Adipose-derived stem cells enhance primary tendon repair: Biomechanical and immunohistochemical evaluation

Background: Primary tendon repair aims at increased tensile strength at the time of mobilisation. Tendon repair and regeneration using mesenchymal stem cells have been described in different studies; however, adipose-derived stem cell (ASC) use for tendon regeneration and repair has recently been taken into consideration. In this study, we sought to determine whether ASCs would be beneficial in primary tendon healing. Materials and methods: Both the Achilles tendons of rabbits (n = 6) were incised and consequently repaired. To the left side was applied platelet-rich plasma (PRP) gel and to the right side autologous ASC-mixed PRP. The tensile strength was measured on the 4th week. The samples were taken for immunohistochemical evaluation of collagen type I, transforming growth factor beta (TGF-beta) 1, 2, 3, fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF). Results: The tensile strengths in control and experimental groups were found out to be 29.46 +/- 3.66 and 43.06 +/- 3.80 kgf. Collagen type I, FGF and VEGF levels were statistically higher, whereas TGF-beta 1, 2, 3 were lower in the experimental group. Conclusion: ASCs enhance primary tendon healing; however, the complex interaction and the cascades by which ASCs could increase collagen type I, FGF and VEGF and decrease TGF-beta levels should further be investigated. (c) 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.