Impact of combinatory growth factor application on rabbit Achilles tendon injury with operative versus conservative treatment: A pilot study

Abstract

Abstract. Acute Achilles tendon (AT) rupture is a common injury with a comparatively high complication rate. Presently, surgical treatments compete with nonoperative treatment modalities. The aim of this study was to elucidate the possible beneficial effects of short-term combinatory application of growth factors on tendon healing during operative or conservative treatment. In this controlled laboratory study, the left ATs of 40 adult New Zealand White rabbits were transected and either sutured or treated conservatively. Half of the animals from each treatment modality group repetitively received a mixture of VEGF165, bFGF, and rPDGF which was administered peritendineally. The left legs were immobilized with external fixateurs for 6 weeks. The ATs were harvested 3 months after intervention. Tensile strength tests revealed no significant differences between operative and conservative treatments. Compared to the normal right ATs, 60% of the average breaking strength was reached 3 months after surgery. Growth factor application did not result in significant improvements. Only a tendency towards higher blood vessel densities was noted in the groups treated with the factors. Collagen type I/III ratios also displayed no significant differences. This study indicates that there is no difference in the biomechanical outcome of conservative versus operative AT rupture treatment and only a marginal impact of short-term combinatory growth and angiogenesis factor application.

Structural and Biomechanical Characteristics After Early Mobilization in an Achilles Tendon Rupture Model: Operative Versus Nonoperative Treatment

“…24 The second important finding of the current study is that conservative treatment of dissected Achilles tendons led to increased length and decreased diameter at the defect site. This finding is supported by a study by Konerding et al, 29 who showed that sutured Achilles tendons were shorter and thicker in appearance, whereas the nonsutured tendons appeared elongated and more slender. Furthermore, nearly identical maximum tensile strengths (median, 245 vs 253.4 N) were reported 3 months after tenotomy in operatively and nonoperatively treated animals.…”

The Effect of Autologous Platelet Rich Plasma in the Treatment of Achilles Tendon Ruptures: An Experimental Study on Rabbits

“…Zhang et al (17) reported the promising effect of vascular endothelial growth factor on rat Achilles tendon repair. Despite these positive findings, Konerding et al (2) studied the effect of short-term application of a combination of growth factors on tendon healing in cases of conservative and operative treatment, and reported that the use of growth factor did not result in a significant biomechanical or histological improvement in collagen type ratios.…”

Improved tendon healing using bFGF, BMP-12 and TGFβ1 in a rat model

“…Improved Achilles tendon healing is reported using bFGF together with VEGF in a rabbit model where both GFs are coated onto a stabilising mineral nanostructure (Yu et al, 2017). However, in a larger study using 40 rabbits, repeated treatment with VEGF, bFGF and rPDGF (day of surgery and day 3, 5 and 7) does not improve healing under conservative or operative conditions (Konerding et al, 2010).…”