The effects of glucosamine chondroitin sulphate on healing of tendon material which is placed to bone tunnel

ABSTRACTIntroduction: Today, tendon injuries have become frequent. These injuries can result from overuse, trauma or inflammatory processes. As tendon injuries can lead to function losses when left to heal on their own, they require surgical repairment. Following surgical treatment, strong reattachment of the tendon to the bone is essential in terms of enabling functional joint movements. There have been numerous studies in order to enable restructuring a robust reattachment of the tendon and the bone and many agents have been tried in order to enhance healing. Glucosamine chondroitin sulfate (GlcN-CS) is an agent that has been shown to stimulate tenocyte activity in cell cultures. This study aims to research the contribution of glucosamine chondroitin sulfate to the healing of tendons within the bone tunnel.Equipment and Method: 28 New Zelland rabbits have been used as subjects in the study. The subjects were divided into two groups. The first was the control group, while the second one was planned to receive a preparation of glucosamine chondroitin sulfate. In each of the 28 rabbits, tendons of the extensor digitorum longus (EDL) muscles, located in their right hind legs, were surgically detached from the points of attachment and then placed in tunnels drilled in their tibias. The subjects were sacrificed on the 6th and 12th postoperative weeks and their tibias and EDL muscles were removed. In the group for each of the above weeks, 4 of the samples were set aside for histological examinations, and 3 for biomechanical studies. The samples reserved for histological examination were then prepared accordingly, dyed with H&E, Masson Trichrome and toluidine blue and studied. The results were scored semi-quantitatively. The samples reserved for biomechanical testing were subjected to tension tests at the rate of 10 mm/min. The results for each of these samples were recorded separately.Findings: Upon examining and semi-quantitatively scoring the histological samples, a significant difference has been observed in GlcN-CS areas 75of the 6th and 12th week groups, taking the total score into consideration (p<0.05). Although statistically significant differences were not observed in the biomechanical test group (p>0.05), in the GlcN-CS group, as opposed to the control group, when tendons reached the breaking strength, they detached not from inside the bone tunnel but from the muscle- tendon connections or from the tendon body itself.Conclusion: Taking histological and biomechanical results into consideration, when GlcN-CS is orally applied following surgical attachment of tendons to bones, in the early recovery period of 6th week and 12th week, it has a positive effect on recovery in the bone tunnel- tendon connection point.Key words: Bone tunnel-tendon connection, tendon recovery, glucosamine chondroitin sulfate.