REPAIR AND REHABILITATION OF FLEXOR TENDON INJURY

描述(来自申请人的逐字)：肌腱损伤是一种常见的 往往是破坏性的问题，主要影响到年轻的成年人。 尽管有相当数量的正在进行的研究，临床上的改进 在过去的几十年里，结果相对有限。更好的 对术后早期康复的机械事件的理解 肌腱损伤与康复过程中力学因素的控制 到目前为止，方案是最有效的干预措施。这是竞争激烈的 更新建议评估滑行阻力、断裂强度和 新型肌腱修复的组织学和新康复的效果 方法肌腱修复后。在最初的资助期，使用部分 在肌腱断裂模型中，我们确定了一些决定摩擦的因素 在肌腱修复后，显示摩擦增加与 体内试验结果较差。我们发现，目前的高强度修复是 受到高摩擦成本的影响，我们证明了这种疗法 增强肌腱滑动在体内产生了更好的最终结果，但代价是 早期修复缺口。我们现在建议通过研究更新的技术来扩展这项工作 可以结合高强度和低摩擦的修复，以及康复 针对肌腱滑动力学量身定做的治疗方法如下 随着时间的推移肌腱愈合情况会有所不同。我们的假设是通过优化肌腱 在康复期间滑行，无论是极限肌腱运动还是 极限肌腱强度可以提高。为了研究这一假设， 提出了以下三个具体目标：1)识别高强度、低强度 体外完全性撕裂犬模型中的摩擦修复，2) 描述对滑行和做功的阻力的短期自然历史 在此模型体内的屈曲，以及3)在体内测试滑行 的特征、抗缺口形成的强度和组织学 该模型的高强度、低滑动阻力修复，与 根据具体的康复结果设计优化的康复模型 目的2常规治疗。我们早期的结果，证明了 协同运动的好处，已经被纳入临床 在我们的机构里练习。我们相信，这项研究的结果将 也迅速转移到临床领域。

DESCRIPTION (Verbatim from the Applicant): Tendon injuries are a frequent and often devastating problem which primarily affects the young adult population. Despite a considerable volume of ongoing research, improvements in clinical outcome have been relatively limited over the past few decades. A better understanding of the mechanical events surrounding early recovery following tendon injury and control of mechanical factors during the rehabilitation program have thus far been the most effective interventions. This competitive renewal proposes to assess the gliding resistance, breaking strength, and histology of newer types of tendon repairs and the effect of new rehabilitation methods after tendon repair. In the initial funding period, using a partial tendon laceration model, we identified a number of determinants of friction following tendon repair and showed that increased friction is associated with poorer results in vivo. We found that the current high strength repairs are compromised by high friction costs, and we demonstrated that therapy which enhanced tendon gliding produced better final results in vivo, but at a cost of early repair gapping. We now propose to expand upon this work by studying newer repairs that may combine high strength and low friction, and rehabilitation methods which tailor the therapy to the mechanics of tendon gliding as these vary over time with tendon healing. Our hypothesis is that by optimizing tendon gliding during the rehabilitation period, both ultimate tendon motion and ultimate tendon strength can be improved. In order to study this hypothesis the following three Specific Aims are proposed: 1) to identify high strength, low friction repairs in a complete laceration canine model in vitro, 2) to characterize the short-term natural history of resistance to gliding and work of flexion in this model in vivo, and 3) to test in vivo the gliding characteristics, strength resistance to gap formation, and histology of a high-strength, low gliding resistance repair in this model, comparing an optimized rehabilitation model designed on the basis of the results in Specific Aim 2 with conventional therapy. Our earlier results, demonstrating the benefits of synergistic motion, have already been incorporated into clinical practice at our institution. We believe that the results of this study will also have rapid transference to the clinical arena.