The aim of this study was to compare the applicability and efficacy of commercially available allograft for fibroosseous pulley reconstruction. The A2 pulleys of rabbits were excised and reconstructed with solvent-dehydrated bovine pericardium or acellular dermal matrix and were compared with fascia lata or free tendon graft controls. Biomechanical testing was performed at 8 and 12 weeks that did not reveal any statistical difference between the groups. The authors conclude that bovine pericardium and acellular dermal matrix are effective alternatives for fibroosseous pulley reconstruction.
Material used for pulley reconstruction must be biocompatible, strong, malleable, and have a smooth surface to minimize gliding friction. Tendon grafts, extensor retinaculum, and fascia lata are ideal substances for pulley reconstruction; yet, carry the liability of donor site morbidity. In this study, the authors compared the efficacy of commercially available substitutes (that possess the aforementioned characteristics) for fibroosseous pulley reconstruction in a Rabbit model and found no statistically significant biomechanical differences. This is an important preliminary investigation of biocompatible commercially available material that can be used for pulley reconstruction. Further investigation is certainly necessary to determine whether the pulleys maintain their integrity beyond the 12-week time point where the post surgical scar tissue begins to dissipate. Or, if allograft reconstruction can withstand the comparatively greater weight bearing and functional demands of the human hand.