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The influence of indomethacin on tendon healing

A biomechanical and biochemical study

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Summary

The influence of indomethacin on the biomechanical and biochemical properties of tendons during their healing was investigated. In 68 New Zealand White rabbits a transverse tenotomy followed by repair with a criss-cross suture was performed in the plantaris longus tendon of the left hind limb. The leg was immobilized for 4 weeks postoperatively in a long-leg plastic splint. Half of the animals were treated with indomethacin, 10 mg/kg/day orally, and the other half with placebo. After 4, 8, and 16 weeks of treatment the animals were killed and biomechanical and biochemical parameters were measured. After 16 weeks there was a significant increase in tensile strength in the indomethacin group. There were only small biochemical differences between the groups. However, there was a slight but significant decrease in the amount of soluble collagen in the Indomethacin group. This may indicate a higher degree of cross-linkage following indomethacin treatment, which might explain the increased tensile strength.

Zusammenfassung

Es wurde die Wirkung von Indomethacin auf die biomechanischen und biochemischen Eigenschaften von Sehnen während der Heilung untersucht. Achtundsechzig New Zealand White Kaninchen bekamen eine quere Tenotomie an der Sehne des M. plantaris longus am linken Hinterbein. Die Tenotomie wurde dann mit einer „crisscross” Naht repariert, und das Bein in einem die ganze Extremität umfassenden Verband aus Hexalite vier Wochen lang ruhiggestellt. Die Hälfte der Versuchstiere wurde mit Indomethacin per os in der Dosis von 10 mg/kg/die behandelt, und die andere Hälfte bekam Placebo. Nach 4, 8 und 16 Wochen wurden die Tiere geopfert, und die Sehne auf ihre biomechanischen und biochemischen Eigenschaften untersucht. Nach 16 Wochen fanden wir einen signifikanten Anstieg der Zugfestigkeit nach Indomethacin-Behandlung. Nur geringe biochemische Unterschiede zwischen beiden Gruppen wurden gefunden. In der Indomethacin-Gruppe registrierten wir eine kleine, jedoch signifikante Abnahme in dem Gehalt an löslichem Kollagen. Dieser Fund spricht für einen höheren Grad von „cross-links” nach Indomethacin-Behandlung, was die Zunahme der Zugfestigkeit erklären könnte.

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Carlstedt, C.A., Madsén, K. & Wredmark, T. The influence of indomethacin on tendon healing. Arch. Orth. Traum. Surg. 105, 332–336 (1986). https://doi.org/10.1007/BF00449937

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