Hasan Tatari1, Sermin Özkal2, Eyad Skiak1, Hakan Destan1, Çağnur Ulukuş2, Erdener Özer2, Safa Satoğlu1

1Departments of Orthopedics and Traumatology Medicine Faculty of Dokuz Eylül University
2Departments of Pathology, Medicine Faculty of Dokuz Eylül University

Keywords: Achilles tendon/pathology; hyaluronic acid/therapeutic use; injections, intra-articular; rats; tendon injuries/drug therapy; wound healing/drug effects.


Objectives: The treatment of Achilles tendon disorders remains controversial. This study was designed to observe the local early and late term effects of intratendinous hylan G-F 20 injections on experimentally induced rat Achilles tendonitis. Materials and methods: After inducing Achilles degeneration with local corticosteroid injections in the Achilles tendons, 36 male Wistar rats were divided into two main groups for early (group 1) and late (group 2) term observations. The right Achilles tendons served as the hylan injection group, and the left Achilles tendons injected with saline as the control group. Injections were given at 5-day intervals until day 60 of the experiment. The tendons and paratenons were excised at the end of 60 and 75 days in group 1 and at the end of four and six months in group 2 for histopathologic and statistical evaluations.
Results: Semiquantitative scoring of histopathological changes showed that histological appearances significantly differed between hylan and saline groups in the early term. Hylan-injected tendons and paratenons demonstrated significantly lower scores especially after 75 days. However, in the late period, the differences were mostly insignificant.
Conclusion: Hylan G-F 20 appears to have a promising curative effect on degenerated tendon processes in the early acute and subacute periods. Further studies, either biomechanical or biochemical, will show how useful this chemical agent is in treating tendon disorders.