We have recently reported that application of carbodiimide-derivatized hyaluronic acid and gelatin (cd-HA gelatin) to a peroneus longus tendon graft increased tendon graft gliding ability and decreased work of flexion compared with untreated grafts in a canine model in vivo. In this study, we investigated the effect of this modification on adhesions, stiffness, strength of the distal attachment, and fibroblast count.
A total of 24 dogs were used for this study. The peroneus longus tendons of each hind leg were grafted into the 2nd and 5th digits of one forepaw in each dog. One peroneus longus tendon was treated with cd-HA gelatin prior to grafting, and the other one was immersed in 0.9% saline solution as a control. Animals were killed 1, 3, or 6 weeks postoperatively.
The adhesion score of cd-HA gelatin–treated tendons was significantly less than that in the saline-treated tendons at all time points. There was no significant difference in the indentation stiffness between HA- and saline-treated grafts at any time point. For the ultimate force at the distal attachment, there was a significant difference among the time points, with a steady increase over time, but no significant difference between treated and control tendons at any time point. There was no significant difference in fibroblast count between treated and control tendons at any time point.
Although gross adhesion formation was less, there was no significant difference in strength at the distal tendon-bone interface, cellularity, or tendon graft stiffness when comparing saline-treated and cd-HA gelatin–treated tendon grafts in vivo.
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Accepted: March 6, 2007
Received: September 25, 2006
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Supported by grants from the Orthopaedic Research and Education Foundation and from NIH/NIAMS (AR49407).
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.