| ObjectiveTendon adhesion is one of the most common causes of disability following tendonsurgery. Therefore, prevention of peritendinous adhesion after surgical repair of tendonis a major challenge. With the rat Achilles tendon injury model, the collagen membraneis applied to wrapping injuried tendon during the surgical repair. The role of thecollagen membrane in the tendon strength and healing quality, and preventing tendonadhesion is underinvestigated to explore the feasibility of its clinical application.Methods120Achilles tendons of the60male Sprague-Dawley rats’s (250±18g) hind limbswere cut in surgery and sutured by a modified Kessler’s technique. All the tendons wererandomly divided into control group (G1, with skin incision and soft tissue separationbut no cut in tendons, n=40), surgery group (G2, with tendons incision and simplesutured, n=40), collagen membrane treatment group (G3, with tendons cut, surgicalsuture and collagen membrane wrapped, n=40). The rats were killed and the Achillestendons were harvested at4and8weeks after surgery respectively. Macroscopic,morphological and biomechanical evaluations were applied to evaluated the recovery ofthe injured tendon.ResultsMacroscopical observation showed that the collagen membrane treatment grouphad significantly less tendon adhesion.The results of biomechanical testing showed that: at4weeks after surgery, both theaverage maximum tensions of surgery group and collagen membrane treatment grouptendon were lower than that of the control group (P <0.05), but the one of collagen membrane treatment group was higher than that of the surgery group (P <0.05); at8weeks after surgery, the average maximum tension of collagen membrane treatmentgroup was high than of surgery group (P <0.05), the maximum tension of collagenmembrane treatment group had no significant difference with the one of the controlgroup (P>0.05).HE stain histological observation:4weeks at after surgery, the collagen fiberbundle of the tendon in collagen membrane treatment group was more irregular anddenser, and the alignment was superior to the fibers of the surgery group. Comparedwith that at4weeks after surgery, both the surgery group and collagen membranetreatment group had more mature scars, more intensive collagen matrix, more intensivecollagen matrix, more regularly arranged collagen fiber bundle, and more area of totalcollagen matrix at8weeks after surgery. At8weeks after surgery, and the total area ofcollagen matrix in collagen membrane treatment group was more than that of thesurgery group. Ossification is found in some part of the surgery group at8weeks aftersurgery.The relative expressions of collagen type Ⅰ and collagen type Ⅱ inimmunohistochemical staining were quantified by Image-Pro Plus Version6.0forWindows software. The data showed that at4weeks and8weeks after surgery, theexpressions of collagen type Ⅰ in collagen membrane treatment group weresignificantly stronger than the corresponding surgery group (P <0.05),respectively.Brown staining of collagen type Ⅱ could be observed in the surgery groupat both4and8weeks after surgery, but the more observed at8weeks after surgery.Both at4and8weeks after surgery the expressions of collagen type Ⅱ in collagenmembrane treatment group were weaker than those of the surgery group (P <0.05).ConclusionsWrapping the tendon with a collagen membrane may be an efficient approach fortendon repair and preventing tendon adhesion after its ruptures. |
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