendon grafts for reconstruction of flexor tendons in zone 2: An experimental study in primates

Singer, Daniel I.; Morrison, Wayne A.; Gumley, Graham J.; O’Brien, Bernard McC.; Mitchell, Geraldine M.; Barton, Ronald M.; Frykman, Gary K.

doi:10.1016/0363-5023(89)90059-2

Cited by 35 publications

(18 citation statements)

References 9 publications

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“…These contributions include cell proliferation, migration, and ECM synthesis that contribute to the formation of scar tissue and adhesion [21, 22]. The biological mechanisms of flexor tendon graft repair and adhesion formation remain poorly understood, despite being studied for decades in various animal models including non-human primates [23], canine [24–28], chicken [29–31], rabbits [32–34], and rats [35–37]. To address this, we have previously developed a murine flexor tendon repair model that permits the study of simple repair and segmental reconstruction [16–18, 38, 39].…”

Section: Discussionmentioning

confidence: 99%

Cellular and Molecular Factors in Flexor Tendon Repair and Adhesions: A Histological and Gene Expression Analysis

Juneja

Schwarz

O’Keefe

et al. 2013

Connective Tissue Research

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Flexor tendon healing is mediated by cell proliferation, migration, and ECM synthesis that contribute to the formation of scar tissue and adhesion. The biological mechanisms of flexor tendon adhesion formation has been linked to TGF-β. To elucidate the cellular and molecular events in this pathology, we implanted live FDL grafts from the reporter mouse Rosa26LacZ/+ in WT recipients, and used histological β-galactosidase (β-gal) staining to evaluate the intrinsic versus extrinsic cellular origins of scar, and RT-PCR to measure gene expression of TGF-β and its receptors, extracellular matrix (ECM) proteins, and MMPs and their regulators. Over the course of healing, graft cellularity and β-gal activity progressively increased, and β-gal-positive cells migrated out of the Rosa26LacZ/+ graft. In addition, there was evidence of influx of host cells (β-gal-negative) into the gliding space and the graft, suggesting that both graft and host cells contribute to adhesions. Interestingly, we observed a biphasic pattern in which Tgfb1 expression was highest in the early phases of healing and gradually decreased thereafter, whereas Tgfb3 increased and remained upregulated later. The expression of TGF-β receptors was also upregulated throughout the healing phases. In addition, type III collagen and fibronectin were upregulated during the proliferative phase of healing, confirming that murine flexor tendon heals by scar tissue. Furthermore, gene expression of MMPs showed a differential pattern in which inflammatory MMPs were highest early and matrix MMPs increased over time. These findings offer important insights into the complex cellular and molecular factors during flexor tendon healing.

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Section: Discussionmentioning

confidence: 99%

Cellular and Molecular Factors in Flexor Tendon Repair and Adhesions: A Histological and Gene Expression Analysis

Juneja

Schwarz

O’Keefe

et al. 2013

Connective Tissue Research

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“…This is reflected by previous studies which have used a wide range of species as models for tendon injuries, including non-human primates, horses, goats, dogs, rabbits, rats and mice. [12][13][14][15][16][17][18][19][20][21][22][23][24] From a translational standpoint, non-human primates represent the most ideal species to use in tendon research as they are the closest to humans in terms of anatomy and physiology. However, their use is limited by ethical considerations and a lack of availability which results in extraordinary high costs (table 1).…”

Section: Selection Of Appropriate Speciesmentioning

confidence: 99%

Animal models for the study of tendinopathy

2006

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Tendinopathy is a common and significant clinical problem characterised by activity-related pain, focal tendon tenderness and intratendinous imaging changes. Recent histopathological studies have indicated the underlying pathology to be one of tendinosis (degeneration) as opposed to tendinitis (inflammation). Relatively little is known about tendinosis and its pathogenesis. Contributing to this is an absence of validated animal models of the pathology. Animal models of tendinosis represent potential efficient and effective means of furthering our understanding of human tendinopathy and its underlying pathology. By selecting an appropriate species and introducing known risk factors for tendinopathy in humans, it is possible to develop tendon changes in animal models that are consistent with the human condition. This paper overviews the role of animal models in tendinopathy research by discussing the benefits and development of animal models of tendinosis, highlighting potential outcome measures that may be used in animal tendon research, and reviewing current animal models of tendinosis. It is hoped that with further development of animal models of tendinosis, new strategies for the prevention and treatment of tendinopathy in humans will be generated.

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“…Usually, these injuries are managed by primary soft tissue coverage, followed by secondary tendon and bone reconstruction. 6,20,21 Ideally, surgical management of these injuries should involve reconstruction of each structure in a 22 Limited studies using lateral arm flap 7,8 or other vascularized tendons such as reverse flow tendocutaneous radial forearm flap, 23 free tendocutaneous groin flap, 24 and dorsalis pedis flap 25 in hand reconstruction report inconsistent but promising results. Lateral arm flap with vascularized triceps tendon has the advantage of providing a 1-stage reconstruction for composite soft tissue and tendon defects.…”

Section: Discussionmentioning

confidence: 97%

Free Lateral Arm Flap for 1-Stage Reconstruction of Soft Tissue and Composite Defects of the Hand

Ulusal

Lin

Ulusal

et al. 2007

Annals of Plastic Surgery

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In this article, the long-term outcomes of hand defects after 1-stage reconstruction with lateral arm flap were retrospectively analyzed in a large series. Between the years 1990 and 2004, 118 traumatic hand defects were reconstructed using lateral arm fasciocutaneous flap (n = 104), lateral arm fascial flap (n = 6), and composite lateral arm flap (n = 8) in Chang Gung Memorial Hospital. There were 22 females and 96 males with an average age of 32.5 +/- 13.3 years. The mean follow-up period was 17 +/- 6.2 months. The overall success rate was 97.5%. The cosmetic outcomes were satisfactory and only 16.1% of the patients required debulking. The functional recovery of the hand contractures secondary to crush injury were generally associated with poor results. In the composite flap group, reconstruction of the extensor tendons with triceps tendon yielded limitation in tendon excursion and poor functional results. However, complete bone healing without complication was uniformly detected in all cases. Lateral arm fasciocutaneous flap endured secondary interventions well and no complications regarding wound healing was encountered.

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Comparative study of vascularized and nonvascularized tendon grafts for reconstruction of flexor tendons in zone 2: An experimental study in primates

Cited by 35 publications

References 9 publications

Cellular and Molecular Factors in Flexor Tendon Repair and Adhesions: A Histological and Gene Expression Analysis

Cellular and Molecular Factors in Flexor Tendon Repair and Adhesions: A Histological and Gene Expression Analysis

Animal models for the study of tendinopathy

Free Lateral Arm Flap for 1-Stage Reconstruction of Soft Tissue and Composite Defects of the Hand

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