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A Journal on Orthopedics and Traumatology

Official Journal of the Piedmontese-Ligurian-Lombard Society of Orthopedics and Traumatology
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Minerva Ortopedica e Traumatologica 2013 August;64(4):445-52

language: English

Tendon healing in vivo and in vitro: chitosan improves range of motion after flexor tendon repair

Xia C. S., Rong C., Wang C. Y., Tian S. C., Wang Y. Z.

Department of Orthopedics Medical College Affiliated Hospital Qingdao University, Qingdao, China


Aim: Adhesion formation between the flexor tendon and its surrounding fibro-osseous sheath results in a decreased postoperative range of motion (ROM) in the hand. Transforming growth factor-beta (TGF-β) is a key cytokine in the pathogenesis of tissue fibrosis. In this study, the effects of chitosan were investigated in vitro and in vivo.
Methods: In the in vitro investigation, primary cell cultures from rabbit flexor tendon sheath, epitenon, and endotenon were established and each was supplemented with TGF-βalong with increasing doses of chitaosan. Collagen I production was measured with enzyme-linked immunosorbent assay. In the in vivo study, rabbit zone-II flexor tendons were transected and then immediately repaired. Chitosan or phosphate-buffered saline solution (control) was added to the repair sites, and the forepaws were tested for the ROM and repair strength at 8 weeks postoperatively.
Results: Chitosan reduced TGF-βupregulated collagen production. Intraoperative application of chitosan significantly improved the ROM of the operatively treated digits.
Conclusion: The effect on breaking strength of the tendon repair was inconclusive.

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