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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2013 August;64(4):445-52
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.