Vascularized tendon grafting in the rabbit.

Using a conventional free tendon graft, adhesion formation, with a consequent loss of gliding ability, occurs if the surrounding soft tissue is heavily scarred. An animal experiment was conducted, to evaluate whether a free vascularized tendon graft provides a better gliding surface, with minimal adhesion formation. In order to scar the gliding floor, the lateral aspect of the legs of 40 adult rabbits, including the peroneus tendon and its surrounding soft tissue, was exposed to liquid nitrogen. Two weeks after this induction of frostbite, all the rabbits were randomly divided into two groups: a vascularized tendon graft group and a free tendon graft group. Histologic examination revealed less adhesion of the tendon to the surrounding soft tissues in the vascularized tendon graft group. The tendon pull-out test demonstrated that less pull-out weight was required for vascularized tendons. A microangiographic study disclosed better circulation through the tendon graft and the surrounding soft tissues in the vascularized tendons. These results suggest that, even if scarring is heavy, the free vascularized tendon graft is less likely to adhere to the surrounding soft tissue than the conventional free tendon graft and, consequently, it provides a better gliding surface.