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Title: Flexor tendon healing : evaluation of peritendinous adhesion formation and tendon strength after tenotomy and primary repair in an ovine model
Author: Davidson, K. Elaine
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
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This experimental study was designed to assess the effects of different surgical repair techniques on the process of flexor tendon healing. In particular, it aimed to evaluate the effects of incorporating a novel biocompatible, biodegradable ‘wrap’ into the process of tendon repair. This inorganic polymer wrap, Controlled Release Glass (Giltech Limited, Ayr, Scotland, UK) was composed of a combination of sodium and calcium cations with phosphate and oxide anions and degraded into simple ionic substances normally found in tissue fluid. The hypothesis to be tested stated that ‘the addition of this potentially anti-adhesiogenic substance to the process of flexor tendon repair would result in no difference in musculoskeletal function or tendon characteristics after recovery’. Tenotomy and primary repair of the ovine Flexor Digitorum Superficialis (Pars Superficialis slip) was performed using a variety of different repair methods, involving combinations of the following elements of repair; modified Kessler core suture, circumferential epitenon suture, CRG wrap, triamcinolone paste. Eleven experimental groups of twelve cases were set-up and evaluated in two time cohorts; six weeks and six months after surgery. A control group of twelve non-operated cases was also assessed. Results of statistical analyses showed that for the experimental groups which incorporated CRG wrap, the proliferative vascular response to injury was diminished toward ‘normal’ range at six weeks and within ‘normal’ range by six months after repair. This occurred in the absence of any significant difference in superficial blood flow beyond the site of repair or in the strength of these groups of repaired tendons. Also, at six weeks after operation these experimental groups showed a reduction in fibrous tissue at the sites of tendon repair without any other significant differences in morphological features of the healing tendon. The implications for clinical practice of these findings are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available