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Dexamethasone Enhances Achilles Tendon Healing in an Animal Injury Model, and the Effects Are Dependent on Dose, Administration Time, and Mechanical Loading Stimulation
Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Orthopaedics in Linköping.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-6718-034X
2022 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 50, no 5, p. 1306-1316, article id 03635465221077101Article in journal (Refereed) Published
Abstract [en]

Background: Corticosteroid treatments such as dexamethasone are commonly used to treat tendinopathy but with mixed outcomes. Although this treatment can cause tendon rupture, it can also stimulate the tendon to heal. However, the mechanisms behind corticosteroid treatment during tendon healing are yet to be understood. Purpose: To comprehend when and how dexamethasone treatment can ameliorate injured tendons by using a rat model of Achilles tendon healing. Study Design: Controlled laboratory study. Methods: An overall 320 rats were used for a sequence of 6 experiments. We investigated whether the drug effect was time-, dose-, and load-dependent. Additionally, morphological data and drug administration routes were examined. Healing tendons were tested mechanically or used for histological examination 12 days after transection. Blood was collected for flow cytometry analysis in 1 experiment. Results: We found that the circadian rhythm and drug injection timing influenced the treatment outcome. Dexamethasone treatment at the right time point (days 7-11) and dose (0.1 mg/kg) significantly improved the material properties of the healing tendon, while the adverse effects were reduced. Local dexamethasone treatment did not lead to increased peak stress, but it triggered systemic granulocytosis and lymphopenia. Mechanical loading (full or moderate) is essential for the positive effects of dexamethasone, as complete unloading leads to the absence of improvements. Conclusion: We conclude that dexamethasone treatment to improve Achilles tendon healing is dose- and time-dependent, and positive effects are perceived even in a partly unloaded condition.

Place, publisher, year, edition, pages
Sage Publications Inc , 2022. Vol. 50, no 5, p. 1306-1316, article id 03635465221077101
Keywords [en]
corticosteroids; repair; resolution; rat; calcaneal tendon; biomechanics
National Category
Surgery
Identifiers
URN: urn:nbn:se:liu:diva-183597DOI: 10.1177/03635465221077101ISI: 000764184200001PubMedID: 35234541OAI: oai:DiVA.org:liu-183597DiVA, id: diva2:1644875
Available from: 2022-03-15 Created: 2022-03-15 Last updated: 2023-05-04Bibliographically approved

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Dietrich, FrancieleAspenberg, PerEliasson, Pernilla

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Dietrich, FrancieleAspenberg, PerEliasson, Pernilla
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Faculty of Medicine and Health SciencesDivision of Surgery, Orthopedics and OncologyDepartment of Orthopaedics in LinköpingDivision of Cell Biology
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American Journal of Sports Medicine
Surgery

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