Abstract
Mechanical loading affects tendon healing and recovery. However, our understanding about how physical loading affects recovery of viscoelastic functions, collagen production and tissue organisation is limited. The objective of this study was to investigate how different magnitudes of loading affects biomechanical and collagen properties of healing Achilles tendons over time. Achilles tendon from female Sprague Dawley rats were cut transversely and divided into two groups; normal loading (control) and reduced loading by Botox (unloading). The rats were sacrificed at 1, 2- and 4-weeks post-injury and mechanical testing (creep test and load to failure), small angle x-ray scattering (SAXS) and histological analysis were performed. The effect of unloading was primarily seen at the early time points, with inferior mechanical and collagen properties (SAXS), and reduced histological maturation of the tissue in unloaded compared to loaded tendons. However, by 4 weeks no differences remained. SAXS and histology revealed heterogeneous tissue maturation with more mature tissue at the peripheral region compared to the center of the callus. Thus, mechanical loading advances Achilles tendon biomechanical and collagen properties earlier compared to unloaded tendons, and the spatial variation in tissue maturation and collagen organization across the callus suggests important regional (mechano-) biological activities that require more investigation.
Highlights
Tendons are soft connective tissues responsible for load transmission with an energy-storing capacity that enables efficient locomotion
Diminishing effects of mechanical loading over time during rat Achilles tendon healing time, but was larger in the loaded group compared to the unloaded group at 1 and 2 weeks post-injury (Fig 4B)
In this study we investigated how two different magnitudes of daily loading affect the biomechanical and collagen properties of healing rat Achilles tendons over time
Summary
Tendons are soft connective tissues responsible for load transmission with an energy-storing capacity that enables efficient locomotion. Tendons recover poorly after injury, where the scar tissue that is formed has inferior biomechanical function. Tendons derive from mesenchymal stem cells and are mechanosensitive, meaning that tendons are affected by biophysical stimuli similar to other musculoskeletal tissues. How biophysical stimuli affects tendon healing is poorly understood, and this leaves many clinical treatments debated. The Achilles tendon is the largest and the most commonly injured tendon in the body. Clinical reviews have shown that only 50% of patients with Achilles tendon ruptures regain
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