Hand: Tendon

Augmentation of Zone II Flexor Tendon Repair Using Growth Differentiation Factor 5 in a Rabbit Model

Henn RF III, Kuo CE, Kessler MW, et al (Hosp for Special Surgery, NY; North Shore and Long Island Jewish Hosps, Manhasset, NY) J Hand Surg 35A:1825-1832, 2010^§

Abstract

Purpose

Modulation of zone II flexor tendon repair healing using growth factors may reduce the incidence of complications, such as rupture and fibrosis. We hypothesized that sutures coated with growth differentiation factor 5 (GDF5) will stimulate the healing of zone II flexor tendon repairs.

Methods

We created and immediately repaired zone II flexor tendon lacerations in the second and fourth toe of the right forepaw of 44 New Zealand White rabbits. One tendon was repaired with suture coated with GDF5, whereas the other tendon was repaired with suture without GDF5 (control). We randomized the allocation of GDF5 and control suture to either toe. A proximal tenotomy of the flexor digitorum profundus at the level of the wrist was performed to relieve tension on the more distal repairs. Rabbits were euthanized at 21 or 42 days after repair. Four rabbits (8 tendons) underwent histological analysis at each time point; the remaining repairs were tested biomechanically in a blinded fashion.

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