Effects of decellulerised amniotic membrane impregnated with adipose derived mesenchymal stem cell and/or tendon derived mesencymal stem cell in tendon healing

Even after all precotions in occupational health, tendon injuries are still quite often. Even if a tendon repair is conducted in a correct way, there will still be some crucial problems such as peritendinous adhesion formation and delayed tendon healing. These problems can usually cause disabilities that can affect the overall quality of a patient's life. Recent advances in stem cell therapy have hinted at the accelerated healing of a tendon and the prevention of peritendinous adhesion formation. Because of that, it has been aimed to analyze the best stem cell source for tendon repair and the effect of coexistence of adipose derived mesenchymal stem cell and tendon derived mesencymal stem cell. Effects of each indivdual stem cells and effect of thier coexistence on peritendinous adhesion and tendon healing were investigated. 70 female Wistar rats divided into five groups, with each group comprising 14 test subjects. After right leg achilles tendon of each rat had been cut and repaired, no further operations were performed in the first group. In the second group, the repaired tendon area was wrapped with decellularised amniotic membrane (DAM). In the third group, the repaired area was wrapped with DAM that was seeded with adipose-derived mesenchymal stem cells (ADMSC). In the fourth group, the repaired tendon area was wrapped with DAM that was seeded with tendon derived stem cell (TDSC). In the fifth group, the repaired tendon area was wrapped with DAM that was seeded with ADMSC and TDSC. All primary repairs on rats were concluded. After a postoperative follow up that lasted for a month, rats were sacrificed, and the repaired achilles tendons were excised. The specimens obtained were examined for biomechanical (tensile strength test) and morphological analyses. Both the biomechanical and the histological data demonstrated the same findings. Although results of the stem cells groups were better than that of control groups, the results obtained from the groups with tendon derived stem cells were better than that of ADMSC group. As the number of tendons derived stem cells in the groups decreases the healing parameters changes accordingly. Therefore, these findings support the thesis that the more the stem cells are obtained from similar tissues to be operated, the better results will be in terms of tissue regeneration and healing. In order to clarify the whole picture about hybrid use of stem cells, two groups with the same number of tendon derived stem cells should be compared while one group has additional fat derived stem cells.