The role of the synovial fluid and tendon sheath for flexor tendon nutrition. An experimental tracer study on diffusional pathways in dogs.

Radioactive tracers were used to analyse nutritional mechanisms of flexor tendons of dogs during various experimental conditions. The transport and distribution of methyl glucose in the tendon was analysed 15 min after intravenous injection during the following experimental conditions: (1) normal state--rest; (2) passive mobilization of the tendon; (3) active mobilization of the tendon; (4) exclusion of exposure to synovial fluid-preservation of vascular supply; (5) exclusion of vascular supply--preservation of exposure to synovial fluid. The results indicate that active mobilization gives a significant increase in tracer concentration in the volar part of the tendon, while passive mobilization has no such effect. Diffusional pathways from the synovial fluid plays a major role for transport of tracer into the tendon, while the intrinsic vascular system apparently is of no or minor importance in this respect. The main mechanism for solute transport within the tendon is passive diffusion. Transport of sulphate in the volar part follows a similar pattern as in other avascular tissues and the incorporation of sulphate by the cells is low and comparable to that in articular cartilage. The results support our previous hypothesis that the flexor tendon system physiologically corresponds to a joint, and that the synovial fluid plays an important role for flexor tendon nutrition.