Flexor Tendon Injury and Repair: The Influence of Synovial Environment on the Early Healing Response in a Canine Model

摘要: BACKGROUND Environmental conditions strongly influence the healing capacity of connective tissues. Well-vascularized extrasynovial tendons typically undergo a robust wound-healing process following transection and repair. In contrast, avascular intrasynovial do not mount an effective repair response. The current study tests hypothesis that flexor tendons, as function their synovial environment, exhibit unique inflammatory, angiogenic, metabolic responses to injury METHODS Flexor present distinct opportunity test hypothesis, they have proximal regions are distal intrasynovial. internally controlled design, second fifth forepaw were transected repaired in either or anatomical region. Histological, gene expression, proteomics analyses performed at 3 7 days define early biological events drive environment-dependent responses. RESULTS Uninjured avascular, contained high levels proteoglycans, expressed inflammatory factors, complement proteins, glycolytic enzymes. well vascularized, low enriched inflammation inhibitors oxidative phosphorylation response was markedly different between 2 tendon regions. Extrasynovial displayed rapid neovascularization response, increased expression acute shift metabolism glycolysis, whereas showed minimal vascularity muted CONCLUSIONS regional molecular profiles intact revealed extensive differences innate immune metabolism, vascularization, extracellular matrix environment. These reveal mechanisms through which heal more effectively than tendons. CLINICAL RELEVANCE To improve outcomes after operative repair, future treatment strategies should promote features healing, such enhanced vascularization modulation system and/or glucose metabolism.