Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears

Category: Basic Sciences/Biologics; Sports Introduction/Purpose: There is growing interest in nonoperative treatment for the management of Achilles tendon ruptures (ATRs). However, nonoperative treatment is limited by the risk of tendon reruptures and low satisfaction rates. Recently, atelocollagen...

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Main Authors: Jaehwang Song MD, PhD, Chan Kang MD, PhD, Seongkyeong Jo MS
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011424S00132
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author Jaehwang Song MD, PhD
Chan Kang MD, PhD
Seongkyeong Jo MS
author_facet Jaehwang Song MD, PhD
Chan Kang MD, PhD
Seongkyeong Jo MS
author_sort Jaehwang Song MD, PhD
collection DOAJ
description Category: Basic Sciences/Biologics; Sports Introduction/Purpose: There is growing interest in nonoperative treatment for the management of Achilles tendon ruptures (ATRs). However, nonoperative treatment is limited by the risk of tendon reruptures and low satisfaction rates. Recently, atelocollagen injections have been reported to have beneficial effects on tendon healing. The purpose of this study is to evaluate the beneficial effects of injected atelocollagen on Achilles tendon healing and investigate the mechanism of atelocollagen on tendon healing. Methods: Percutaneous tenotomy of the right Achilles tendon in 66 rats was performed. The animals were equally divided into the noninjection group (NG) and the collagen injection group (CG). At 1, 3, and 6 weeks, the Achilles functional index (AFI), cross-sectional area, load to failure, stiffness, stress, and the modified Bonar score were assessed. Transmission electron microscopy (TEM), western blotting, and immunohistochemistry were also performed. Results: The AFI (–6.8 vs 243.0, respectively; P = .040), load to failure (42.1 vs 27.0 N, respectively; P = .049), and stiffness (18.8 vs 10.3 N/mm, respectively; P = .049) were higher in the CG than those in NG at 3 weeks. There were no significant differences in histological scores. TEM analysis showed that the mean diameter of collagen fibrils in the CG was greater than that in the NG at 3 weeks (117.2 vs 72.6 nm, respectively; P < .001) and 6 weeks (202.1 vs 144.0 nm, respectively; P < .001). Western blot analysis showed that the expression of collagen type I in the CG was higher than that in the NG at 1 week (P = .005) and 6 weeks (P = .001). Conclusion: An atelocollagen injection had beneficial effects on the healing of nonoperatively treated Achilles tendon injuries. The Achilles tendon of CG rats exhibited better functional, biomechanical, and morphological outcomes compared with NG rats. The molecular data indicated that the mechanism of atelocollagen injections may be associated with an increased amount of collagen type I. The scheme and the outcomes of the present study 1. The flowchart of the experiment groups and surgical procedures involved in this study. 2. Functional analysis. 3. Biomechanical testing. 4. Histological analysis. 5. Transmission electron microscopy (TEM) analysis. 6. Western blot analysis.
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spelling doaj-art-41d500e2875b4ad1a91d25bf5fb398662024-12-20T08:04:30ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-12-01910.1177/2473011424S00132Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon TearsJaehwang Song MD, PhDChan Kang MD, PhDSeongkyeong Jo MSCategory: Basic Sciences/Biologics; Sports Introduction/Purpose: There is growing interest in nonoperative treatment for the management of Achilles tendon ruptures (ATRs). However, nonoperative treatment is limited by the risk of tendon reruptures and low satisfaction rates. Recently, atelocollagen injections have been reported to have beneficial effects on tendon healing. The purpose of this study is to evaluate the beneficial effects of injected atelocollagen on Achilles tendon healing and investigate the mechanism of atelocollagen on tendon healing. Methods: Percutaneous tenotomy of the right Achilles tendon in 66 rats was performed. The animals were equally divided into the noninjection group (NG) and the collagen injection group (CG). At 1, 3, and 6 weeks, the Achilles functional index (AFI), cross-sectional area, load to failure, stiffness, stress, and the modified Bonar score were assessed. Transmission electron microscopy (TEM), western blotting, and immunohistochemistry were also performed. Results: The AFI (–6.8 vs 243.0, respectively; P = .040), load to failure (42.1 vs 27.0 N, respectively; P = .049), and stiffness (18.8 vs 10.3 N/mm, respectively; P = .049) were higher in the CG than those in NG at 3 weeks. There were no significant differences in histological scores. TEM analysis showed that the mean diameter of collagen fibrils in the CG was greater than that in the NG at 3 weeks (117.2 vs 72.6 nm, respectively; P < .001) and 6 weeks (202.1 vs 144.0 nm, respectively; P < .001). Western blot analysis showed that the expression of collagen type I in the CG was higher than that in the NG at 1 week (P = .005) and 6 weeks (P = .001). Conclusion: An atelocollagen injection had beneficial effects on the healing of nonoperatively treated Achilles tendon injuries. The Achilles tendon of CG rats exhibited better functional, biomechanical, and morphological outcomes compared with NG rats. The molecular data indicated that the mechanism of atelocollagen injections may be associated with an increased amount of collagen type I. The scheme and the outcomes of the present study 1. The flowchart of the experiment groups and surgical procedures involved in this study. 2. Functional analysis. 3. Biomechanical testing. 4. Histological analysis. 5. Transmission electron microscopy (TEM) analysis. 6. Western blot analysis.https://doi.org/10.1177/2473011424S00132
spellingShingle Jaehwang Song MD, PhD
Chan Kang MD, PhD
Seongkyeong Jo MS
Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears
Foot & Ankle Orthopaedics
title Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears
title_full Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears
title_fullStr Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears
title_full_unstemmed Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears
title_short Atelocollagen Injection Enhances the Healing of Nonoperatively Treated Achilles Tendon Tears
title_sort atelocollagen injection enhances the healing of nonoperatively treated achilles tendon tears
url https://doi.org/10.1177/2473011424S00132
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AT seongkyeongjoms atelocollageninjectionenhancesthehealingofnonoperativelytreatedachillestendontears