The effect of surgery on patellar tendinopathy: Novel use of MRI questions the exploitability of the rat collagenase model to humans

Abstract

Backgroundpatellar tendinopathy is an overuse condition most commonly affecting jumping athletes. Surgery is reserved for refractory cases; however, it lacks high level clinical evidence and basic science to support its use. The purpose of this study was to determine the biomechanical and histological response of surgical excision on patellar tendinopathy in the rat collagenase tendinopathy model and correlate MRI findings. MethodsForty-eight Long Evans rats were divided into three groups: i) no patellar tendinopathy with surgical excision, ii) patella tendinopathy with surgical excision, and iii) patellar tendinopathy with no surgical excision. Endpoints included histology, mechanical testing, and MRI pre- and post-surgical intervention at one and four weeks. ResultsNo difference in failure load or histological grading was seen between the groups at all time points. MRIs showed initial loss of tendon continuity followed by complete healing with elongated and thickened tendons in all groups. ConclusionsWhile other research has reported immunohistochemistry and histology of collagenase-induced tendinopathy may be correlated with human pathogenesis, the novel MRI findings from our study suggest that the rat collagenase tendinopathy surgical model may be limited when extrapolating to humans. Further work is needed to determine if any correlation exists between the dosing, location, and animal effect of the collagenase injection model with MRI findings. This is needed before any collagenase model can be used to determine the effect of surgery in the pathogenic response to patella tendinopathy.