Doxycycline-coated sutures improve the suture-holding capacity of the rat Achilles tendon.
BACKGROUND
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.
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.


CONCLUSIONS
We provide proof of a novel treatment principle. MMP inhibitor-coated sutures improve suture-holding capacity during early repair of collagenous tissues.
Pasternak
Björn
B
Orthopaedics Section, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. bjorn.pasternak@gmail.com
Missios
Anna
A
Askendal
Agneta
A
Tengvall
Pentti
P
Aspenberg
Per
P
D000125:Achilles Tendon / Q000601:surgery*; D000818:Animals; D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D004318:Doxycycline; D008297:Male; D008422:Materials Testing; D051381:Rats; D017207:Rats, Sprague-Dawley; D013314:Stress, Mechanical; D013536:Suture Techniques / Q000295:instrumentation; D013537:Sutures / Q000592:standards*; D013718:Tensile Strength
D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D004318:Doxycycline