Objective To investigate the feasibility and effect of human amniotic membrane in prevention of tendon adhension after tendon sheat defect repair. Methods The amniotic membrane in size of 1.5 cm × 1.0 cm was harvested from human placenta which was voluntary donated from maternal after cesarean. Forty healthy male Leghorn chicken (aged 3-6 months) were selected, weighing (1.86 ± 0.04) kg. The model of flexor digitorum profundus tendon and tendon sheath defects was established at the third toe. After repair of the flexor digitorum profundus tendon, the human amniotic membrane was used to repair the tendon sheath defect in the right foot (group A), but tendon sheath defect was not repaired in the left foot (group B) . At 1, 2, 4, and 6 weeks after operation, the gross and histological observations were done; the degree of tendon adhesions was graded according to Tang’s tendon adhesion general observation grading standards; and the biomechanical properties (tendon slip length and total flexion angle) were tested. Results All animals survived after operation and incisions healed. Gross and histological observations showed that the new tendon sheath formed with time passing after operation in groups A and B; new tendon sheath was more maturer and smoother in group A than in group B. The degree of tendon adhesions in group A was significantly less than that in group B (P lt; 0.05) at 1 and 6 weeks after operation. The biomechanical test results showed there was no significant difference in the tendon slip length between 2 groups at 1 and 2 weeks after operation (P gt; 0.05), but the tendon slip length of group A was significantly longer than that of group B at 4 and 6 weeks after operation (P lt; 0.05). The total flexion angle of group A was significantly smaller than that of group B at 1, 2, 4, and 6 weeks after operation (P lt; 0.05). Conclusion It is effective in the prevention of tendon adhesion to use the amniotic membrane for repairing the tendon sheath defect, which is beneficial to recovery of the tendon sliding function.
Objective To compare the effect of decimeter wave with sodium hyaluronate product (SHP) on preventing and treating peritendinous adhesion and promoting tendon heal ing. Methods Totally 96 healthy male white 6-month-old Leghorn chickens weighing (2.24 ± 0.07) kg were randomized into group A ( decimeter wave therapy group, n=32),in which decimeter wave therapy was appl ied 1 to 21 days after operation at a frequency of 915 MHz, a power of 8 W, radiation distance of 10 cm, for 10 minutes once per day; group B (SHP group, n=32), in which 5 mL and 1.2% SHP was appl ied; and group C (control group, n=32), in which injury received no treatment. The III and IV toes of left feet of all chickens were made into tendon injury model. The general condition of animal was observed after operation; gross and histological observations were made 7, 10, 14, 18, 21 and 28 days after operation, and the biomechanical analysis was done 14 and 28 days after operation. Results Operative incision healed well, no infection and death occurred. Peritendinous adhesions in groups A, B were looser, and tendon heal ing was better than that of group C 14 and 28 days after operation. More fibroblasts with active metabol ism and more collagen formation in groups A, B than that in group C. The Pmax of group A was better than that of group B 14 and 28 days after operation (P lt; 0.05); the δmax of group A was better than that of group B 18 and 21 days after operation (P lt; 0.05), and the W0 of group A was better than that of group B 18, 21 and 28 days after operation (P lt; 0.05). There was no significant difference between group A and group B at the other time points. Conclusion Topical decimeter wave therapy and appl ication of SHP after flexor tendon repair can promote intrinsic heal ing, meanwhile they can prevent the adhesion of tendon and reduce extrinsic heal ing. Decimeter wave therapy can improve the qual ities of tendon’s wound heal ing.