Olli V Leppänen1, Teemu Karjalainen2, Harry Göransson3, Annika Hakamäki4, Jouni Havulinna5, Jyrki Parkkinen6, Jarkko Jokihaara3. 1. Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland; School of Medicine, University of Tampere, Tampere, Finland. Electronic address: olli.v.leppanen@uta.fi. 2. Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland. 3. Department of Hand- and Microsurgery, University of Tampere, Tampere, Finland. 4. Regea Cell and Tissue Center, BioMediTech, University of Tampere, Tampere, Finland. 5. Pohjola Hospital, Tampere, Finland. 6. Department of Pathology, Fimlab Laboratories, Tampere, Finland.
Abstract
PURPOSE: Clinically proven methods to prevent adhesion formation after flexor tendon repair have not yet been established. The aim of this pilot study was to assess the feasibility of amniotic membrane allograft as a mechanical barrier to decrease adhesion formation. METHODS: Ten patients having flexor tendon injuries were planned to be recruited to the pilot study. The operative treatment consisted of tendon repair and fixation of amniotic membrane allograft around the repaired tendon. The primary outcome variable was the range of motion of the operated finger 6 months after the operation. Patients were monitored for infections and repair failures. RESULTS: The study was terminated owing to unfavorable results after treatment of 5 patients. One patient had extensive stiffness and was subjected to tenolysis and joint release. Histopathological analysis of the tendon sheath revealed focal fibrosis. Another patient had a repair failure. The other 3 patients had fair to good results. CONCLUSIONS: It seems improbable that the use of amniotic membrane allograft would yield clinically relevant improvement compared with the existing techniques. However, it remains unclear whether the unfavorable results are associated with technical factors, amniotic membrane allograft itself, or an irregular distribution of complications. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic V.
PURPOSE: Clinically proven methods to prevent adhesion formation after flexor tendon repair have not yet been established. The aim of this pilot study was to assess the feasibility of amniotic membrane allograft as a mechanical barrier to decrease adhesion formation. METHODS: Ten patients having flexor tendon injuries were planned to be recruited to the pilot study. The operative treatment consisted of tendon repair and fixation of amniotic membrane allograft around the repaired tendon. The primary outcome variable was the range of motion of the operated finger 6 months after the operation. Patients were monitored for infections and repair failures. RESULTS: The study was terminated owing to unfavorable results after treatment of 5 patients. One patient had extensive stiffness and was subjected to tenolysis and joint release. Histopathological analysis of the tendon sheath revealed focal fibrosis. Another patient had a repair failure. The other 3 patients had fair to good results. CONCLUSIONS: It seems improbable that the use of amniotic membrane allograft would yield clinically relevant improvement compared with the existing techniques. However, it remains unclear whether the unfavorable results are associated with technical factors, amniotic membrane allograft itself, or an irregular distribution of complications. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic V.
Authors: Wei Lee Lim; Ling Ling Liau; Min Hwei Ng; Shiplu Roy Chowdhury; Jia Xian Law Journal: Tissue Eng Regen Med Date: 2019-06-26 Impact factor: 4.169