surface treatment of flexor tendon autografts with carbodiimide-derivatized hyaluronic acid by...

Surface Treatment of Flexor Tendon Autografts with Carbodiimide-Derivatized Hyaluronic Acid

by Chunfeng Zhao, Yu-Long Sun, Peter C. Amadio, Toshikazu Tanaka, Anke M. Ettema, and Kai-Nan An

J Bone Joint Surg AmVolume 88(10):2181-2191

October 1, 2006

©2006 by The Journal of Bone and Joint Surgery, Inc.

Carboxyl groups in the hyaluronic acid (HA) are activated by EDC to form O-acylisoureas, which bind to the amino groups on the tendon surface.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

Illustration of the proximal suture technique.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

Work-of-flexion tester. 1 = actuator, 2 = load transducer, 3 = specimen, 4 = two metal beads in the middle phalanx, 5 = metal pin in the distal phalanx, 6 = metal pin in the proximal phalanx, 7 =

weight, and 8 = frame.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

Image obtained with fluoroscopy during testing.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

The work of flexion normalized according to the proximal and distal interphalangeal joint angle (normalized work of flexion) in the normal, cd-HA-treated, and saline-solution-treated groups at

one, three, and six weeks.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

The gliding resistance in the normal, cd-HA-treated, and saline-solution-treated groups at one, three, and six weeks.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

The staining intensity of the cd-HA and saline-solution-treated tendon grafts at one, three, and six weeks.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

A: cd-HA-treated tendon graft harvested at six weeks, showing a smooth surface without adhesions to the flexor sheath.

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.

A: cd-HA-treated tendon graft harvested at six weeks, showing a smooth surface under scanning electron microscopy (×30).

Chunfeng Zhao et al. J Bone Joint Surg Am 2006;88:2181-2191

©2006 by The Journal of Bone and Joint Surgery, Inc.