Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.

BACKGROUND:Mechanical loading stimulates Achilles tendon healing. However, various degrees of loading appear to have different effects on the mechanical properties of the healing tendon, and strong loading might create microdamage in the tissue. This suggests that different mechanisms might be activ...

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Main Authors: Malin Hammerman, Franciele Dietrich-Zagonel, Parmis Blomgran, Pernilla Eliasson, Per Aspenberg
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2018-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC6059492?pdf=render
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author Malin Hammerman
Franciele Dietrich-Zagonel
Parmis Blomgran
Pernilla Eliasson
Per Aspenberg
author_facet Malin Hammerman
Franciele Dietrich-Zagonel
Parmis Blomgran
Pernilla Eliasson
Per Aspenberg
author_sort Malin Hammerman
collection DOAJ
description BACKGROUND:Mechanical loading stimulates Achilles tendon healing. However, various degrees of loading appear to have different effects on the mechanical properties of the healing tendon, and strong loading might create microdamage in the tissue. This suggests that different mechanisms might be activated depending on the magnitude of loading. The aim of this study was to investigate these mechanisms further. METHODS:Female rats had their right Achilles tendon cut transversely and divided into three groups: 1) unloading (calf muscle paralysis by Botox injections, combined with joint fixation by a steel-orthosis), 2) mild loading (Botox only), 3) strong loading (free cage activity). Gene expression was analyzed by PCR, 5 days post-injury, and mechanical testing 8 days post-injury. The occurrence of microdamage was analyzed 3, 5, or 14 days post-injury, by measuring leakage of injected fluorescence-labelled albumin in the healing tendon tissue. RESULTS:Peak force, peak stress, and elastic modulus of the healing tendons gradually improved with increased loading as well as the expression of extracellular matrix genes. In contrast, only strong loading increased transverse area and affected inflammation genes. Strong loading led to higher fluorescence (as a sign of microdamage) compared to mild loading at 3 and 5 days post-injury, but not at 14 days. DISCUSSION:Our results show that strong loading improves both the quality and quantity of the healing tendon, while mild loading only improves the quality. Strong loading also induces microdamage and alters the inflammatory response. This suggests that mild loading exert its effect via mechanotransduction mechanisms, while strong loading exert its effect both via mechanotransduction and the creation of microdamage. CONCLUSION:In conclusion, mild loading is enough to increase the quality of the healing tendon without inducing microdamage and alter the inflammation in the tissue. This supports the general conception that early mobilization of a ruptured tendon in patients is advantageous.
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spelling doaj.art-ed844f08504546399bc1e13787a42b282022-12-22T03:30:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01137e020121110.1371/journal.pone.0201211Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.Malin HammermanFranciele Dietrich-ZagonelParmis BlomgranPernilla EliassonPer AspenbergBACKGROUND:Mechanical loading stimulates Achilles tendon healing. However, various degrees of loading appear to have different effects on the mechanical properties of the healing tendon, and strong loading might create microdamage in the tissue. This suggests that different mechanisms might be activated depending on the magnitude of loading. The aim of this study was to investigate these mechanisms further. METHODS:Female rats had their right Achilles tendon cut transversely and divided into three groups: 1) unloading (calf muscle paralysis by Botox injections, combined with joint fixation by a steel-orthosis), 2) mild loading (Botox only), 3) strong loading (free cage activity). Gene expression was analyzed by PCR, 5 days post-injury, and mechanical testing 8 days post-injury. The occurrence of microdamage was analyzed 3, 5, or 14 days post-injury, by measuring leakage of injected fluorescence-labelled albumin in the healing tendon tissue. RESULTS:Peak force, peak stress, and elastic modulus of the healing tendons gradually improved with increased loading as well as the expression of extracellular matrix genes. In contrast, only strong loading increased transverse area and affected inflammation genes. Strong loading led to higher fluorescence (as a sign of microdamage) compared to mild loading at 3 and 5 days post-injury, but not at 14 days. DISCUSSION:Our results show that strong loading improves both the quality and quantity of the healing tendon, while mild loading only improves the quality. Strong loading also induces microdamage and alters the inflammatory response. This suggests that mild loading exert its effect via mechanotransduction mechanisms, while strong loading exert its effect both via mechanotransduction and the creation of microdamage. CONCLUSION:In conclusion, mild loading is enough to increase the quality of the healing tendon without inducing microdamage and alter the inflammation in the tissue. This supports the general conception that early mobilization of a ruptured tendon in patients is advantageous.http://europepmc.org/articles/PMC6059492?pdf=render
spellingShingle Malin Hammerman
Franciele Dietrich-Zagonel
Parmis Blomgran
Pernilla Eliasson
Per Aspenberg
Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.
PLoS ONE
title Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.
title_full Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.
title_fullStr Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.
title_full_unstemmed Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.
title_short Different mechanisms activated by mild versus strong loading in rat Achilles tendon healing.
title_sort different mechanisms activated by mild versus strong loading in rat achilles tendon healing
url http://europepmc.org/articles/PMC6059492?pdf=render
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