Evaluation of an autologous tendon graft repair method for gap healing of the deep digital flexor tendon in horses.
Abstract: A sutured tenorrhaphy technique that incorporated an autologous tendon graft was compared mechanically and histologically with a sutured tenorrhaphy at 6, 12, and 24 weeks after repair. Tenorrhaphy was performed in the forelimb tendon of the deep digital flexor muscle and the graft was taken from the hindlimb tendon of the lateral digital extensor muscle; one forelimb site included the graft, whereas the other forelimb site was not grafted. Tenotomies were made immediately proximal to the insertion of the accessory ligament into the tendon of the deep digital flexor muscle. Grafted and nongrafted tenorrhaphies were sutured with 2 polydioxanone in a modified double locking-loop pattern. Limbs were supported with a bandage and an extended elevated heel shoe that maintained the dorsal hoof wall angle at 70 degrees to 75 degrees; this support was removed at 12 weeks and dorsal hoof wall angle was maintained at 40 degrees to 45 degrees for the remainder of the study. Gap formation (2.5 +/- .3 cm) was evident at all tenorrhaphy sites at 3 days on ultrasound examination. In grafted repairs, the breaking stress was increased (P < .001) between 6 weeks (2.56 +/- .44 MPa) and 12 weeks (17.69 +/- 7.68 MPa), with grafted tendon having a greater breaking stress than nongrafted tendon (8.77 +/- 2.5 MPa; P < .05). No differences in breaking stress were evident at 24 weeks. At 12 weeks, repair tissue in grafted tendon was histologically more mature, had less cellularity, better fibroblast orientation and more homogeneous collagen matrix than nongrafted tendon. Polydioxanone suture was still evident histologically at 24 weeks and was associated with minimal cellular reaction. Incorporation of an autologous tendon graft improved the mechanical properties and histological quality of the repair tissue in equine flexor tenorrhaphies at 12 weeks but not at 24 weeks after repair.
Publication Date: 1996-07-01 PubMed ID: 8810025DOI: 10.1111/j.1532-950x.1996.tb01423.xGoogle Scholar: Lookup
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- Clinical Trial
- Journal Article
- Randomized Controlled Trial
- Research Support
- Non-U.S. Gov't
Summary
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This research article focuses on evaluating a procedure that uses autologous (obtained from the same individual) tendon grafts to improve the healing of deep digital flexor tendon gaps in horses. The performance of the grafts, in comparison with non-grafted tendon repair methods, was analyzed mechanically and histologically up to 24 weeks post-surgery.
Methodology
- The technique, referred to as tenorrhaphy, involved a comparison between a sutured tendon repair method that incorporated an autologous tendon graft and a sutured tenorrhaphy alone at intervals of 6, 12 and 24 weeks after repair.
- The tenorrhaphy operation was conducted on the forelimb tendon of the deep digital flexor muscle and the graft was retrieved from the hindlimb tendon of the lateral digital extensor muscle. On one of the forelimb sites, the graft was included, while the other was left without graft.
- Gap formation (2.5 +/- .3 cm) was observed at all tenorrhaphy sites at 3 days using an ultrasound examination.
- The tendon repair sites were sutured using 2 polydioxanone in a pattern described as a modified double locking-loop.
Results
- The research observed an increase in breaking stress in the grafted repairs from 6 weeks to 12 weeks, with the grafted tendon showing a higher breaking stress than the nongrafted tendon.
- However, by the 24-week mark, there were no distinctive differences in breaking stress between the grafted and non-grafted tendons.
- From the histological perspective, the tissue in the grafted tendon appeared more mature by the 12th week compared to the non-grafted tendon. It demonstrated less cellularity, better fibroblast orientation, and a more homogeneous collagen matrix.
- Polydioxanone suture, used for the stitch, was still evident at 24 weeks and caused minimal cellular reactions.
Conclusion
- The study concluded that the use of an autologous tendon graft enhances the mechanical properties and histological quality of the repairing tissue in horse flexor tenorrhaphies at 12 weeks post-surgery. However, this improvement was not carried over to 24 weeks post-operation.
Cite This Article
APA
Valdés-Vázquez MA, McClure JR, Oliver JL, Ramirez S, Seahorn TL, Haynes PF.
(1996).
Evaluation of an autologous tendon graft repair method for gap healing of the deep digital flexor tendon in horses.
Vet Surg, 25(4), 342-350.
https://doi.org/10.1111/j.1532-950x.1996.tb01423.x Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, USA.
MeSH Terms
- Animals
- Fibroblasts / cytology
- Forelimb
- Horses / injuries
- Horses / physiology
- Horses / surgery
- Surgery, Veterinary / methods
- Suture Techniques / veterinary
- Tendon Injuries / surgery
- Tendon Injuries / veterinary
- Tendons / cytology
- Tendons / surgery
- Tendons / transplantation
- Transplantation, Autologous
- Wound Healing / physiology
Citations
This article has been cited 3 times.- Khajeh A, Baniadam A, Oryan A, Ghadiri A, Naddaf H. Effectiveness of nuchal ligament autograft in the healing of an experimental superficial digital flexor tendon defect in equid.. Vet Res Forum 2021 Winter;12(1):53-61.
- El-Shafaey el-SA, Karrouf GI, Zaghloul AE. Clinical and biomechanical evaluation of three bioscaffold augmentation devices used for superficial digital flexor tenorrhaphy in donkeys (Equus asinus): An experimental study.. J Adv Res 2013 Jan;4(1):103-13.
- Zhao C, Chieh HF, Bakri K, Ikeda J, Sun YL, Moran SL, An KN, Amadio PC. The effects of bone marrow stromal cell transplants on tendon healing in vitro.. Med Eng Phys 2009 Dec;31(10):1271-5.
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