Flexor tendon repair outcomes with fat grafting

Abstract

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. 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. 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). 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.