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

Publication ,  Journal Article
Loiselle, AE; Kelly, M; Hammert, WC
Published in: J Hand Surg Am
January 2016

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.

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Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

January 2016

Volume

41

Issue

1

Start / End Page

144 / 149

Location

United States

Related Subject Headings

  • Wound Healing
  • Transforming Growth Factor beta
  • Tissue Engineering
  • Tendon Injuries
  • Orthopedics
  • Humans
  • Animals
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1103 Clinical Sciences
 

Citation

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Loiselle, A. E., Kelly, M., & Hammert, W. C. (2016). Biological Augmentation of Flexor Tendon Repair: A Challenging Cellular Landscape. J Hand Surg Am, 41(1), 144–149. https://doi.org/10.1016/j.jhsa.2015.07.002
Loiselle, Alayna E., Meghan Kelly, and Warren C. Hammert. “Biological Augmentation of Flexor Tendon Repair: A Challenging Cellular Landscape.J Hand Surg Am 41, no. 1 (January 2016): 144–49. https://doi.org/10.1016/j.jhsa.2015.07.002.
Loiselle AE, Kelly M, Hammert WC. Biological Augmentation of Flexor Tendon Repair: A Challenging Cellular Landscape. J Hand Surg Am. 2016 Jan;41(1):144–9.
Loiselle, Alayna E., et al. “Biological Augmentation of Flexor Tendon Repair: A Challenging Cellular Landscape.J Hand Surg Am, vol. 41, no. 1, Jan. 2016, pp. 144–49. Pubmed, doi:10.1016/j.jhsa.2015.07.002.
Loiselle AE, Kelly M, Hammert WC. Biological Augmentation of Flexor Tendon Repair: A Challenging Cellular Landscape. J Hand Surg Am. 2016 Jan;41(1):144–149.
Journal cover image

Published In

J Hand Surg Am

DOI

EISSN

1531-6564

Publication Date

January 2016

Volume

41

Issue

1

Start / End Page

144 / 149

Location

United States

Related Subject Headings

  • Wound Healing
  • Transforming Growth Factor beta
  • Tissue Engineering
  • Tendon Injuries
  • Orthopedics
  • Humans
  • Animals
  • 4201 Allied health and rehabilitation science
  • 3202 Clinical sciences
  • 1103 Clinical Sciences