Hyaluronic Acid in Flexor Tendon Sheath Fluid After Sheath Reconstructions in Rabbits: A Comparison between Tendon Sheath Transplantation and Conventional Two Stage Procedures

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Abstract
Because the synovial environment has been suggested to be important in limiting the number of postoperative adhesions after flexor tendon surgery, and a high concentration of hyaluronic acid is a characteristic feature of synovial fluid, we have examined the hyaluronic acid concentrations in fluid collected from different kinds of reconstructed flexor tendon sheaths in rabbits. The hyaluronic acid concentration in normal rabbit flexor tendon sheaths was similar to that in normal human sheath and joint fluid. Rabbit tendon sheaths restored by autologous sheath grafts and partial pseudosheaths contained similar or somewhat lower hyaluronic acid concentrations, whereas in complete pseudosheaths the concentrations were considerably lower. The data suggest that tendon sheath reconstructions should consist at least partly of synovial membrane so that they are as similar as possible to normal synovial membrane.