Skleroterapi ile kemik iliği kökenli mezenkimal kök hücre uygulamasının rat aşil tendinopati modelinde incelenmesi
Küçük Resim Yok
Tarih
2024
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Aşil tendinopatisi, genellikle sporcular ve sedanter bireylerde görülen ağrı ve sakatlık nedeni olan bir tendinopatidir. Tedavi yöntemleri arasında birçok seçenek bulunsa da, Polidocanol gibi sklerozan ajanların ve biyolojik tedavilerin etkinliği konusunda net bir fikir birliği yoktur. Bu çalışmanın amacı, Polidocanol ile Kemik İliği Kökenli Mezenkimal Kök Hücre (Kİ-MKH) kombinasyonunun kronik aşil tendinopatisi üzerindeki etkilerini değerlendirmektir. Gereç ve Yöntem: Çalışma, 48 erişkin erkek Wistar Albino sıçanı içermekte olup, kronik aşil tendinopati modeli Tip 1 kollajenaz kullanılarak sağ aşil tendonunda oluşturulmuştur. Sıçanlar, randomize edilerek dört farklı tedavi grubuna ayrıldı: Hasar Kontrol (H/K) (n=12); Polidocanol (POL) (n=12); Kİ-MKH (n=12); POL + Kİ-MKH (n=12) kombinasyonu ile tedavi edilen sıçanlar. Müdahale edilmeyen sol aşil tendonlarından oluşan Sağlıklı Kontrol (S/K) (n=12) grubu da oluşturuldu. Uygulanan tedavilerin ardından denekler 4 hafta süreyle takip edildi ve ardından sakrifiye edildi. Elde edilen örnekler üzerinde histolojik ve biyomekanik analizler gerçekleştirildi. Bulgular: Gruplar arasında maksimum çekme kuvveti ve uzama miktarı değerleri incelendiğinde, S/K grubunda en yüksek maksimum çekme kuvveti (76,172 ± 7,659 N) belirlenirken, en düşük çekme kuvveti POL grubunda (64,154 ± 16,009 N) gözlendi. Ancak, gruplar arasında çekme kuvveti açısından istatistiksel farklılık saptanmadı (p=0,124). Uzama miktarı analizinde, H/K grubunda en yüksek uzama (3,848 ± 1,584 mm) tespit edilirken, POL + Kİ-MKH grubunda en düşük uzama (1,645 ± 0,387 mm) görüldü. Yapılan ikili karşılaştırmalarda, sadece POL + Kİ-MKH ile H/K grubu arasında istatistiksel anlamlı farklılık belirlendi (p=0,011), diğer gruplar arasında farklılık gözlenmedi (p>0,05). Ayrıca, total histolojik skor değerlendirmesinde, H/K grubunda en yüksek skor (11,33 ± 0,52), S/K grubunda ise en düşük skor (0,0 ± 0,0) izlendi. Gruplar arasındaki ikili karşılaştırmalarda, S/K ile H/K grubu arasında, S/K ile POL grubu arasında ve POL + Kİ-MKH ile H/K grubu arasında anlamlı fark belirlenirken (p<0,001, p=0,014, p=0,032; sırasıyla), diğer ikili karşılaştırmalarda farklılık gözlenmedi (p>0,05). Sonuç: Çekme kuvveti ve uzama miktarı değerlerinde anlamlı farklar olmamasına rağmen, histolojik değerlendirmeler tedavi gruplarının aşil tendinopatisinde iyileşmeye işaret ettiğini göstermektedir. Bulgular, Polidocanol ile Kİ-MKH kombinasyonunun potansiyel bir tedavi seçeneği olarak değerlendirilmesine yönelik olumlu bir bakış açısı sunmaktadır. Ancak, daha fazla çalışma ve klinik araştırmaların bu kombinasyonun etkinliğini doğrulaması gerekmektedir.
Introduction: Achilles tendinopathy is a common cause of pain and injury, often observed in both athletes and sedentary individuals. Despite numerous treatment options, there is no clear consensus on the efficacy of sclerosing agents like Polidocanol and biological therapies. This study aims to evaluate the effects of the combination of Polidocanol and Bone Marrow-Derived Mesenchymal Stem Cells (BM-MSC) on chronic Achilles tendinopathy. Materials and Methods: The study included 48 adult male Wistar Albino rats, and a chronic Achilles tendinopathy model was created using Type 1 collagenase in the right Achilles tendon. Rats were randomly assigned to four different treatment groups: Injury Control (I/C) (n=12); Polidocanol (POL) (n=12); BM-MSC (n=12); rats treated with a combination of POL + BM-MSC (n=12). Additionally, a Healthy Control (H/C) group was formed from the untouched left Achilles tendons (n=12). After the interventions, the subjects were followed for 4 weeks and then sacrificed. Histological and biomechanical analyses were performed on the obtained samples. Results: When comparing maximum tensile strength and elongation values among groups, the highest maximum tensile strength was observed in the H/C group (76.172 ± 7.659 N), while the lowest tensile strength was in the POL group (64.154 ± 16.009 N). However, no statistical difference in tensile strength was found among the groups (p=0.124). In the analysis of elongation, the highest elongation was recorded in the I/C group (3.848 ± 1.584 mm), whereas the lowest elongation was in the POL + BM-MSC group (1.645 ± 0.387 mm). Statistically significant differences were only observed between the POL + BM-MSC and I/C groups (p=0.011), with no differences noted between other groups (p>0.05). Moreover, in the evaluation of total histological scores, the highest score was in the I/C group (11.33 ± 0.52), and the lowest score was in the H/C group (0.0 ± 0.0). Statistically significant differences were found in pairwise comparisons between H/C and I/C groups, H/C and POL groups, and POL + BM-MSC and I/C groups (p<0.001, p=0.014, p=0.032, respectively), while no differences were observed in other pairwise comparisons (p>0.05). Conclusion: Despite no significant differences in tensile strength and elongation values, histological assessments indicate improvement in Achilles tendinopathy for the treatment groups. The findings provide a positive outlook on the combination of Polidocanol and BM-MSC as a potential treatment option. However, further studies and clinical research are necessary to confirm the effectiveness of this combination.
Introduction: Achilles tendinopathy is a common cause of pain and injury, often observed in both athletes and sedentary individuals. Despite numerous treatment options, there is no clear consensus on the efficacy of sclerosing agents like Polidocanol and biological therapies. This study aims to evaluate the effects of the combination of Polidocanol and Bone Marrow-Derived Mesenchymal Stem Cells (BM-MSC) on chronic Achilles tendinopathy. Materials and Methods: The study included 48 adult male Wistar Albino rats, and a chronic Achilles tendinopathy model was created using Type 1 collagenase in the right Achilles tendon. Rats were randomly assigned to four different treatment groups: Injury Control (I/C) (n=12); Polidocanol (POL) (n=12); BM-MSC (n=12); rats treated with a combination of POL + BM-MSC (n=12). Additionally, a Healthy Control (H/C) group was formed from the untouched left Achilles tendons (n=12). After the interventions, the subjects were followed for 4 weeks and then sacrificed. Histological and biomechanical analyses were performed on the obtained samples. Results: When comparing maximum tensile strength and elongation values among groups, the highest maximum tensile strength was observed in the H/C group (76.172 ± 7.659 N), while the lowest tensile strength was in the POL group (64.154 ± 16.009 N). However, no statistical difference in tensile strength was found among the groups (p=0.124). In the analysis of elongation, the highest elongation was recorded in the I/C group (3.848 ± 1.584 mm), whereas the lowest elongation was in the POL + BM-MSC group (1.645 ± 0.387 mm). Statistically significant differences were only observed between the POL + BM-MSC and I/C groups (p=0.011), with no differences noted between other groups (p>0.05). Moreover, in the evaluation of total histological scores, the highest score was in the I/C group (11.33 ± 0.52), and the lowest score was in the H/C group (0.0 ± 0.0). Statistically significant differences were found in pairwise comparisons between H/C and I/C groups, H/C and POL groups, and POL + BM-MSC and I/C groups (p<0.001, p=0.014, p=0.032, respectively), while no differences were observed in other pairwise comparisons (p>0.05). Conclusion: Despite no significant differences in tensile strength and elongation values, histological assessments indicate improvement in Achilles tendinopathy for the treatment groups. The findings provide a positive outlook on the combination of Polidocanol and BM-MSC as a potential treatment option. However, further studies and clinical research are necessary to confirm the effectiveness of this combination.
Açıklama
Anahtar Kelimeler
Ortopedi ve Travmatoloji, Orthopedics and Traumatology, Spor
