Effects of High-Dose Vitamin C and Hyaluronic Acid on Tendon Healing

Abstract

Objective:To assess the histopathologic and biomechanical effects of hyaluronic acid (HA) and high-dose vitamin C (VC) on rat Achilles tendon healing. Methods:Forty-eight Sprague-Dawley rats were randomized to HA and VC and control groups with equal numbers. Each group was further divided into two subgroups to be sacrificed on Day 15 (n=8) and Day 30 (n=8). The Achilles tendons were cut and repaired. While the control rats remained untreated, HA and VC were administered after repair. The repaired tendons were removed for biomechanical and histopathologic analyses. In the biomechanical tests, the tendons were stretched to failure and maximum forces were measured. For histopathologic examination, the specimens were interpreted semiquantitatively using Movin’s grading scale and Bonar scores. Results:The highest mean forces were obtained in the HA group on Day 15 and in the VC group on Day 30, with a significant difference between HA and VC on Day 15 between control and VC on Day 30 (p<0.05). Histological examination showed both Movin and Bonar scores decreased in all groups on Day 30, with significant improvements in the HA and VC groups (p<0.05). Conclusion:Our results demonstrated that both VC and HA had therapeutic effects on tendon healing, especially in the late phase. Level of Evidence I; High quality randomized trial with statistically significant difference.

Heterotopia Glial Nasal: Relato De Caso

“…Ele atua como cofator na síntese de colágeno em enzimas envolvidas na cicatrização, a lisil-oxidase é a mais notável, na qual catalisa a formação de ligações cruzadas covalentes pela formação de grupo aldeído nas moléculas de colágeno, além da função antioxidante (AGREN et al, 1990;OLIVEIRA et al, 2017). (OLIVEIRA et al, 2017) , em que ocorre em duas enzimas principais de formação do mesmo, a lisil e a prolil hidroxilases, cujos modos de ação é a catalisação dos resíduos de prolil e lisil por hidroxilação nos peptídeos de colágeno e com isso permitirá a estabilização e a biossíntese de colágeno de tripla hélice (MONTEIRO et al, 2014;DINCEL et al, 2018).…”

Vitamin C in orthopedic practices: Current concepts, novel ideas, and future perspectives

“…43,44 Vitamin C potentiates tendon healing by increasing the collagen fibril diameter and the number of fibroblasts at the injured site, as well as by promoting local angiogenesis. 4 In addition, vitamin C has been shown to reduce peritendinous adhesions in an animal model. 45 Animal studies have investigated the effect of vitamin C on healing of the Achilles tendon (AT).…”

“…43,44 A study by Omerğlu et al 43 tested the effect of high-dose vitamin C supplementation on AT healing in rats, and they found that vitamin C accelerated tendon healing. A study by Dincel et al 4 sought to determine the effect of high-dose vitamin C or hyaluronic acid (HA) on AT healing in rats, and they discovered that both vitamin C and HA, in isolation but more so in combination, led to higher tendon tensile strength measurements when compared to the control. 4 In 2019, Souza et al 44 reported that vitamin C led to faster AT tissue organization, better organization of the collagen network, and improved ultimate tendon functionality compared to the control in rats.…”

“…A study by Dincel et al 4 sought to determine the effect of high-dose vitamin C or hyaluronic acid (HA) on AT healing in rats, and they discovered that both vitamin C and HA, in isolation but more so in combination, led to higher tendon tensile strength measurements when compared to the control. 4 In 2019, Souza et al 44 reported that vitamin C led to faster AT tissue organization, better organization of the collagen network, and improved ultimate tendon functionality compared to the control in rats. Although the beneficial effect of vitamin C on AT healing is generally supported by rat laboratory studies, randomized studies must be conducted on humans before vitamin C can be considered a legitimate nutritional intervention for patients following AT injury.…”

“…Vitamin C (ascorbic acid), is an important antioxidant and deficiency of this mineral is most often associated with scurvy 1 . Vitamin C is vital to the production of collagen in both bone and connective tissue and it has been associated with improved collagen synthesis and subsequent tendon healing 2–4 . It also neutralizes free radicals, which helps to decrease oxidative stress and inflammation 5…”