Effects of sodium hyaluronate on tendon healing and adhesion formation in horses

Earl M. Gaughan From the Departments of Clinical Sciences (Gaughan, Nixon, Yeager, Mohammed) and Pathology (Krook), New York State College of Veterinary Medicine, and the Sibley School of Mechanical and Aerospace Engineering (Mann, Bartel), Cornell University, Ithaca, NY 14853.

Search for other papers by Earl M. Gaughan in
Current site
Google Scholar
PubMed
Close
 DVM
,
Alan J. Nixon From the Departments of Clinical Sciences (Gaughan, Nixon, Yeager, Mohammed) and Pathology (Krook), New York State College of Veterinary Medicine, and the Sibley School of Mechanical and Aerospace Engineering (Mann, Bartel), Cornell University, Ithaca, NY 14853.

Search for other papers by Alan J. Nixon in
Current site
Google Scholar
PubMed
Close
 BVSc, MS
,
Lennart P. Krook From the Departments of Clinical Sciences (Gaughan, Nixon, Yeager, Mohammed) and Pathology (Krook), New York State College of Veterinary Medicine, and the Sibley School of Mechanical and Aerospace Engineering (Mann, Bartel), Cornell University, Ithaca, NY 14853.

Search for other papers by Lennart P. Krook in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
,
Amy E. Yeager From the Departments of Clinical Sciences (Gaughan, Nixon, Yeager, Mohammed) and Pathology (Krook), New York State College of Veterinary Medicine, and the Sibley School of Mechanical and Aerospace Engineering (Mann, Bartel), Cornell University, Ithaca, NY 14853.

Search for other papers by Amy E. Yeager in
Current site
Google Scholar
PubMed
Close
 DVM
,
Kenneth A. Mann From the Departments of Clinical Sciences (Gaughan, Nixon, Yeager, Mohammed) and Pathology (Krook), New York State College of Veterinary Medicine, and the Sibley School of Mechanical and Aerospace Engineering (Mann, Bartel), Cornell University, Ithaca, NY 14853.

Search for other papers by Kenneth A. Mann in
Current site
Google Scholar
PubMed
Close
 MS
,
Hussni Mohammed From the Departments of Clinical Sciences (Gaughan, Nixon, Yeager, Mohammed) and Pathology (Krook), New York State College of Veterinary Medicine, and the Sibley School of Mechanical and Aerospace Engineering (Mann, Bartel), Cornell University, Ithaca, NY 14853.

Search for other papers by Hussni Mohammed in
Current site
Google Scholar
PubMed
Close
 BVSc, PhD
, and
Donald L. Bartel From the Departments of Clinical Sciences (Gaughan, Nixon, Yeager, Mohammed) and Pathology (Krook), New York State College of Veterinary Medicine, and the Sibley School of Mechanical and Aerospace Engineering (Mann, Bartel), Cornell University, Ithaca, NY 14853.

Search for other papers by Donald L. Bartel in
Current site
Google Scholar
PubMed
Close
 PhD

Click on author name to view affiliation information

SUMMARY

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 viscoelastic 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. Treatmerit 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.

SUMMARY

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 viscoelastic 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. Treatmerit 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.

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 102 102 19
PDF Downloads 81 81 21
Advertisement