A new model for partial immobilization of rat hind limb after Achilles tendon excision/reinterposition
There have been several attempts to repair the Achilles tendon by surgery or replacement with graft materials. Because tissue repair is a complex process, tendon healing occurs slowly. In rats, immobilization of the limb is essential during recovery. There are immobilization methods such as plaster or fiber casting. According to prolonged recovery, most of the procedures cause skin ulceration, decrease in weight, restrictions in checking the surgery area, and slipping out of the cast. Our aim was to apply a suture around the defect for immobilization. Tendons of 30 male Wistar rats (250 ± 50 g and aged 8 ± 2 weeks) were dissected and the cut ends were immediately sutured proximally-distally with an 8-0 nonabsorbable suture. For partial immobilization a needle with a 4-0 suture was passed 3 mm proximally and 3 mm distally between the gastrocnemius and calcaneus. A knot was applied close to the calcaneus. The skin was closed with a continuous, Ford interlocking 6-0 suture pattern. The animals were sacrificed after 2 and 4 weeks. No difference was observed in means of muscle atrophy when compared to contralateral intact muscle. No ulcer, sore, or swelling was observed. Tendons were intact and showed superior histological characteristics. Recent techniques seem to be effective in applying strength to protect the defect area from muscle tensile stress of the gastrocnemius during the recovery period.
A new model for partial immobilization of rat hind limb after Achilles tendon excision/reinterposition
There have been several attempts to repair the Achilles tendon by surgery or replacement with graft materials. Because tissue repair is a complex process, tendon healing occurs slowly. In rats, immobilization of the limb is essential during recovery. There are immobilization methods such as plaster or fiber casting. According to prolonged recovery, most of the procedures cause skin ulceration, decrease in weight, restrictions in checking the surgery area, and slipping out of the cast. Our aim was to apply a suture around the defect for immobilization. Tendons of 30 male Wistar rats (250 ± 50 g and aged 8 ± 2 weeks) were dissected and the cut ends were immediately sutured proximally-distally with an 8-0 nonabsorbable suture. For partial immobilization a needle with a 4-0 suture was passed 3 mm proximally and 3 mm distally between the gastrocnemius and calcaneus. A knot was applied close to the calcaneus. The skin was closed with a continuous, Ford interlocking 6-0 suture pattern. The animals were sacrificed after 2 and 4 weeks. No difference was observed in means of muscle atrophy when compared to contralateral intact muscle. No ulcer, sore, or swelling was observed. Tendons were intact and showed superior histological characteristics. Recent techniques seem to be effective in applying strength to protect the defect area from muscle tensile stress of the gastrocnemius during the recovery period.
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- 1 Kannus, P., Jozsa, L., Jarvinnen, M.: Basic science of tendons. In: Garrett, W.J., Speer, K.P., Kirkendall, D.T., Eds. Principles and Practice of Orthopaedic Sports Medicine. 1st edn., Lippincott Williams & Wilkins, Philadelphia, USA. 2000; 21–37. 2 Nakagawa, Y., Majima, T., Nagashima, K.: Effect of ageing on ultrastructure of slow and fast skeletal muscle tendon in rabbit Achilles tendons. Acta Physiol. Scand., 1994; 152: 307–313. 3 Güngörmüş, C., Kolankaya, D.: Characterization of type I, III and V collagens in high-density cultured tenocytes by tripleimmunofluorescence technique. Cytotechnology, 2008; 58: 145–152. 4 Cribb, A.M., Scott, J.E.: Tendon response to tensile stress: an ultrastructural investigation of collagen: proteoglycan interactions in stressed tendon. J. Anat., 1995; 187: 423–428. 5 Clayton, R.A., Court-Brown, C.M.: The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury, 2008; 39: 1338–1344. 6 Doillon, C.J., Dunn, M.G., Bender, E., Silver, F.H.: Collagen fiber formation in repair tissue: development of strength and toughness. Coll. Relat. Res., 1985; 5: 481–492. 7 Liu, S.H., Yang, R.S., Al-Shaikh, R., Lane, J.M.: Collagen in tendon, ligament, and bone healing: a current review. Clin. Orthop. Relat. Res., 1995; 318: 265–278. 8 Leadbetter, W.B.: Cell matrix response in tendon injury. Clin. Sports Med., 1992; 11: 533–578. 9 Reddy, G.K., Stehno-Bittel, L., Enwemeka, C.S.: Matrix remodeling in healing rabbit Achilles tendon. Wound Repair Regen., 1999; 7: 518–527. 10 Ahmed, I.M., Lagopoulos, M., McConnell, P., Soames, R.W., Sefton, G.K.: Blood supply of the Achilles tendon. J. Orthop. Res., 1998; 16: 591–596. 11 Woo, S.L., Hildebrand, K., Watanabe, N., Fenwick, J.A., Papageorgiou, C.D., Wang, J.H.: Tissue engineering of ligament and tendon healing. Clin. Orthop. Relat. Res., 1999; 367: 312–323. 12 Möller, H.D., Evans, C.H., Maffulli, N.: Current aspects of tendon healing. Orthopade, 2000; 29: 182–187. 13 Bagnaninchi, P.O., Yang, Y., El Haj, A.J., Maffulli, N.: Tissue engineering for tendon repair. Br. J. Sports Med., 2007; 41: 1–5. 14 Franco, B., Vincenzo, V., Alessandro, D.V., Tonello, C., Abatangelo, G., Mazzoleni, F.: Tissue engineering approaches for the construction of a completely autologous tendon substitute. Indian J. Plast. Surg., 2008; 41: 38–46. 15 Kuru, İ., Maralcan, G., Ulukan, İ., Bozan, M.E., Altınel, L., Tokyol, Ç.: Biomechanical and histologic comparison of Achilles tendon ruptures reinforced with intratendinous and peritendinous plantaris tendon grafts in rabbits: an experimental study. Arch. Orthop. Trauma Surg., 2004; 124: 608–613. 16 Awad, H.A., Butler, D.L., Boivin, G.P., Smith, F.N., Malaviya, P., Huibregtse, B., Caplan, A.I.: Autologous mesenchymal stem cell-mediated repair of tendon. Tissue Eng., 1999; 5: 267–277. 17
- Koob, T.J., Willis, T.A., Qiu, Y.S., Hernandez, D.J.: Biocompatibility of NDGA-polymerized collagen fibers. II. Attachment, proliferation, and migration of tendon fibroblasts in vitro. J. Biomed. Mater. Res., 2001; 56: 40–48. 18 Krapf, D., Kaipel, M., Majewski, M.: Structural and biomechanical characteristics after early mobilization in an Achilles tendon rupture model: operative versus nonoperative treatment. Orthopedics, 2012; 35: e1383–e1388. 19 Suchak, A.A., Bostick, G.P., Beaupré, L.A., Durand, D.C., Jomha, N.M.: The influence of early weight-bearing compared with non-weight-bearing after surgical repair of the Achilles tendon. J. Bone Joint Surg., 2008; 90: 1876–1883. 20 Virchenko, O., Aspenberg, P.: How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks? Interplay between early regeneration and mechanical stimulation. Acta Orthop., 2006; 77: 806–812. 21 Booth, F.W., Kelso, J.R.: Production of rat muscle atrophy by cast fixation. J. Appl. Physiol., 1973; 34: 404–406. 22 Enwemeka, C.S.: Inflammation, cellularity, and fibrillogenesis in regenerating tendon: implications for tendon rehabilitation. Phys. Ther., 1989; 69: 816–825. 23 Coutinho, E.L., Gomes, A.R.S., Franca, C.N., Salvini, T.F.: A new model for the immobilization of the rat hind limb. Braz. J. Med. Biol. Res., 2002; 35: 1329–1332. 24 Jaspers, S.R, Fagan, J.M., Satarug, S., Cook, P.H., Tischler, M.E.: Effects of immobilization on rat hind limb muscles under nonweight-bearing conditions. Muscle Nerve, 1988; 11: 458–466. 25 Murrell, G.A., Lilly, E.G., Goldner, R.D., Seaber, A.V., Best, T.M.: Effects of immobilization on Achilles tendon healing in a rat model. J. Orthop. Res., 1994; 12: 582–591. 26 Hornberger, T.A., Hunter, R.B., Kandarian, S.C., Esser, K.A.: Regulation of translation factors during hindlimb unloading and denervation of skeletal muscle in rats. Am. J. Physiol. Cell Physiol., 2001; 281: 179–187. 27 Palmes, D., Spiegel, H.U., Schneider, T.O., Langer, M., Stratmann, U., Budny, T., Probst, A.: Achilles tendon healing: long-term biomechanical effects of postoperative mobilization and immobilization in a new mouse model. J. Orthop. Res., 2002; 20: 939–946. 28 Booth, F.W.: Effect of limb immobilization on skeletal muscle. J. Appl. Physiol., 1982; 52: 1113–1118. 29 Murrell, G.A., Jang, D., Deng, X.H., Hannafin, J.A., Warren, R.F.: Effects of exercise on Achilles tendon healing in a rat model. Foot Ankle Int., 1998; 19: 598–603. 30 Da Silva, C.A., Guirro, R.R.J., Polacow, M.L.O., Cancelliero, K.M., Durigan, J.L.Q.: Rat hindlimb joint immobilization with acrylic resin orthoses. Braz. J. Med. Biol. Res., 2006; 39: 979– 9 31 Jaspers, S.R., Tischler, M.E.: Atrophy and growth failure of rat hindlimb muscles in tail-cast suspension. J. Appl. Physiol., 1984; 57: 1472–1479. 32 Jaspers, S.R., Fagan, J.M., Tischler, M.E.: Biochemical response to chronic shortening in unloaded soleus muscles. J. Appl. Physiol., 1985; 59: 1159–1163. 33 Helsinga, J.W., te Kronnie, G., Huijing, P.A.: Growth and immobilization effects on sarcomeres: a comparison between gastrocnemius and soleus muscles of the adult rat. Eur. J. Appl.
- Physiol. Occup. Physiol., 1996; 70: 49–57. 34 Stoll, C., John, T., Conrad, C., Lohan, A., Hondke, S., Ertel, W., Kaps, C., Endres, M., Sittinger, M., Ringe, J., Schulze-Tanzil, G.: Healing parameters in a rabbit partial tendon defect following tenocyte/biomaterial implantation. Biomaterials, 2011; 32: 4806–4815.