Differences in proliferative rate and collagen lattice contraction between endotenon and synovial fibroblasts

Injured and surgically repaired tendons heal with the formation of scar tissue. Scar tissue represents 1 of the most unpredictable factors contributing to postoperative morbidity. The main cell involved in scar formation is the fibroblast. The relative activity of fibroblasts from the fibro-osseous sheath (the tissue surrounding the tendon in zone II) and the endotenon (the core of the tendon) with respect to proliferation and the ability to contract a collagen lattice were compared in vitro. The fibroblasts derived from the fibro-osseous sheath were more active in both these respects. In addition, the amount of matrix metalloproteinase activity was found to be greater for the fibro-osseous sheath fibroblasts, implying a greater capacity to degrade and disorganize connective tissue and thus migrate. These results imply that the fibro-osseous fibroblasts represent a more active population of cells compared with endotenon fibroblasts, and perhaps should be specifically targeted in future modes of therapy. Copyright (C) 1998 by the American Society for Surgery of the Hand.