Study Of Human Amniotic To Repair The Injured Tendon

Objective:Tendon injuries are common among the field of hand surgery,tendon injury of zone Ⅱwould often associated with tendon sheath injury.The exogenous healing of the tendon is the main reason for adhesions aftersurgery.It may lead to a loss of hand functions. It is a problem eager to besolved. The tendon sheath is a membrane-like structure. Amniotic membrane asoft, translucent and transparent film. There is no immune rejection responseafter allogeneic transplantation.It can gegrade slowly in vivo.Immunosuppressive factors can be secreted to inhibit the inflammatoryresponse after transplantation, and it also can selectively inhibits the activityof fibroblast. This experiment based on researches of structure and function ofthe tendon sheath. We use amniotic membrane to repair the tendon sheathdefect to observe the effect of amniotic membrane on prevention of tendonadhension. We expect to find out an ideal material in repair of tendon sheathdefect.The result can provide a theoretical basis for prevention of tendonadhesion.Methods:Forty3to6-months-old white healthy male leghorn chickenswere used as the experimental model,with an average1.86±0.04kg. We usechicken model of flexor digitorum profundus (FDP) injury and tendon sheathdamage at the certain region of the third(longest) toe. Using self-controlcontrast method, group A was the right feet:repairing the tendon sheath withamniotic membrane after the the flexor digitorum profundus tendon wasrepaired; Group B was the left feet: received no treatment after the after thethe flexor digitorum profundus tendon was repaired.Each group has40toes.At1,2,4and6weeks after surgery,we do general observation, histologicalobservation, the degree of tendon adhesions(Refer to tang’s tendon adhesiongeneral observe grading standards), electron microscope observation and the test of biomechanical. The biomechanical testing include tendon slip lengthtests and total flexion angles tests.Results:General observation shows: After surgery, with the passage oftime,there was new tendon sheath regeneration both in group A and group B.The difference between both groups was statistically significant(P<0.05) at1,6weeks after sugery: There was less tendon adhesion in group A than ingroup B.The histological observation results shows:At the first week after surgery,compared with group B,group A had less congestion, edema andinflammatory reaction. At the sixth week after surgery, the regenerated sheathwas more maturer and smoother in group A than in group B. The synovialcells of the tendon sheath of group A arranged neater than that of group B.TEM observation shows: At4and6weeks after surgery, Synovial cellscontain vesicles, expansioned rough endoplasmic reticulum and ribosomeswere seen in group A.In group B, synovial cells were seen occasionally.The biomechanical test results shows:The differences of tendon sliplength were not statistically significant (P>0.05)between the two groups at1,2weeks after operation. The tendon slip length of group A were longer thanthat of group B at2,6weeks after operation(P<0.05). The total flexion anglesof group A at each time point after surgery were smaller than those of groupB.The difference between both groups was statistically significant（P<0.05）.The function of group A was better than that of group B.Conclusion:The connection between the tendon and the surroundingtissue was blocked by amniotic membrane,and it also bolcked exogenoushealing.Withing the tendon sheath was repaired by the amnioticmembrane,there were fewer adhesions produced，which conducive to therecovery of the tendon sliding function.