Research progress in the mechanism and intervention of tendon adhesion

doi:10.3969/j.issn.1674-8115.2022.08.017

Abstract

Abstract:

As one of the clinical challenges, tendon adhesion is a common complication after the repair of tendon injuries and difficult to treat. In recent years, with the continuous updating and development of medical science, research into the mechanism of tendon healing has been advanced, which provides a theoretical basis for the prevention and treatment of tendon adhesion and functional recovery after surgery. The key to prevent tendon adhesion is to inhibit exogenous healing and inflammatory reaction and to promote endogenous healing. The occurrence of tendon adhesion is mainly related to transforming growth factor-β (TGF-β), basic fibroblast growth factor, vascular endothelial growth factor and other cytokines. Additionally, TGF-β/Smad signal transduction pathway is of significance. Clinically, improvement of suturing methods and early rehabilitation activities play an important role in the prevention and treatment of tendon adhesion, the principle of which is related to the effect of mechanical loading on cell behavior. The combination of materials and drugs is the current research hotspot in the prevention and treatment of tendon adhesion. The existing anti-adhesion membrane mainly acts as physical barrier, and the drug-loaded membrane can efficiently inhibit adhesion by inhibiting inflammatory responses, regulating cell proliferation and metabolism, reducing oxidative stress, and inhibiting TGF-β. This article presents a review of recent research progress in the mechanisms of tendon adhesion and interventions in the areas of surgery, rehabilitation, materials and drugs, in order to promote the transformation and application of basic research, which may provide reference significance for clinical prevention and treatment of tendon adhesion.

Key words: tendon adhesion, wound healing, tendon injury, mechanism, prevention

CLC Number:

R318

SHA Pan, ZHAO Xuewen, ZHU Haotian, GAO Chongzhou, LIU Shen. Research progress in the mechanism and intervention of tendon adhesion[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2022, 42(8): 1116-1121.

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References 47

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