Reducing friction by chemically modifying the surface of extrasynovial tendon grafts

In this study we evaluated methods to reduce the friction of an extrasynovial tendon under a pulley in vitro. The surface of canine peroneus longus (PL) tendons was modified with gelatin and/or hyaluronic acid (HA) under different conditions. The gliding resistance between treated or control tendons and the canine digital flexor pulley was measured during 500 cycles of simulated flexion/extension. After 500 cycles, the gliding resistance of normal PL tendon increased 10-fold (p<0.05), while the gliding resistance of tendons coated with carbodiimide derivatized gelatin (cd-gelatin) or carbodiimide derivatized gelatin/HA (cd-gelatin-HA) did not increase significantly. The PL tendon treated with cd-gelatin-HA had a similar friction response during the repetitive motion as the intrasynovial flexor digitorum profundus (FDP) tendon. Scanning electron microscopy after 500 cycles of motion showed that the tendon surface in the group treated with cd-gelatin-HA appeared smoother than tendons in the other groups.