%0 Journal Article
%T The results of preventing postoperative achilles tendon adhesion using cross-linked and non-cross-linked hyaluronic acid, a study with rat model.
%A Hsu CH
%A Chen P
%A Yang CP
%A Chuang CA
%A Chan YS
%A Chiu JC
%J J Orthop Surg Res
%V 19
%N 1
%D 2024 Aug 2
%M 39095889
%F 2.677
%R 10.1186/s13018-024-04952-0
%X <B>BACKGROUND: </B>There are many adhesion barrier materials, cross-linked or non-cross-linked hyaluronic acid (HA), used during surgeries.<BR><B>OBJECTIVE: </B>This study investigates the efficacy of cross-linked and non-cross-linked HA in preventing Achilles tendon adhesions. We hypothesized that non-cross-linked HA may be more effective than cross-linked HA in preventing Achilles tendon adhesions following injury and repair.<BR><B>METHODS: </B>Twenty male Sprague Dawley rats, totaling 40 legs, underwent Achilles tendon transection and repair. Following the surgery, they were treated simultaneously with cross-linked and non-cross-linked HA formulations. The rats were divided into four groups: a positive control group, a group treated with BMC non-cross-linked HA gel, a group treated with DEFEHERE cross-linked HA gel, and a group treated with ANIKA cross-linked HA gel. Four weeks after surgery, macroscopic evaluation of peritendinous adhesion and histological analysis were conducted to assess the effectiveness of the treatments.<BR><B>RESULTS: </B>Non-cross-linked BMC HA demonstrated superior efficacy in preventing tendon adhesions compared to cross-linked HA and control groups. Histological analysis confirmed reduced adhesion severity in the non-cross-linked HA group (P < 0.05). The findings support the potential of non-cross-linked HA as a treatment to inhibit tendon adhesions. Further research, including clinical trials, is warranted to validate these results in human subjects.<BR><B>CONCLUSIONS: </B>Non-cross-linked BMC HA had significantly lower tendon adhesions parameters and better healing scores in histological analysis than cross-linked HA and control group did. Non-cross-linked HA holds promise as a potential treatment to inhibit the formation of such adhesions.