Effect of previous nerve injury on the regeneration of free autogenous muscle grafts.

Abstract Free autogenous skeletal muscle transplantation is now an established experimental and clinical procedure. However, when large muscles are used, surviving grafts are found to contain substantial amounts of noncontractile tissue. This may result from delayed reinnervation and may itself impede innervation. Previous workers have suggested that prior denervation of a muscle improves the rate of regeneration after grafting. It has also been reported that accelerated axonal regeneration follows nerve transection when the nerve has been “primed” by a prior crush. Experiments have been carried out to show whether or not the latter procedure, either alone or in combination with prior graft denervation, would further improve the functional performance of a graft by hastening reinnervation. The tibialis anterior muscles of rats were transposed 2 weeks after one or both common peroneal nerves had been crushed. Three months after transposition the muscles were weighed and the maximum isometric tension developed was recorded. The transplanted muscles which had been both denervated prior to transposition and reinnervated by a nerve primed by a previous crush developed substantially greater tensions per g of muscle than did those that had been subjected to either of these procedures alone. We concluded that a more rapid reinnervation of regenerating fibers leads to a greater proportion of functioning contractile tissue in muscle grafts.