Abstract
Background: Therapeutic strategies targeting neovessels responsible for musculoskeletal chronic pain have emerged, including neovessels embolization. Our study aimed to develop a large animal model of patellar tendinopathy with neovascularization. Methods: Nine 3-month-old male piglets (18 patellar tendons) received percutaneous injections of increasing doses of collagenase (0 to 50 mg) at day 0 (D0). Tendinopathy was evaluated by ultrasound (D7 and D14). Neovascularization was evaluated visually and on angiographies. Bonar score was used for histological analysis (D14). Correlations were evaluated using Spearman’s rank (Rs) test. Results: Research protocol was well tolerated. All tendons were enlarged with a median increase of 31.58% [25–40.28] at D7 (p = 0.244) at D7 and 57.52% [48.41–91.45] at D14 (p = 0.065). Tendons with collagenase injection had more hypoechoic changes, with one tendon rupture (p = 0.012). Neovascularization was reported above 5 mg collagenase (p < 0.01) at D7 and D14 with dose-related neovessels induction (Rs = 0.8, p < 0.001). The Bonar score increased above 5 mg collagenase, correlated with the dose (Rs = 0.666, p = 0.003). Conclusions: The study shows the feasibility, safety and reproducibility of this new large animal model of patellar tendinopathy with neovascularization after collagenase injection. It will allow studying new treatments on direct embolization of neovessels by endovascular approach.
Highlights
The present study aimed to evaluate the feasibility of a chemicallyinduced piglet model of patellar tendinopathy with focus on neovessels
All patellar tendons were enlarged: the median increase was of 32% (25–40.28) at day 7 (D7) and of 58% (48.41–91.45) at D14, without any difference between the groups (Table 1)
This study showed that injection under ultrasound guidance of type 1 collagenase inside the patellar tendon allowed the generation of a tendinopathy model with neovessels in piglets
Summary
Tendinopathy is a common and significant clinical problem. This disabling condition mostly affects active young and middle-aged people, and has a significant impact on their quality of life [1], on both personal and professional activities. The major symptom of tendinopathy is chronic pain [2]. Athletes and sportsmen/women are especially impacted with 14% reporting chronic patellar tendinopathy [3]. Up to 53% of athletes with patellar tendinopathy had to quit their sports career because of their knee problem [4]
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