Adhesion reduction after knee surgery in a rabbit model by Hyaloglide®, a hyaluronan derivative gel

Abstract

A randomized controlled experimental trial was performed in a rabbit model of surgical adhesions to investigate the anti-adhesive effects of Hyaloglide@, a highly viscous hyaluronan derivative absorbable gel after knee surgery. Twenty New Zealand white rabbits were prepared and randomly divided into two groups of 10 animals each. An intra-articular fibro-adhesive scar was created in the right knee joint of the hind paw of each rabbit using a standardized surgical procedure, and Hyaloglide@ was administered into the joint cavity of the knee at the end of intervention in the animals belonging to the treatment group. No anti-adhesive treatment was applied in the control group. Additionally, immobilization using a Kirschner wire was applied in order to increase the risk of adhesions. Six weeks after surgery the animals were euthanized and after removal of the immobilization system, adhesions were evaluated both macroscopically and histologically. Results of gross observations using a specific adhesion scoring system showed a significant reduction (p < 0.01) of both incidence and severity of adhesions in the hyaluronan-treated group compared to the control group. Histologically, adhesions in the treated group were thinner with less collagenic fibers.In conclusion, Hyaloglide@ may be considered as a promising absorbable barrier for prevention of post-operative fibrotic adhesions after knee surgery.

<p>Effects of losartan and atorvastatin on the development of early posttraumatic joint stiffness in a rat model</p>

“…In the existing studies on medical inhibition of the development of joint contracture (Table 2), an improvement of the range of motion could be achieved mostly after intraarticular application of the respective active agents. 16,17,64,[95][96][97][98][99][100][101][102][103][104] Although these results constitute an opportunity for the development of a medical treatment of patients with PTJS, the intraarticular application is unfavorable for a number of reasons: i) it is a painful and invasive procedure for the patient, ii) it bears the risk of septic arthritis, iii) it might damage the articular cartilage by chondrotoxic effects or iv) weaken the capsule and ligaments of the knee. [105][106][107] Based on the rabbit models of PTJS of Hildebrand et al and Nesterenko et al, our group established a rat model of PTJS of the knee joint that included a rupture of the posterior joint capsule, a hemarthrosis, an intraarticular bone damage and a temporary fixation of the joint.…”

Effect of carbodiimide‐derivatized hyaluronic acid gelatin on preventing postsurgical intra‐abdominal adhesion formation and promoting healing in a rat model

“…It is possible that the presence of HA molecules at the wound surface might reduce inflammation and result in less scarring. The structure of HA could limit face to face contact to prevent postoperative adhesions, which has been demonstrated in the knee, rotator cuff, temporomandibular joint, flexor tendons, and abdomen . However, the flow of HA and its derivatives limits their efficacy to prevent adhesion formation.…”

“…In addition, HA can bind to receptors in cells and initiate signal transduction pathways leading to angiogenesis . It was found that HA could reduce adhesions in abdominal or pelvic surgery, knee, rotator cuff, and temporomandibular joint . Films or fluids containing HA have been used for anti‐adhesion .…”

A Comparative Study of the Preventive Effects of Mitomycin C and Chitosan on Intraarticular Adhesion after Knee Surgery in Rabbits

“…Although this intervention confers a satisfactory range of joint extensive motion, it is not uncommon to redevelop adhesion after the treatment due to bleeding and fibrous tissue hyperplasia [4,5]. In this regard, some anti-adhesion materials were used to prevent intraarticular adhesion such as steroid anti-inflammatory drugs, biofilms, etc., which inhibited the scar hyperplasia; however, all these materials were not without limitations and the effects were controversial [6,7]. Mitomycin C(MMC) and chitosan are known to inhibit the proliferation of fibroblast and reduce tissue adhesion.…”