Abstract
Background and AimPosttraumatic peritendinous adhesion is the greatest obstacle to achieve normal tendon function following lacerations of extrinsic flexor tendons of the hand. In this study, we aimed to evaluate whether single-dose radiotherapy (RT) has the potential to modulate intrasynovial tendon adhesions.Materials and MethodsA total of 80 tendons from the third to fourth flexor profundus of both hind paws of 20 adult New Zealand rabbits were used in this study. Rabbits in the RT group received 3 Gy of X-irradiation in a single fraction. Histopathological evaluation of longitudinal sections of tendons was made using the Tang grading system for peritendinous adhesions. Intratendinous quality of the healing tissue in the laceration zone was assessed using a modified Movin scale.ResultsAdhesion and inflammatory response were greater in the RT group (p˂0.001). Tendon healing in the radiation group was found to be more uniform and organized compared with the control group. However, this difference was not statistically significant. The nuclei of the tenocytes in the radiation group showed a closer resemblance to normal tendon tissue when compared with the control group (p=0.007).ConclusionsDespite RT’s certain advantages such as extracorporeal use, anti-inflammatory effect, and homogenous tissue penetration, 3-Gy X-irradiation resulted in increased peritendinous posttraumatic adhesion, possibly due to dose imbalance. Increased roundness in the tenocyte nuclei was present in the RT group. Studies with different dosing regimens and a higher number of subjects are necessary to establish an ideal dose suppressing the synovial response without compromising tendon healing.
Highlights
Tendons are connective tissue elements that provide joint movement by transmitting muscle contraction to the bones
Despite RT’s certain advantages such as extracorporeal use, anti-inflammatory effect, and homogenous tissue penetration, 3-Gy X-irradiation resulted in increased peritendinous posttraumatic adhesion, possibly due to dose imbalance
Increased roundness in the tenocyte nuclei was present in the RT group
Summary
Tendons are connective tissue elements that provide joint movement by transmitting muscle contraction to the bones. Adhesion between the area of injury and the surrounding tissues following tendon injuries is the greatest undesirable interference to the normal functioning of the tendon. Tendon healing is a multifactorial process with intercellular mediators and dense cell chemotaxis, of which different elements are targeted in order to prevent adhesions at different stages of tendon repair [2]. Early postoperative rehabilitation, use of physical barriers, antiadhesive pharmacological chemicals, agents effective on tendon surface lubrication enhancement, cell cycle, and apoptosis are among the suggested tools for the prevention of postoperative adhesion following the surgical treatment of flexor tendon injuries [3]. The method of action for RT is the prevention of undesirable excess cell and tissue formation in response to different mediators, its efficiency on synovial fibroblasts and the management of. We aimed to evaluate whether single-dose radiotherapy (RT) has the potential to modulate intrasynovial tendon adhesions.
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