Gliding Resistance of Extrasynovial and Intrasynovial Tendons through the A2 Pulley*

Uchiyama, Shigeharu; Amadio, Peter C.; Coert, J. Henk; Berglund, L. J.; An, Kai Nan

doi:10.2106/00004623-199702000-00009

Cited by 104 publications

(94 citation statements)

References 15 publications

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“…Friction force (F R ) can be obtained The coefficient of friction (m) for eccentric flexion can be determined as follows, assuming that the graph is linear (linear increase of gliding resistance between tendon and pulley, Uchiyama et al, 1997) and passes through zero, a represents the arc of contact between the flexor tendon and the pulleys…”

Section: Quantification Of Frictional Force and Coefficient Of Frictionmentioning

confidence: 99%

“…The most important reason for this was to assess friction after trauma (Lane et al, 1976) and friction of different suture techniques and tendon grafts (Peterson et al, 1986;Woo et al, 1981;Uchiyama et al, 1997;Coert et al, 1995;Williams and Amis, 1995;Nishida et al, 1998). Therefore, various indirect measurement techniques and models (Fowler and Nicol, 2000) and measurements in animals have been described (Lane et al, 1976).…”

Section: Friction In the Tendon-pulley Interfacementioning

confidence: 99%

“…Furthermore, friction would explain the mechanism of injury to the A2 pulleys in rock climbers more exactly (Bollen, 1990;Gabl et al, 1998), (A2 pulley: annular like ligament, part of the flexor tendon sheath, at the volar side of the proximal phalanx, prevents flexor tendons from bowstringing). Until now there is only evidence that friction between flexor tendons and pulleys may be apparent in a few in vitro measurements (Uchiyama et al, , 1997.…”

Section: Introductionmentioning

confidence: 99%

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Friction between human finger flexor tendons and pulleys at high loads

Schweizer

Frank

Ochsner

et al. 2003

Journal of Biomechanics

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A method was developed to indirectly measure friction between the flexor tendons and pulleys of the middle and ring finger in vivo. An isokinetic movement device to determine maximum force of wrist flexion, interphalangeal joint flexion (rolling in and out) and isolated proximal interphalangeal (PIP) joint flexion was built. Eccentric and concentric maximum force of these three different movements where gliding of the flexor tendon sheath was involved differently (least in wrist flexion) was measured and compared. Fifty-one hands in 26 male subjects were evaluated. The greatest difference between eccentric and concentric maximum force (29.9%) was found in flexion of the PIP joint. Differences in the rolling in and out movement (26.8%) and in wrist flexion (14.5%) were significantly smaller. The force of friction between flexor tendons and pulleys can be determined by the greater difference between eccentric and concentric maximum force provided by the same muscles in overcoming an external force during flexion of the interphalangeal joints and suggests the presence of a non-muscular force, such as friction. It constitutes of 9% of the eccentric flexion force in the PIP joint and therefore questions the low friction hypothesis at high loads. r

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Section: Quantification Of Frictional Force and Coefficient Of Frictionmentioning

confidence: 99%

Section: Friction In the Tendon-pulley Interfacementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Friction between human finger flexor tendons and pulleys at high loads

Schweizer

Frank

Ochsner

et al. 2003

Journal of Biomechanics

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“…tendons [24]; laboratory studies suggest that the higher the friction, the more the adhesion formation [25].…”

Section: Introductionmentioning

confidence: 99%

Surface Treatment of Flexor Tendon Autograft and Allograft Decreases Adhesion Without an Effect of Graft Cellularity: A Pilot Study

Karabekmez

Zhao

2012

Clinical Orthopaedics &Amp; Related Research

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Background Flexor tendon grafting is often required to reconstruct a failed tendon repair. Previous reports have demonstrated flexor grafts coated with lubricants such as carbodiimide derivatized hyaluronic acid (cd-HA) decrease adhesion formation and improve digit function. However, whether this surface modification would affect graft adhesion and cellularity is unknown. Questions/Purposes Adhesion score and the cellularity of the graft of untreated and cd-HA surface-modified autograft and allograft tendons were studied using a canine forepaw in vivo model. Methods The peroneus longus tendons (n = 6) and flexor digitorum profundus tendons (n = 8) were used as extrasynovial autograft and intrasynovial allograft, respectively. The flexor digitorum profundus (FDP) tendons in the second and fifth digits in each dog were reconstructed with one digit treated with cd-HA and the other treated with saline as a control. Six weeks after surgery, the grafted tendons were harvested for histological evaluation with hematoxylin and eosin staining. During dissection, the adhesions were observed and scored. Results The adhesion score was greatest in the extrasynovial autograft without surface modification and the least in the intrasynovial allograft with surface modification. Autograft tendons had a higher cell density than the allografts regardless of surface treatment. Cd-HA graft treatment did not affect cellularity when compared with controls. Conclusions Our observations suggest surface modification of a tendon graft with cd-HA decreased the adhesion formation without altering the cellularity in either autologous or allograft tendon. We therefore presume this surface modification would not adversely affect graft healing.

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“…[3][4][5] However, the availability of intrasynovial tendon for a donor graft is limited. Because extrasynovial tendons produce higher friction against a pulley compared to intrasynovial tendons, 6,7 it is possible that the rougher surface of extrasynovial tendon is a factor leading to the formation of adhesions.…”

Section: Introductionmentioning

confidence: 99%

Optimization of surface modifications of extrasynovial tendon to improve its gliding ability in a canine model in vitro

et al. 2006

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Previous studies have shown that the carboxyl groups in hyaluronic acid (HA) could be activated by 1-ethy 1-3-[3-dimethylaminopropyl] carbodiimide hydrochloride (EDC)/N-hydroxysuccinimide (NHS) to form intermediate O-acylisoureas, which can chemically bind to exposed amino groups on the tendon surface, leading to improved gliding ability. However, the optimal ratio and concentrations of the components in this chemical mixture were not investigated. The purpose of this study was to optimize the constituents of this tissue engineering approach to tendon surface modification, to reduce friction and improve durability. Peroneus longus (PL) tendons (n ¼ 40) were harvested from adult mongrel dogs along with the A2 pulley obtained from the ipsilateral hind paw. After the gliding resistance of the normal PL tendon was measured, the tendons were treated under varying concentrations of HA (0.5, 1, and 2%) and EDC/NHS (0.05, 0.25, and 1%) mixed with a 10% gelatin. Tendon friction was measured for 1000 cycles of simulated flexion/extension motion. Following testing, the residual HA on the tendon surface was evaluated by immunohistochemisty. The gliding resistance of the untreated PL tendons had a mean value of 0.087 AE 0.021 N. After surface treatment, there was no significant difference in friction due to HA concentration alone, but the concentration of EDC/NHS and the interaction between HA concentration and EDC/NHS concentration had a significant effect on friction. Regardless of HA concentration, the friction after 1000 cycles was significantly decreased in preparations which included a 1% concentration of EDC/ NHS. The tendons with lower gliding resistance presented a smoother surface on light microscopy and maintained more residual HA on the tendon surface. By varying the relative concentrations of HA, EDC, and NHS it is possible to optimize the effect of surface treatment on friction and durability in a canine extrasynovial tendon in vitro. ß

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Gliding Resistance of Extrasynovial and Intrasynovial Tendons through the A2 Pulley*

Cited by 104 publications

References 15 publications

Friction between human finger flexor tendons and pulleys at high loads

Friction between human finger flexor tendons and pulleys at high loads

Surface Treatment of Flexor Tendon Autograft and Allograft Decreases Adhesion Without an Effect of Graft Cellularity: A Pilot Study

Optimization of surface modifications of extrasynovial tendon to improve its gliding ability in a canine model in vitro

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