Effect of hyaluronic acid on the excursion resistance of flexor tendon, tendon sheath reconstruction.

初级屈肌腱修复后，肌腱和肌腱鞘之间的粘连是常见的，术后手指功能偶尔不理想。减少摩擦可以促进肌腱的活动，从而减少粘连和限制活动范围的风险。我们考虑了利用透明质酸（HA）作为润滑剂的可能性。为了评估HA的效果，我们评估并比较了HA使用前后，采用改良的Kessler缝合技术与行外延缝合修复的犬指深屈肌腱与位于近端指骨的环形滑轮（相当于人类的A2滑轮）之间的滑动阻力。高可用性解决方案测量组确定如下：完整肌腱作为对照；修复肌腱;肌腱浸泡在0.1、1和10 mg/mI HA中。修复后抗性升高，10 mg/ml HA浸泡后抗性降低。本研究结果显示，透明质酸可降低屈肌腱修复后的偏移阻力。我们认为，在滑膜表面完全发育之前，某种形式的HA给药可能会减少偏移阻力并防止粘连。

Adhesion between the tendon and tendon sheath after primary flexor tendon repair is seen frequently, and postoperative finger function is occasionally unsatisfactory. A reduction of the friction may facilitate tendon mobilization, which in turn may reduce the risk of the adhesion and restriction of range of motion. We considered the possibility of utilizing the hyaluronic acid (HA) as a lubricant. To evaluate the effect of HA, the gliding resistance between the canine flexor digitorum profundus tendon repaired by a modified Kessler suture technique with running epitendinous suture and the annular pulley located on the proximal phalanx (corresponding to the A2 pulley in humans) was evaluated and compared before and after administration of HA. The HA solution measurement groups were identified as follows; intact tendon as a control; repaired tendon; tendon soaked in 0.1, 1, and 10 mg/mI HA. The resistance increased after repairing, then it decreased after soaking in 10 mg/ml HA solution. The results of this study revealed that HA diminishes the excursion resistance after flexor tendon repair. We believe that some style of administration of the HA might reduce the excursion resistance and prevent adhesion until the synovial surface is fully developed.