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Doxycycline-coated sutures improve the suture-holding capacity of the rat Achilles tendon
Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Linköping University, Faculty of Health Sciences.
Linköping University, Department of Physics, Chemistry and Biology. Linköping University, The Institute of Technology.
Linköping University, Department of Physics, Chemistry and Biology, Applied Physics . Linköping University, The Institute of Technology.
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2007 (English)In: Acta Orthopaedica, ISSN 1745-3674 (print) 1745-3682 (online), Vol. 78, no 5, 680-686 p.Article in journal (Refereed) Published
Abstract [en]

There is evidence of high matrix metalloproteinase (MMP) activity around sutures inserted into tendons. This probably results in tissue breakdown, allowing the suture to cut through the tendon, and thus contributes to repair-site elongation and gap formation. We therefore hypothesized that treatment with the MMP inhibitor doxycycline would improve the sutureholding capacity of tendon. Animals, methods and results In the first sub-study, rats received a suture in the Achilles tendon. One group was treated with systemic doxycycline and the other received no treatment. At 3, 5, and 7 days, suture-holding capacity was measured mechanically. The pull-out force and energy were reduced in all tendons, at 3 days compared to freshly inserted sutures, but no further reduction was detected at later time points. Doxycycline- treated tendons showed improved suture-holding capacity as measured by higher energy uptake than in untreated tendons. Force at failure showed a trend towards improvement. The effect was most evident on day 3. In the second sub-study, sutures were coated with doxycycline. At 3 days, local doxycycline treatment caused improved suture-holding capacity—as measured by higher force at failure and higher energy uptake.

Place, publisher, year, edition, pages
2007. Vol. 78, no 5, 680-686 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13149DOI: 10.1080/17453670710014392OAI: diva2:17916
Available from: 2008-05-07 Created: 2008-05-07 Last updated: 2009-08-20
In thesis
1. Towards surgical use of matrix metalloproteinase biology
Open this publication in new window or tab >>Towards surgical use of matrix metalloproteinase biology
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Matrix metalloproteinases (MMPs), such as collagenases, are a family of enzymes capable of degrading most constituents of the extracellular matrix. MMPs are thought to be involved in the aetiopathogenesis of tendon rupture. Additionally, failure of healing has in some instances been associated with elevated levels of MMPs. We have studied (a) the effects of the MMP-inhibitor doxycycline on healing of tendons and intestines in experimental models and (b) systemic levels of MMPs and their endogenous inhibitors (TIMPs) in patients with tendon rupture.

In the first study, systemic doxycycline treatment lead to weakened rat Achilles tendons during healing after injury.

Subsequently, systemic doxycycline was shown to improve biomechanical properties of tendon suture fixation in the rat Achilles tendon. Sutures were also coated with doxycycline, leading to similar improvement in mechanical strength of the suture construct during healing.

In the third study, doxycycline-coated sutures improved the strength of healing intestinal anastomoses in an experimental model.

Finally, we showed that patients with a history of Achilles tendon rupture had elevated levels of MMP-2, MMP-7 and TIMP-2 in serum. In addition, MMP-7 correlated inversely to mechanical strength of the tendon during healing.

In conclusion, MMP-inhibitors can be administered systemically and locally to manipulate healing of tendons and intestines. Generalised alterations in the MMP-TIMP system may be involved in the pathogenesis of Achilles tendon rupture and associated with differences in outcome of healing.

Place, publisher, year, edition, pages
Linköping University Electronic Press, 2008. 61 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1057
Achilles tendon, colon, tetracyclines, tissue inhibitor of metalloproteinases (TIMP), wound healing., colorectal surgery, extracellular matrix, humans, matrix metalloproteinases (MMPs), rats, surgical anastomosis, sutures, tendon injuries
National Category
urn:nbn:se:liu:diva-11489 (URN)978-91-7393-931-7 (ISBN)
Public defence
2008-05-09, Linden, Hälsonuniversitetet, Linköping, 13:30 (English)
Available from: 2008-05-07 Created: 2008-05-07 Last updated: 2015-11-19

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Pasternak, BjörnAskendal, AgnetaTengvall, PenttiAspenberg, Per
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Orthopaedics and Sports Medicine Faculty of Health SciencesDepartment of Physics, Chemistry and BiologyThe Institute of TechnologyApplied Physics Department of Orthopaedics Linköping
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