Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 20, Issue 10, pp 1907–1914

Effect of BMP-12, TGF-β1 and autologous conditioned serum on growth factor expression in Achilles tendon healing

  • Patricia E. Heisterbach
  • Atanas Todorov
  • Rudolf Flückiger
  • Christopher H. Evans
  • Martin Majewski
Experimental Study

DOI: 10.1007/s00167-011-1772-x

Cite this article as:
Heisterbach, P.E., Todorov, A., Flückiger, R. et al. Knee Surg Sports Traumatol Arthrosc (2012) 20: 1907. doi:10.1007/s00167-011-1772-x



Achilles tendon ruptures are devastating and recover slowly and incompletely. There is a great demand for biomolecular therapies to improve recovery, yet little is understood about growth factors in a healing tendon. Here, the role of growth factors during tendon healing in a rat model and their reaction to single and multiple growth factor treatment are explored.


Rat tendons were transected surgically and resutured. The expression of bFGF, BMP-12, VEGF and TGF-β1 was assessed by immunohistochemical analysis one to 8 weeks after surgery. Paracrine effects of TGF-β1 or BMP-12 added by adenoviral transfer, as well as the effect of autologous conditioned serum (ACS) on growth factor expression, were evaluated.


bFGF, BMP-12 and VEGF expression was highest 1 week after transection. bFGF and BMP-12 declined during the remaining period whereas VEGF expression persisted. TGF-β1 expression dramatically increased after 8 weeks. ACS treatment increased bFGF (P = 0.007) and BMP-12 (P = 0.004) expression significantly after 8 weeks. Also overall expression of bFGF, BMP-12 and TGF-β1 regardless of time point was significantly greater than controls with ACS treatment (P < 0.05). Both BMP-12 and TGF-β1 treatments had no significant effect. No effect was observed in VEGF with any treatment.


bFGF, BMP-12, VEGF and TGF-β1 are differentially expressed during tendon healing. Additional BMP-12 or TGF-β1 has no significant influence, whereas ACS generally increases expression of all factors except VEGF. Staged application of multiple growth factors may be the most promising biomolecular treatment.


Growth factors Tendon healing Biological repair Animal model 



Autologous conditioned serum


Basic fibroblast growth factor, a.k.a. FGF-2


Bone morphogenic protein


Cartilage-derived morphogenic protein


Growth and differentiation factor


Insulin-like growth factor 1


Platelet-derived growth factor


Transforming growth factor beta 1


Vascular endothelial growth factor

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Patricia E. Heisterbach
    • 1
  • Atanas Todorov
    • 1
  • Rudolf Flückiger
    • 2
  • Christopher H. Evans
    • 2
  • Martin Majewski
    • 1
  1. 1.Orthopädische Klinik, Behandlungszentrum BewegungsapparatUniversität BaselBaselSwitzerland
  2. 2.Center for Molecular OrthopaedicsHarvard Medical SchoolBostonUSA

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