Effects of sodium hyaluronate on tendon healing and adhesion formation in horses.
Abstract: Sodium hyaluronate reduces adhesions after tendon repair in rodents and dogs, and has been used in limited clinical trials in people. To evaluate its effect on tendon healing and adhesion formation in horses and to compare these effects with those of a compound of similar visco-elastic properties, a study was performed in horses, using a model of collagenase injection in the flexor tendons within the digital sheath. Eight clinically normal horses were randomly allotted to 2 groups. Adhesion formation between the deep digital flexor tendon and the tendon sheath at the pastern region was induced in the forelimbs of all horses. Using tenoscopic control, a 20-gauge needle was inserted into the deep digital flexor tendon of horses under general anesthesia and 0.2 ml of collagenase (2.5 mg/ml) was injected. The procedure was repeated proximally at 2 other sites, spaced 1.5 cm apart. A biopsy forceps was introduced, and a 5-mm tendon defect was created at each injection site. Group-A horses had 120 mg of sodium hyaluronate (NaHA) gel injected into the tendon sheath of one limb. Group-B horses had methylcellulose gel injected at the same sites. The contralateral limbs of horses in both groups served as surgical, but noninjected, controls. Horses were euthanatized after 8 weeks of stall rest. Ultrasonographic evaluation revealed improved tendon healing after NaHa injection, but no difference in peritendinous adhesion formation. Tendon sheath fluid volume and hyaluronic acid (HA) content were greater in NaHA-treated limbs. Gross pathologic examination revealed considerably fewer and smaller adhesions when limbs were treated with NaHA. However, significant difference in pull-out strengths was not evident between NaHA-treated and control limbs. Histologically, the deep digital flexor tendon from the NaHA-treated limbs had reduced inflammatory cell infiltration, improved tendon structure, and less intratendinous hemorrhage. Treatment with methylcullulose had no significant effect on tendon healing, adhesion size, quantity, or strength or on the volume and composition of the tendon sheath fluid. Sodium hyaluronate, administered intrathecally, appears to have a pharmaceutically beneficial action in this collagenase-induced tendinitis and adhesion model in horses.
Publication Date: 1991-05-01 PubMed ID: 1854104
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- Journal Article
Summary
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The research investigates the effects of sodium hyaluronate (a compound known to reduce adhesions – abnormal bands of tissue that grow between two surfaces inside the body – in other animal species) on tendon healing and adhesion formation in horses. The findings suggest that sodium hyaluronate improves tendon healing and reduces adhesion formation in horses, showing promise for potential therapeutic use.
Study Methodology
- Eight clinically normal horses were picked for the study and divided randomly into two groups.
- Adhesion formation was induced in the forelimbs of all horses using collagenase injections.
- Group A received an injection of sodium hyaluronate gel into the affected tendon sheath and Group B received methylcellulose gel (a compound of similar visco-elastic properties used for comparison).
- The contralateral limbs (the opposite limbs) of the horses were used as surgical controls but were not injected.
- After eight weeks of stall rest, the horses were euthanatized, and ultrasonographic evaluations, as well as pathologic examinations, were conducted to evaluate the impact of the treatment.
Key Findings
- Sodium hyaluronate treatment resulted in improved tendon healing and fewer adhesion formations in comparison to controls.
- Hydrologic evaluation revealed both the volume and hyaluronic acid content were greater in limbs treated with sodium hyaluronate.
- Pathologic examinations showed considerably fewer and smaller adhesions in the sodium hyaluronate treated limbs.
- However, no significant difference was observed in the pull-out strengths (force required to pull something) between the sodium hyaluronate treated limbs and control limbs.
- Microscopic analysis of the tendons from the sodium hyaluronate treated limbs revealed less inflammation, better tendon structure, and reduced hemorrhage inside the tendon.
- Contrarily, treatment with methylcellulose showed no significant effect on tendon healing or adhesion size or strength.
Implications
- The research suggests that sodium hyaluronate may have therapeutic benefits in treating collagenase-induced tendinitis and adhesion formation in horses.
- These findings hold considerable potential for future research involving sodium hyaluronate as a pharmaceutical treatment for injuries in horses.
- Although more studies are required to verify and extend these findings, the initial outcomes indicate sodium hyaluronate could be an effective treatment option without significant side effects.
Cite This Article
APA
Gaughan EM, Nixon AJ, Krook LP, Yeager AE, Mann KA, Mohammed H, Bartel DL.
(1991).
Effects of sodium hyaluronate on tendon healing and adhesion formation in horses.
Am J Vet Res, 52(5), 764-773.
Publication
Researcher Affiliations
- Department of Clinical Sciences, New York State College of Veterinary Medicine, NY.
MeSH Terms
- Animals
- Horse Diseases / drug therapy
- Horse Diseases / prevention & control
- Horses
- Hyaluronic Acid / pharmacology
- Hyaluronic Acid / therapeutic use
- Muscular Diseases / prevention & control
- Muscular Diseases / veterinary
- Random Allocation
- Synovial Membrane / pathology
- Tendon Injuries / complications
- Tendon Injuries / drug therapy
- Tendon Injuries / veterinary
- Tendons / diagnostic imaging
- Tendons / pathology
- Tissue Adhesions / prevention & control
- Tissue Adhesions / veterinary
- Ultrasonography
- Wound Healing / drug effects
Citations
This article has been cited 15 times.- Oda H, Kaizawa Y, Franklin A, Sanchez Rangel U, Storaci H, Min JG, Wang Z, Abrams GD, Chang J, Fox PM. Assessment of a Synergistic Effect of Platelet-Rich Plasma and Stem Cell-Seeded Hydrogel for Healing of Rat Chronic Rotator Cuff Injuries.. Cell Transplant 2023 Jan-Dec;32:9636897231190174.
- Wang L, Liu Q, Hao R, Xiong J, Li J, Guo Y, He L, Tu Z. Characterization of a Hyaluronidase-Producing Bacillus sp. CQMU-D Isolated from Soil.. Curr Microbiol 2022 Sep 25;79(11):328.
- Zinger G, Bregman A, Safran O, Beyth S, Peyser A. Hyaluronic acid injections for chronic tennis elbow.. BMC Sports Sci Med Rehabil 2022 Jan 12;14(1):8.
- Ahn KH, Park ES, Choi CY, Cha HG, Hwang Y, Nam SM. Hyaluronic Acid Treatment Improves Healing of the Tenorrhaphy Site by Suppressing Adhesions through Extracellular Matrix Remodeling in a Rat Model.. Polymers (Basel) 2021 Mar 17;13(6).
- Li X, Chen S, Yan L, Wang J, Pei M. Prospective application of stem cells to prevent post-operative skeletal fibrosis.. J Orthop Res 2019 Jun;37(6):1236-1245.
- Dincel YM, Adanir O, Arikan Y, Caglar AK, Dogru SC, Arslan YZ. EFFECTS OF HIGH-DOSE VITAMIN C AND HYALURONIC ACID ON TENDON HEALING.. Acta Ortop Bras 2018 Mar-Apr;26(2):82-85.
- Farah Z, Fan H, Liu Z, He JQ. A concise review of common animal models for the study of limb regeneration.. Organogenesis 2016 Jul 2;12(3):109-118.
- Ji X, Reisdorf RL, Thoreson AR, Berglund LR, Moran SL, Jay GD, An KN, Amadio PC, Zhao C. Surface Modification with Chemically Modified Synovial Fluid for Flexor Tendon Reconstruction in a Canine Model in Vivo.. J Bone Joint Surg Am 2015 Jun 17;97(12):972-8.
- Amadio PC. Gliding resistance and modifications of gliding surface of tendon: clinical perspectives.. Hand Clin 2013 May;29(2):159-66.
- Ozgen M, Fırat S, Sarsan A, Topuz O, Ardıç F, Baydemir C. Short- and long-term results of clinical effectiveness of sodium hyaluronate injection in supraspinatus tendinitis.. Rheumatol Int 2012 Jan;32(1):137-44.
- Crockett RJ, Centrella M, McCarthy TL, Grant Thomson J. Effects of cyclic strain on rat tail tenocytes.. Mol Biol Rep 2010 Jul;37(6):2629-34.
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- Halici M, Karaoglu S, Canoz O, Kabak S, Baktir A. Sodium hyaluronate regulating angiogenesis during Achilles tendon healing.. Knee Surg Sports Traumatol Arthrosc 2004 Nov;12(6):562-7.
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