Comparative Study Of Cell-free Amniotic Membrane And Medical Membrane Repairing Chicken Tendon Sheath Defect For Prevention Of Tendon Adhesion

Objectives: Tendon injuries are common among the field of hand surgery diseases.Over the years,the restoration of normal function after these injuries is often unsatisfactory because of the formation of adhesions around the repair site that restrict the gliding of the tendons.Especially the tendon within the tendon sheath have complex anatomical structures and higher risk injury.Currently,to prevent adhesion of tendon postoperative remain a challenging clinical problem.Scholars study found that the reconstruction of flexor tendon sheath can significantly inhibit tendon adhesion.Searching for a suitable tendon sheath repair materials received extensive attention of scholars.The goal of the experiment is to investigate the best repair materials of tendon sheath reconstruction through repair chicken flexor tendon sheath defects by using cell-free amniotic membrane and to reveal the mechanism of preventing adhesion of reconstructing tendon sheath defects with cell-free amniotic membrane.Methods: Take 66 male white leghorn chicken.Make tendon injury,tendon sheath defect model on each chicken's feet of the third toe,enrolled into 3 group(n = 22): cell-free amniotic membrane for repairing the tendon defect(group A),medical membrane(B group),control group only damage,defect model without repair of tendon sheath(group C).General and histological observations,biomechanical evaluations of tendon excursion,the total flexion angle and the maximum tensile strength of tendon were studied after operation.Results: 12 weeks postoperatively,amniotic membrane and medical film group have formed complete tendon sheath,tendon healing well,no adhesion;the control group tendon adhesion seriously.8 weeks after the operation,there are abundant synovial cells in the false sheath of amniotic membrane group,and the rough endoplasmic reticulum highly expansion,secrete exuberantly in the substrate.Secondly the medical film group,control group minimum number of synovial cells,and distribution disorderly,expansion of vacuoles in the matrix,two groups of weak earlier,The expansion of cavity is weak compared with former two groups in the substrate.12 weeks after surgery,for groups A and B,Fibroblasts distribution orderly,structure densly.For group C,the structure of false sheath is loose,fibroblasts distributed disorderly.Amniotic membrane and medical film groups,the total flexor distance of tendon gliding and total flexor toe angle of amniotic membrane and medical film groups were greater than the control group(p<0.05).There was no significant difference between groups A and B.The difference of maximum fracture load has no significant statistical significance between 3 groups.Conclusion: The results show that Application of cell-free amniotic membrane and medical film to reconstructing of tendon sheath defects can significant barrier tendon exogenous healing,prevent tendon adhesion.