# FLEXOR TENDON: RESTORATION OF THE GLIDING SURFACE

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 1993 · $281,904

## Abstract

Recent studies have demonstrated that the healing response of connective
tissue is influenced dramatically by physical forces.  A particularly
striking functional response has been noted in digital flexor tendons.
Studies in our laboratories have shown a variety of favorable responses to
early mobilization of digital flexor tendons repaired primarily, including
increased strength and excursion, digital angular rotation, peritendinous
vascular remodeling, and repair site and sheath DNA content compared to
delayed mobilized and immobilized controls.  The frequent incidence of poor
digital function following one- and two-stage flexor tendon grafts has
stimulated a new interest in postoperative protected early motion.  Our
hypothesis is that autogenous flexor tendon graft healing, not associated
with synovial adhesion ingrowth, is stimulated by early controlled motion.
In addition, the healing response is donor tissue specific with
intrasynovial flexor tendon donors exhibiting greater cellular survival and
increased collagen synthesis than extrasynovial extensor tendon donors.  We
propose that tendon autografts treated by reinstitution of the relevant
function of tendon bypass the stages of autograft transformation (avascular
necrosis, revascularization, cellular proliferation, and remodeling).
Revascularization by adhesions, applicable only to immobilized autogenous
grafts, leads to repair that is structurally inferior when compared to
grafts mobilized early.  The intrinsic healing process, relying on cellular
survival and proliferative sheath response when the autograft is
immobilized.  The objective of this proposal is to determine the specific
manner by which flexor tendon autografts heal in the absence of synovial
sheath adhesion ingrowth under conditions of early passive motion.  The
flexor tendon autografts' gliding surface and synovial sheath will be
characterized using morphological, biochemical, and biomechanical
techniques.

## Key facts

- **NIH application ID:** 3156505
- **Project number:** 5R01AR033097-15
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **SAM.gov UEI:** FLJ7DQKLL226
- **Principal Investigator:** RICHARD H GELBERMAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1993
- **Award amount:** $281,904
- **Award type:** 5
- **Project period:** 1987-05-01 → 1995-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3156505

## Citation

> US National Institutes of Health, RePORTER application 3156505, FLEXOR TENDON: RESTORATION OF THE GLIDING SURFACE (5R01AR033097-15). Retrieved via MORVS 2026-10-24 from https://api.morvs.ai/grant/nih/3156505. Licensed CC0.

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