Abstract
ABSTRACTObjective:To assess the histopathologic and biomechanical effects of hyaluronic acid (HA) and high-dose vitamin C (VC) on rat Achilles tendon healing. Methods:Forty-eight Sprague-Dawley rats were randomized to HA and VC and control groups with equal numbers. Each group was further divided into two subgroups to be sacrificed on Day 15 (n=8) and Day 30 (n=8). The Achilles tendons were cut and repaired. While the control rats remained untreated, HA and VC were administered after repair. The repaired tendons were removed for biomechanical and histopathologic analyses. In the biomechanical tests, the tendons were stretched to failure and maximum forces were measured. For histopathologic examination, the specimens were interpreted semiquantitatively using Movin’s grading scale and Bonar scores. Results:The highest mean forces were obtained in the HA group on Day 15 and in the VC group on Day 30, with a significant difference between HA and VC on Day 15 between control and VC on Day 30 (p<0.05). Histological examination showed both Movin and Bonar scores decreased in all groups on Day 30, with significant improvements in the HA and VC groups (p<0.05). Conclusion:Our results demonstrated that both VC and HA had therapeutic effects on tendon healing, especially in the late phase. Level of Evidence I; High quality randomized trial with statistically significant difference.
Highlights
Achilles tendon rupture is typically seen in men during their thirties and forties who rarely engage in sports and spend most of their time in office work.[1]
Our results demonstrated that both vitamin C (VC) and hyaluronic acid (HA) had therapeutic effects on tendon healing, especially in the late phase
Two study groups were formed to receive hyaluronic acid (HA group: n=16) and high-dose vitamin C (VC group: n=16), and the remaining 16 rats were assigned as the control group
Summary
Achilles tendon rupture is typically seen in men during their thirties and forties who rarely engage in sports and spend most of their time in office work.[1] Researchers have examined many factors to better understand the mechanisms of tendon healing to speed this process. These factors include growth factors, mesenchymal stem cells, cytokines, gene therapy approaches, sodium hyaluronate, platelet concentrates, anticoagulants, and hyperbaric oxygen.[2,3] there is no gold-standard treatment that can improve tendon healing by applying exogenous agents. Hyaluronic acid (HA) is known to have a preventive effect on adhesions, but its effects on tendon biomechanics are not fully known.
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