Flexor tendon repair outcomes with fat grafting
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ORIGINAL PAPER
Flexor tendon repair outcomes with fat grafting Ahmed A. Taha 1
&
Ahmed Nour El Deen 1 & Mohamed Ragab 1 & Rama A. Ali 1
Received: 13 April 2020 / Accepted: 20 July 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Young working adults frequently suffer from tendon injuries. However, despite the many advancements in repair techniques and postoperative physiotherapy programs that improved recovery, the benefit of fat injections in improving the outcome through their regenerative properties has remained under trial. Methods A total of 50 patients with isolated flexor tendon injuries (zone II) presenting to the Emergency Department of Cairo University Hospitals from June 2018 to June 2019 were included and randomly divided into two groups. Group A cases received conventional tendon repair techniques without fat injection, whereas group B received fat injection as an adjunctive procedure after conventional repair. The outcomes were recorded and statistically analyzed. Results Patients mean age was 25 years (range 17–50, standard deviation (SD) 2.4). The median for TAM (total active motion) in group A was 120 and 170, pre- and postoperatively. For group B, the median for TAM was 125 and 180, pre- and postoperatively. A comparison between both groups showed that group B had a higher postoperative median for TAM than group A (p < 0.622). However, both groups had similar postoperative medians for TPM (total passive motion) (p < 0.379). Conclusions The current study showed that the fat injection group had increased TAM but decreased TPM. Although fat injection might help minimize adhesion formation after tendon repair, further work and research need to be done to understand why TPM decreased and whether it is related to joint stiffness or not. Level of Evidence: Level III, therapeutic study. Keywords Fat . Injection . Tendon . Repair . Outcomes
Introduction Restoration of hand function following tendon injuries remains a real challenge, with young, healthy, male adults being mostly affected [1–4]. Given that timely and near-normal restoration of hand function is of utmost importance [5], many techniques have been developed and frequently revised.
* Ahmed A. Taha [email protected] 1
Department of Plastic Surgery, Faculty of Medicine, Cairo University, Kasr Al Ainy street, CAIRO 11562, Egypt
Pittsburgh’s team of plastic surgeons and researchers had discovered an abundance of adipose tissues with stem cells [6]. These adipose-derived stem cells (ASCs) have the potential to differentiate into other types of cells, such as tenocytes and myocytes [7], and have a paracrine function through the release of growth factors and cytokines [8]. Furthermore, adipose tissues are an excellent source of stromal vascular fractions (SVFs) that have repair and regenerative potential [9]. This may explain the role of fat grafting in accelerating the healing process and replacing damaged or missing cells. Currently, fat injection has become a popular procedure given its estheti
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