Eren POLAT, Mustafa KÖM, Oktay YİĞİT, Fatih BÜYÜK, İlknur ÇALIK

Ratlarda Hyaluronik Asit’in Tendon İyileşmesi ve AdezyonÜzerine Etkisi

Beşerî ve Veteriner hekimlikte tendon yaralanmaları sonrasında adezyon ve tendon kopmasısıklıkla karşılaşılan ortopedik problemlerdendir. Bu çalışmada tendon iyileşmesinde tekrarlayanhyaluronik asit (HA) uygulanmasının etkinliğinin makroskobik, biyomekanik ve histopatolojik olarakortaya konulması amaçlandı.Çalışmada 6 aylık 30 adet spraq dawley ırkı rat kullanıldı. Aşil tendonlarında primer tendon onarımıoluşturulan ratlar rastgele üç gruba ayrıldı. Birinci gruptaki ratlar kontrol grubu olarak değerlendirildive operasyon sonrası herhangi bir tedavi uygulanmadı. İkinci gruptaki ratlarda operasyon sonrası0.075 mL/kg HA tendonun çevresine tek doz halinde uygulandı. Üçüncü gruptaki ratlara ise,operasyon sonrası 3., 7. ve 14. günlerde aynı dozda HA tendon çevresine tekrarlayan uygulamalaryapıldı. Ötenazi sonrası yapılan makroskobik, biyomekanik ve histopatolojik değerlendirmelerde;HA uygulaması yapılan tedavi gruplarında kontrol grubuna göre daha az düzeyde adezyon olduğugörüldü. Makroskobik değerlendirme sonucunda, tedavi gruplarının adezyon derecesinin kontrolgrubuna göre istatistiki açıdan anlamlı derecede düşük olduğu saptandı (P0.05).İnflamasyon derecesi tekrarlayan HA uygulaması yapılan 3. grupta istatistiksel olarak anlamlıderecede düşük olduğu tespit edildi (P0.05). Biyomekanik incelemede ise, 3.gruptaki kopma öncesi maksimum direnç kontrol ve 2 gruplardakinden fazlaydı. Sonuç olarak, adezyonları önlemek için HA uygulamalarının kullanılabilir bir tedavi seçeneği olduğuve HA uygulamalarının tek doz veya tekrarlayan dozlarda yapılmasıyla ilgili ise daha detaylıçalışmalar yapılmasının gerekli olduğu kanısına varıldı.

Effect of Hyaluronic Acid on Adhesion and Tendon Healing in Rats

Adhesion and tendon rupture are one of the problems after tendon injuries in human and veterinarymedicine. In this study, it was aimed to demonstrate the effect of repeated hyaluronic acid (HA)applications macroscopically, biomechanically and histopathologically. Thirty spraq dawley rats, 6 months old, were used in the study. The rats which was created afterprimary tendon repair in achilles tendons were randomly divided into three groups. The first groupwere evaluated as the control group and no treatment was applied after the operation. In thesecond group, 0.075 ml/kg HA was applied around the tendon as a single dose after the operation.In the third group, the same dose of HA was applied around the tendon on the 3rd, 7th and 14thdays after the operation. After scarification, in the macroscopic, biomechanical andhistopathological evaluations, it was observed that there was less adhesion in the treatment groupscompared to the control group. As a result of the macroscopic evaluation, it was determined thatthe adhesion degree of the treatment groups was significantly lower than the control group(P0.05). The degree of inflammation was found significantly lower in the 3rd group whoreceived repeated HA administration (P0.05). Biomechanically,maximum force to rupture in group 3 were higher in control group and group 2.In conclusion, it was determined that HA applications are useful treatment options to preventadhesions that may occur during surgical treatments performed after tendon injuries. It wasconcluded that detailed studies should be carried out regarding the application of HA in single orrepeated doses during tendon healing.

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