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The Journal of Bone & Joint Surgery British Volume
Vol. 86-B, Issue 6 | Pages 918 - 924
1 Aug 2004
Nishida J Araki S Akasaka T Toba T Shimamura T Amadio PC An K

The excursion resistance between the tendon and pulley is an important factor contributing to the limitation of function after surgery to the hand. The administration of hyaluronic acid (HA) in the early rehabilitation after tendon grafting may help to prevent adhesions. We evaluated changes in the excursion resistance between potential sources of flexor tendon grafts and the annular pulley in a canine model after administration of HA.

The intrasynovial and extrasynovial tendons were soaked in 10 mg/ml of HA for five minutes. The excursion resistance between these tendons and the annular pulley of an intact proximal phalanx and that of the same tendons of the opposite foot without administration of HA were evaluated. The tendon of flexor digitorum profundus of the second toe without administration of HA was used as a control.

The gliding resistance of canine tendons was significantly decreased after the administration of HA especially in the extrasynovial tendons. Our findings suggest that the administration of HA may improve the gliding function of a flexor tendon graft.


Orthopaedic Proceedings
Vol. 84-B, Issue SUPP_III | Pages 226 - 226
1 Nov 2002
Yamazaki K Kato S Toba T Shimamura T
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This study reports on postoperative changes of intra and epidural space of both degenerative lumbar spinal canal stenosis(DLSCS) and degenerative spondylolisthesis(DO)on MRI. 48cases(DLSCS:20cases, DO:28cases)were investigated in this study. All cases performed bilateral wide fenestration.

The average age of these patients was 65 years and average follow-up period was 60 months. The average improvement ratio(%) of JOA score was 68% at the last follow-up. Symptomes had deteriorated in 8 cases, according to an increase in the volume of the postlaminectomy membrane, at the last follow-up. There were 8 cases(29%)in DO. showing an increase of % slip on X-ray at the last follow-up, accompanied with both a slight decreasing of the cross-sectional area(CSA)of dural sac and a slight deterioration of clinical results.

Discussion: Symptomes in around 17% of the cases deteriorated, and there were three factors on MRI ; a poor expansion of the dural sac, a grouping of the cauda equina, and a decrease in the CSA of the dural sac.