The American Journal of Sports Medicine · 1999 · 225 citations · 35 references
MedicineOrthopaedic SurgerySurgeryEnhanced Recovery After SurgeryInflammationWound HealingAchilles TendinopathyGrowth Factor TherapySurgical Wound HealingTendon RepairWound Healing ResponseAchilles Tendon FunctionAchilles Tendon PathophysiologyAchilles Tendon SurgeryCarrageenanFunctional Recovery MetricsGrowth Factors In RepairInsulin-like Growth Factor-1Sham Treatment
We studied the effects of insulin-like growth factor I on Achilles tendon healing in a rat model. Rats were randomized into groups of six each: sham surgery, transection alone, and transection plus growth factor. Postoperatively, rats treated with growth factor had a significantly smaller maximum functional deficit and a decreased time to functional recovery than rats in the untreated groups. Biomechanical testing revealed no significant differences in the measured parameters between the treated and the untreated groups after transection. To study the mechanism of action, six additional animals received an Achilles tendon injection of the inflammatory agent carrageenan alone and six received carrageenan plus growth factor. Rats treated with growth factor did not show the inflammation-induced functional deficit experienced by the control rats. Spectrometric myeloperoxidase assays on the remaining eight rats after Achilles tendon transection demonstrated no significant difference between the untreated and the growth factor-treated groups, indicating a mechanism other than neutrophil recruitment by which the growth factor limits inflammation. Histologic studies were performed on carrageenan-injected rats at postinjection day 2 and on surgically treated rats at postoperative day 15. No gross histologic differences were seen between untreated and growth factor-treated groups. This study demonstrated that via a possible antiinflammatory mechanism, insulin-like growth factor I reduces maximum functional deficit and accelerates recovery after Achilles tendon injury.
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Cell-Matrix Response in Tendon Injury
Wayne B. Leadbetter · Clinics in Sports Medicine · 1992 · 599 citations
William E. Garrett · Medicine & Science in Sports & Exercise · 1990 · 465 citations
Martina Kirstein, Christopher E. Aston, Raymond L. Hintz et al. · Journal of Clinical Investigation · 1992 · 268 citations · Full text