ISSN:
0021-9304
Keywords:
Chemistry
;
Polymer and Materials Science
Source:
Wiley InterScience Backfile Collection 1832-2000
Topics:
Medicine
,
Technology
Notes:
Clinical studies will permit only small sections of tendon sheaths to be removed for biopsy at restricted levels as the sheaths were to be used for tendon grafting. In active gliding programs, biopsy has been limited to small sheath sections in immediate relation to the distal or proximal anastomosis where gliding motion may be induced or minimal. In the passive gliding programs, biopsy has been limited to the most proximal segments where considerable folding of the sheath occurs or cul-de-sac buckling of the implant may produce irritation.As these were the only practical clinical sources of sheath sections for biopsy and study, the authors felt that a comparison study of sheath development in animals would broaden our understanding in humans. With this objective in mind, three canine laboratory studies were carried out where, for pure purposes of investigation, entire sheath sections were removed at designated time intervals for study.The flexible implants were well accepted, affording the opportunity to observe development of early sheaths in a controlled connective tissue environment, free from the stress of joint motion.The semi-rigid implants showed equal acceptance in side-by-side tissue level of the same dog as the flexible implant. This influenced changes in artificial tendon development from extrusion to the more exacting mold fabrication. It seemed evident that the degree of increase in stiffness of the new artificial tendons to gain a superior surface for gliding and increased strength would not change tissue acceptance providing flexibility was maintained.The cellular response in this study did not seem to represent a foreign body phenomena but an orderly acceptance of the soft tissue environment to the smooth surface of the inert implant.It is concluded that this study confirmed in animals the clinical findings of Mayer, Bunnell, Milgram, and Carroll.The consistent orderly development of the new sheaths formed in response to the static implants is impressive. The authors believe the appearance of these histologic sections are likely correlations with the development of new sheaths around the Hunter Tendon Prosthesis during the three-four week postoperative period when the hand is resting in a functional dressing.
Additional Material:
5 Ill.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1002/jbm.820080316
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