Use of bioprosthetic tendon in digital pulley reconstruction--an experimental study

The potential clinical application of Glutaraldehyde treated bioprosthetic material in the hand as implants to substitute for damaged pulley, tendon or ligament has not been fully explored. This study tries to evaluate the efficacy and safety of the proposed bioprosthetic pulley in an experimental model. One of the digital flexor pulleys of the rabbit's foot was excised and replaced by a bioprosthetic pulley using a standardized technique. Autogenous tendon graft was used as the control on the opposite foot. Altogether twenty rabbits (40 feet) were included in the study and they were sacrificed at different time intervals up to one year. The retrievals were analysed for flexor tendon adhesions and rupture of the pulley macroscopically. Histological and Electron Microscopy study of the 'pulley' and 'pulley-bone' junction were also carried out. Results show consistently the progressive creeping substitution of the bioprosthetic material by the rabbit's own tissue without significant inflammatory reactions. Neither adhesions nor breakage of the pulley were detected, the results comparing favourably with the control group using autografts except for the longer time taken for the substitution process.