Fibrin biopolymer sealant and aquatic exercise association for calcaneal tendon repair.

Silvia Maria Cardoso Magalhães Hidd,Marcello Magri Amaral,Carla Roberta Tim,Rui Seabra Ferreira,José Figueiredo Silva,Lívia Assis,Antônio Luiz Martins Maia Filho,Benedito Barraviera,Eneas De Freitas Dutra

doi:10.1590/acb360407

Silvia Maria Cardoso Magalhães Hidd, Marcello Magri Amaral + Show 7 more

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https://doi.org/10.1590/acb360407

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Abstract

ABSTRACTPurposeThe aim of this work was to analyze the effect of fibrin biopolymer sealant (FS) associated or not to aquatic exercise (AE) on the calcaneal tendon repair.MethodsForty-four female Wistar rats were randomly divided into four experimental groups: Lesion control (L), Lesion and FS (LS), Lesion and AE (LE) and Lesion and FS associated to AE (LSE). The edema volume (EV), collagen ratio, and histopathological analysis were evaluated after 7, 14, and 21 days of partial tendon transection.ResultsThe EV was statistically reduced for all treatment groups after 7 and 21 days when compared to L group. The LS and LSE had the highest EV reduction after 21 days of treatment. The FS group didn’t induce tissue necrosis or infections on the histopathological analysis. It was observed tenocytes proliferation, granulation tissue and collagen formation in the tendon partial transection area in the FS group. The LSE demonstrated higher amount of granulation tissue and increased the collagen deposition at the injury site.ConclusionsOur data suggests that the therapeutic potential of the association of heterologous fibrin biopolymer sealant with aquatic exercise program should be further explored as it may stimulate the regeneration phase and optimize calcaneal tendon recovery.

Highlights

Tendons are exposed to extreme mechanical demands of the human body because they are responsible for transmitting muscular forces to the skeleton and allowing body movement[1]
The animals were randomly divided in four experimental groups: lesion control (L), heterologous fibrin biopolymer sealant (LS), aquatic exercise (LE), and heterologous fibrin biopolymer sealant associated to aquatic exercises (LSE)
Our findings suggest that both isolated fibrin biopolymer sealant (FS) and aquatic exercise (AE) treatments were effective in preventing tendon degenerative morphological modifications

Summary

Introduction

Tendons are exposed to extreme mechanical demands of the human body because they are responsible for transmitting muscular forces to the skeleton and allowing body movement[1]. The incidence of tendon rupture had increased in the last four decades, more often in males 30 to 50 years old[2]. The calcaneal tendon is the most commonly affected, with an annual incidence of 40 per 100,000 person-years[3]. The ruptured tendon can be treated with surgical and nonsurgical therapies, there is no consensus regarding the optimal treatment protocol. Non-operative treatment is associated with a higher risk of future tendon disruption[5,6,7]. Orthopedic surgeons have applied the invasive surgical repair for acute calcaneal tendon rupture[8,9]. This procedure may result in devastating surgery-specific complications, such as infection or sural nerve injury. Several strategies have been studied to obtain a minimally invasive approach and to minimize the surgical risks[10,11,12]

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