Experimental Study Of Bone Cement Induction Membrane On Preventing Rabbit Forelimb Flexor Tendon Adhesion

Objective: A rabbit model of flexor toe tendon injury in the forelimb was established,the tendon was sutured with a modified kessler suture method,and the suture area of the tendon was wrapped with bone cement to explore the experimental effect of bone cement-induced biofilm in preventing tendon adhesion after repair of rabbit flexor toe tendon injury.Methods: 36 healthy experimental rabbits,both male and female,were randomly divided into a suture group(group A)and a biofilm group(group B),with 18 rabbits in each group.Two groups of flexor tendon injury models were established.Group A only had simple tendon suture,and group B used bone cement to wrap the suture end of the tendon.An incision was made along the original surgical opening 4 weeks after the operation.Only the tendons were exposed in group A,and the bone cement was taken out while maintaining the integrity of the biofilm in group B.The incision was closed,and no tendon lysis was performed in either group.Both groups of experimental rabbits used 1-0 non-absorbable sutures to fix the toe metacarpophalangeal joints and the proximal interphalangeal joints after surgery,and they were removed one week later.At 6,8,and 10 weeks after operation,6 experimental rabbits in each group were euthanized(given a sufficient amount of anesthetic)as the experimental end point.The experimental rabbits in each group were evaluated macroscopically(by naked eyes)and histological observation(HE staining of tendons)at each time point.And biomechanical testing,data collection,statistical analysis.Another 4 experimental rabbits were taken to establish the same experimental model as group B.Euthanasia was performed 4 weeks after the operation,and the thin tissue induced by bone cement was removed for histomorphological observation.Results:1.A bone cement-induced biofilm-encapsulated rabbit flexor tendon injury model was constructed,and it was preliminarily verified that the cement-induced biofilm has the effect of preventing tendon adhesion.2.Morphological observation of biofilm: The structure of biofilm is roughly divided into three layers,the inner layer is synovial epithelial cells;the middle layer is fibroblasts,myofibroblasts,collagen fibers,etc.;the outermost layer is blood vessels,etc.3.Macroscopic evaluation: At 6,8,and 10 weeks after operation,the sliding distance of the tendon in group B was greater than that in group A(p<0.05),and the difference was statistically significant;while the breaking force of two groups A and B was not statistically significant(p>0.05).4.Biomechanical evaluation: There was no significant difference in breaking force between groups A and B at 6,8,and 10 weeks after surgery(p>0.05),and the difference was not statistically significant.5.Histological evaluation: At 6,8,and 10 weeks after operation,the number of two-component fibroblasts gradually decreased over time.The number of fibroblasts in group B was significantly less than that in group A(p<0.05),and the difference was statistically significant.Conclusion: The biofilm induced by bone cement restricts the exogenous healing of the tendon,thereby preventing the adhesion after the repair of the tendon injury.