Resurfacing with chemically modified hyaluronic acid and lubricin for flexor tendon reconstruction

Chunfeng Zhao, Takahiro Hashimoto, Ramona L. Kirk, Andrew R. Thoreson, Gregory D. Jay, Steven L. Moran, Kai Nan An, Peter C. Amadio

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


We assessed surface coating with carbodiimide derivatized hyaluronic acid combined with lubricin (cd-HA-Lubricin) as a way to improve extrasynovial tendon surface quality and, consequently, the functional results in flexor tendon reconstruction, using a canine in vivo model. The second and fifth flexor digitorum profundus tendons from 14 dogs were reconstructed with autologs peroneus longus (PL) tendons 6 weeks after a failed primary repair. One digit was treated with cd-HA-Lubricin, and the other was treated with saline as the control. Six weeks following grafting, the digits and graft tendons were functionally and histologically evaluated. Adhesion score, normalized work of flexion, graft friction in zone II, and adhesion breaking strength at the proximal repair site in zone III were all lower in the cd-HA-Lubricin treated group compared to the control group. The strength at the distal tendon/bone interface was decreased in the cd-HA-Lubricin treated grafts compared to the control grafts. Histology showed inferior healing in the cd-HA-Lubricin group at both proximal and distal repair sites. However, cd-HA-Lubricin treatment did not result in any gap or rupture at either the proximal or distal repair sites. These results demonstrate that cd-HA-Lubricin can eliminate graft adhesions and improve digit function, but that treatment may have an adverse effect on tendon healing.

Original languageEnglish
Pages (from-to)969-975
Number of pages7
JournalJournal of Orthopaedic Research
Issue number6
Publication statusPublished - 2013 Jun

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine


Dive into the research topics of 'Resurfacing with chemically modified hyaluronic acid and lubricin for flexor tendon reconstruction'. Together they form a unique fingerprint.

Cite this