The effect of erythropoietin on biomechanical properties of the Achilles tendon during the healing process: an experimental study

Abstract

BackgroundThe aim of this study was to examine the potential biomechanical and histological benefits of systemic erythropoietin administration during the healing of Achilles tendon injury in a rat experimental model.MethodsEighty Sprague-Dawley female rats were included in this study. Animals were randomly assigned into two groups with 40 animals in each: erythropoietin group and control group. Then each group was further divided into four subgroups corresponding to four time points with 10 animals in each. A full-thickness cut was made on the Achilles tendon of each animal and then the tendon was sutured with modified Kessler method. Erythropoietin groups received intraperitoneal erythropoietin (500 IU/kg/day) every day at same time throughout the study period, and the control groups received saline in a similar manner. Animals were sacrificed at four time points, and tensile test was performed on each tendon sample to assess maximum load for each sample. In addition, histopathological examination and scoring was done.ResultsBoth groups had improvement on tensile test (maximum load) over time. However, groups did not differ with regard to maximum load in any of the time points. Similarly, groups did not differ with regard to any of the histopathological scores over time.ConclusionsThe findings of this study do not support the benefit of systemic erythropoietin administration in Achilles tendon healing process. Further evidence from larger experimental studies is required to justify any such potential benefit.Electronic supplementary materialThe online version of this article (doi:10.1186/s13018-016-0390-1) contains supplementary material, which is available to authorized users.

The effect of erythropoietin on rat rotator cuff repair model: An experimental study

“…Journal of Orthopaedic Surgery 27 (2) et al on the effects of EPO on the Achilles tendon investigated at 3 weeks, the EPO-treated group showed worse results than did the control group when vascular formation was examined. 18 This result is inconsistent with our findings. The reason for this conflict may be related to their design, because they observed that the control group also showed a decrease in vascular formation over time, but it was not statistically significant.…”

“…In an Achilles tendon repair model, Bilal et al found no effect on tendon healing with systemic EPO (500 U/kg) administration either histopathologically or biomechanically. 18 In our study, we found better results biomechanically in the early systemic group (10th day), and histopathologically, we found better results in the late systemic and the late local groups compared to the late control group (28th day). This result could be related to the differences between the rotator cuff and Achilles tendon structures.…”

“…One study showed a positive effect of EPO on patellar tendon healing, 17 and another study showed the ineffectiveness of EPO on Achilles tendon healing. 18 Angiogenesis is necessary for repairing damaged tissue, and it is mainly provided by hypoxic stimulation and proangiogenic factors such as EPO. 13,18 The purpose of this study was to investigate the role of systemic and local EPO administration on the healing of an experimental RCR assessed both biomechanically and histopathologically.…”

“…18 Angiogenesis is necessary for repairing damaged tissue, and it is mainly provided by hypoxic stimulation and proangiogenic factors such as EPO. 13,18 The purpose of this study was to investigate the role of systemic and local EPO administration on the healing of an experimental RCR assessed both biomechanically and histopathologically. We hypothesized that the administration of EPO would have a positive effect on rotator cuff healing.…”

Revisión normativa y conceptual relacionada con la incapacidad medicolegal en Colombia

“…En otro estudio, al comparar dos técnicas de intervención: el uso de tornillos absorbibles versus tornillos metálicos para lesiones por sindesmosis tibioperoneales distal, resultó similar en cuanto a tiempos de reparación, a diferencia de las reacciones de cuerpo extraño y las reoperaciones [44]. Existen estudios que demuestran la disminución de los tiempos de reparación de las heridas con la aplicación de eritropoyetina, pero con la cual no se ha demostrado eficacia en lesiones tendinosas [45]. Y en otros casos, el uso de productos sanguíneos autólogos, como los geles de concentrados plaquetarios autólogos, sirven para disminuir el tiempo de reparación de las lesiones osteocondrales, musculares, tendinosas y ligamentarios, pero sin efecto en grandes articulaciones [46].…”