Effect of hyperdry amniotic membrane in preventing tendon adhesion in a rabbit model

J Orthop Sci. 2022 May;27(3):707-712. doi: 10.1016/j.jos.2021.03.005. Epub 2021 Apr 28.

Abstract

Background: No anti-adhesive materials are currently in clinical use for orthopaedic surgery. We developed a hyperdry amniotic membrane (HD-AM) for easy storage and transplantation as amniotic membrane. The purpose of this study was to examine the application of HD-AM to reduce peritendinous adhesions without impairing tendon healing.

Methods: We randomly divided 3 digits (2nd, 3rd, and 4th digits) from each rabbit into three groups: a tendon repair group; a tendon repair with HD-AM group (HD-AM group); and a control group (cast only). The effects of HD-AM on peritendinous adhesions and tendon healing were examined using microscopic, histological, and mechanical analyses in a rabbit flexor digitorum profundus tendon model.

Results: Adhesions on macroscopic evaluation of the tendon repair site were significantly smaller in the HD-AM group than in the tendon repair group. Little adhesion formation or foreign body reactions were seen by on histologic evaluation in the HD-AM group. Range of motion following tendon repair was significantly better in the HD-AM group than in the tendon repair group. Maximal tensile strength required to pull the tendon from the site of adhesion was significantly smaller in the HD-AM group than in the tendon repair group. As for tendon repair site, no significant difference was seen between the tendon repair and HD-AM groups.

Conclusions: HD-AM prevented peritendinous adhesion macroscopically, pathologically, and mechanically without impairing the sutured tendon. HD-AM has already been clinically applied in neurosurgery, ophthalmology, and otolaryngology, and clinical application as an anti-adhesive materials may be achieved in the future.

MeSH terms

  • Amnion* / pathology
  • Animals
  • Rabbits
  • Tendon Injuries* / prevention & control
  • Tendon Injuries* / surgery
  • Tendons / pathology
  • Tendons / surgery
  • Tissue Adhesions / etiology
  • Tissue Adhesions / pathology
  • Tissue Adhesions / prevention & control
  • Wound Healing