Dynamic exacerbation in inflammation and oxidative stress during the formation of peritendinous adhesion resulted from acute tendon injury

Background Peritendinous adhesion is among the common complications after tendon injury. Numerous studies have been carried out to prevent its formation, including modifications of surgical procedures, postoperative cares, application of medicines, etc. This study dynamically monitored fluctuations of inflammation, state of oxidative stress, and histopathologic changes around injured tendon to provide theoretical basis for further exploration in mechanisms of peritendinous adhesion formation. Methods Eighteen mature Sprague-Dawley male rats were randomly allocated into 6 equal groups. Compared with control and sham group, every rat's right hind Achilles tendon in experimental groups was cut and repaired by the modified Kessler technique. Besides control and sham group, samples of tendon margin and serum were collected at different time points after the surgery. Content of TNF-alpha, IL-1 beta, and TGF-beta were assayed in harvested serum. Reactive oxygen species (ROS) were detected, expression levels of related genes (IL-1 beta, IL-6, SOD1, SOD2, COL1, HIF1A) were quantified by qPCR, and various histopathological evaluations were performed. Results Indicators (TNF-alpha, IL-1 beta, TGF-beta 1, ROS) were noticed to have a similar trend of significant rising 24 h after the surgery except TGF-beta which was rising 72 h later. So were the expression trends of IL-1 beta, IL-6, SOD1, SOD2, and COL1. HIF1A, inversely correlated with SOD2, showed the progressive relief of regional tissue hypoxia. Histological evaluation showed the same tendency that fibrosis and inflammation were getting serious 48 h later after the surgery. Conclusions Inflammation, oxidative stress in injured tendon resulted from acute trauma, would be getting intense in 24 h. Peritendinous adhesion emerges and aggravates after 48 h. Thus, prompt efficient measures are advised to be taken after the injury as soon as possible.

Automated summary

The study found that various indicators, such as inflammatory factors and oxidative stress, significantly increased 24 hours after tendon injury, while fibrosis and inflammation around the tendon began to worsen 48 hours after surgery. Prompt and effective measures should be taken as soon as possible after tendon injury.