Investigation of the biomechanical and histopathological effects of autologous conditioned serum on healing of Achilles tendon

Objective: The aim of this study to evaluate the effects of autologous conditioned serum (ACS) on the healing of transected rat Achilles tendons via the assessment of biomechanical and histological parameters. Methods: The study was conducted on 45 male SpragueeDawley rats. Five rats were used as donors for ACS preparation. Animals were randomly assigned to the experimental or control group. In both groups, the Achilles tendon was cut transversally and then sutured. In the placebo control and ACS-treated groups, saline or ACS, respectively, was injected into the repair zone three times after surgery. Ten rats from each group (ACS group, n ¼ 20; control group, n ¼ 20) were euthanized at days 15 and 30 after surgery for histopathological (n ¼ 5) and biomechanical (n ¼ 5) testing. The histopathological findings were interpreted using the Bonar and Movin scales. Tendon remodelling was evaluated via the immu-nohistochemical staining of collagen type 3. Biomechanical effects were assessed by tensile testing. Results: The Bonar and Movin scale scores were significantly better in the ACS-treated group on both day 15 (p ¼ 0.003 and p ¼ 0.003, respectively) and day 30 (p ¼ 0.005 and p ¼ 0.004, respectively). The immunohistochemical density of collagen type 3 was significantly lower in the ACS-treated group on day 30 (p ¼ 0.018). The type 1/3 collagen ratios of the groups were similar on days 15 and 30, as determined by Sirius Red staining (p ¼ 0.910 and p ¼ 0.133, respectively). In the biomechanical assessment results, the ACS-treated group's maximum load to failure values were significantly higher on day 15 (p ¼ 0.049). Conclusion: Injection of ACS had a positive effect on the histopathological healing of rat Achilles tendons on days 15 and 30 and on biomechanical healing on day 15. ACS treatment contributed to lowering the collagen type 3 density by day 30. According to our study, ACS may be favourable for the treatment of human Achilles tendon injuries and tendinopathies. © 2018 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).

___

23. Heisterbach PE, Todorov A, Flückiger R, et al. Effect of BMP-12, TGF-b1 and autologous conditioned serum on growth factor expression in Achilles tendon healing. Knee Surg Sports Traumatol Arthrosc. 2012;20(10): 1907e1914.

22. Baltzer AW, Ostapczuk MS, Stosch D, et al. A new treatment for hip osteoar-thritis: clinical evidence for the efficacy of autologous conditioned serum. Orthop Rev. 2013;5(2):13.

21. Yang KA, Raijmakers NJ, van Arkel ER, et al. Autologous interleukin-1 receptor antagonist improves function and symptoms in osteoarthritis when compared to placebo in a prospective randomized controlled trial. Osteoarthritis Cartilage. 2008;16(4):498e505.

20. Geburek F, Lietzau M, Beineke A, et al. Effect of a single injection of autologous conditioned serum (ACS) on tendon healing in equine naturally occurring tendinopathies. Stem Cell Res Therapy. 2015;6(1):1.

19. Lopez-Najera D, Rubia-Zaragoza M, Sopena-Juncosa JJ, et al. Effects of plasma rich in growth factors (PRGF) on biomechanical properties of Achilles tendon repair. Knee Surg Sports Traumatol Arthrosc. 2015;24(12):1e8.

18. Yüksel S, Adanır O, Gültekin MZ, et al. Effect of platelet-rich plasma for treatment of Achilles tendons in free-moving rats after surgical incision and treatment. Acta Orthopaedica et Traumatologica Turcica. 2014;49(5): 544e551.

17. Maffulli N. Current concepts review e rupture of the Achilles tendon. J Bone Joint Surg Am. 1999;81(7):1019e1036.

16. Wright-Carpenter T, Klein P, Schaeferhoff P, et al. Treatment of muscle injuries by local administration of autologous conditioned serum: a pilot study on sportsmen with muscle strains. Int J Sports Med. 2004;25(8):588e593.

15. Rutgers M, Saris DB, Dhert WJ, et al. Cytokine profile of autologous conditioned serum for treatment of osteoarthritis, in vitro effects on cartilage metabolism and intra-articular levels after injection. Arthritis Research and Therapy. 2010;12(3):1.

14. Darabos N, Trsek D, Miklic D, et al. Comparison of double-bundle anterior cruciate ligament reconstruction with and without autologous conditioned serum application. Knee Surg Sports Traumatol Arthrosc. 2014;24(10):1e8.

13. Evans CH, Chevalier X, Wehling P. Autologous conditioned serum. Phys Med Rehabil Clin. 2016;27(4):893e908.

12. Berkoff DJ, Kallianos SA, Eskildsen SM, et al. Use of an IL1-receptor antagonist to prevent the progression of tendinopathy in a rat model. J Orthop Res. 2015;34(4):616e622.

11. Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand. 2004;75(1):93e99.

10. Longo UG, Lamberti A, Maffuli N, et al. Tissue engineered biological augmentation for tendon healing: a systematic review. Br Med Bull. 2011;98(1):31e59.

9. Forslund, D. Rueger, P. Aspenberg A comparative dose–response study of cartilage-derived morphogenetic protein (CDMP)-1, -2 and-3 for tendon healing in rats J Orthop Res, 21 (4) (2003), pp. 617-621

8. Thomopoulos S, Das R, Sakiyama-Elbert S, et al. bFGF and PDGF-BB for tendon repair: controlled release and biologic activity by tendon fibroblasts in vitro. Ann Biomed Eng. 2010;38(2):225e234.

7. Drissi H, Lomri A, Lasmoles F, et al. Skeletal unloading induces biphasic changes in insulin-like growth factor-I mRNA levels and osteoblast activity. Exp Cell Res. 1999;251(2):275e284.

6. Wang XT, Liu PY, Tang JB. Tendon healing in vitro: genetic modification of tenocytes with exogenous PDGF gene and promotion of collagen gene expression. J Hand Surg. 2004;29(5):884e890.

5. Zhang F, Liu H, Stile F, et al. Effect of vascular endothelial growth factor on rat Achilles tendon healing. Plast Reconstr Surg. 2003;112(6):1613e1619.

4. Majewski M, Ochsner PE, Liu F, et al. Accelerated healing of the rat Achilles tendon in response to autologous conditioned serum. Am J Sports Med. 2009;37(11):2117e2125.

3. Daghino W, Enrietti E, Sprio AE, et al. Subcutaneous Achilles tendon rupture: a comparison between open technique and mini-invasive tenorrhaphy with Achillon® suture system. Injury. 2016;47(11):2591e2595.

2. Inglis AE, Sculco TP. Surgical repair of ruptures of the tendo Achillis. Clin Orthop Relat Res. 1981;156(3):160e169.

1. Maquirriain J. Achilles tendon rupture: avoiding tendon lengthening during surgical repair and rehabilitation. Yale J Biol Med. 2011;84(3):289e300.
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

Intraoperative evaluation of polymorphonuclear leukocyte during second-stage revision surgery promote overdiagnosis of persistent periprosthetic joint infection

Yoshinobu SAITOH, Takao SETOGUCHI, Takako YOSHIOKA, Junichiro NISHI, Akihide TANIMOTO, Setsuro KOMIYA

Malignant triton tumor of the gluteal region in a patient unaffected by neurofibromatosis: A case report

Abdullah MERTER, Kerem BAŞARIR, Yusuf YILDIZ, Yener SAĞLIK

Lunate excision with capitohamate fusion in the treatment of stage IIIB and IIIC Kienbock's€ disease

Mesut TAHTA, Cem ÖZCAN, Gürkan YILDIZ, İzge GÜNAL, Muhittin ŞENER

Treatment outcome of dome osteotomy of the pelvis combined with trochanteric advancement for sequelae of Perthes' disease

Asep SANTOSO, Pramod Shaligram INGALE, Ik-Sun CHOI, Young-Rok SHİN, Kyung-Soon PARK, Taek-Rim YOON

Lunate excision with capitohamate fusion in the treatment of stage IIIB and IIIC Kienbock's€ disease

Muhittin ŞENER, Mesut TAHTA, Cem ÖZCAN, Gürkan YILDIZ, İzge GÜNAL

Brown-Sequard syndrome caused by hyperextension in a patient with atlantoaxial subluxation due to an os odontoideum

Dong-Yeong LEE, Soon-Taek JEONG, Tae-Ho LEE, Dong-Hee KIM

Cross-cultural adaptation of Kerlan-Jobe Orthopaedic Clinic shoulder and elbow score: Reliability and validity in Turkish-speaking overhead athletes*

ELİF TURGUT, VOLGA BAYRAKCI TUNAY

Surgical correction of hallux valgus deformity in children with cerebral palsy

İlker Abdullah SARIKAYA, ALİ ŞEKER, Ozan Ali ERDAL, Mehmet Ali TALMAÇ, Muharrem İNAN

Anterior decompression and plate fixation in treatment of cervical myelopathy: A multicentric retrospective review

Carla DORIA, Giulia Raffaella MOSELE, Massimo BALSANO, Gianluca MAESTRETTİ, Gianfilippo CAGGIARI

Analysis of factors affecting baseline SF-36 Mental Component Summary in Adult Spinal Deformity and its impact on surgical outcomes

Tiro MMOPELWA, Selim AYHAN, SELCEN YÜKSEL, Vugar NABIYEV, Asli NIYAZI, Ferrán PELLISÉ, Ahmet ALANAY, Francisco Javier Sanchez Perez GRUESO, Frank KLEINSTUCK, Ibrahim OBEID, Emre ACAROĞLU