Biological Augmentation of Flexor Tendon Repair: A Challenging Cellular Landscape.

Journal Article (Journal Article;Review)

Advances in surgical technique and rehabilitation have transformed zone II flexor tendon injuries from an inoperable no-man's land to a standard surgical procedure. Despite these advances, many patients develop substantial range of motion-limiting adhesions after primary flexor tendon repair. These suboptimal outcomes may benefit from biologic augmentation or intervention during the flexor tendon healing process. However, there is no consensus biological approach to promote satisfactory flexor tendon healing; we propose that insufficient understanding of the complex cellular milieu in the healing tendon has hindered the development of successful therapies. This article reviews recent advances in our understanding of the cellular components of flexor tendon healing and adhesion formation, including resident tendon cells, synovial sheath, macrophages, and bone marrow-derived cells. In addition, it examines molecular approaches that have been used in translational animal models to improve flexor tendon healing and gliding function, with a specific focus on progress made using murine models of healing. This information highlights the importance of understanding and potentially exploiting the heterogeneity of the cellular environment during flexor tendon healing, to define rational therapeutic approaches to improve healing outcomes.

Full Text

Duke Authors

Cited Authors

  • Loiselle, AE; Kelly, M; Hammert, WC

Published Date

  • January 2016

Published In

Volume / Issue

  • 41 / 1

Start / End Page

  • 144 - 149

PubMed ID

  • 26652792

Electronic International Standard Serial Number (EISSN)

  • 1531-6564

Digital Object Identifier (DOI)

  • 10.1016/j.jhsa.2015.07.002

Language

  • eng

Conference Location

  • United States