title: Temporary inductions of matrix metalloprotease-3 (MMP-3) expression and cell apoptosis are associated with tendon degeneration or rupture after corticosteroid injection.
abstract: Corticosteroid injections are widely used to treat enthesopathy and tendinitis, but are also associated with possible side effects, such as tendon degeneration or rupture. However, the mechanism of tendon degeneration or rupture after corticosteroid injection remains controversial. The purpose of this study was to reveal the mechanism of tendon degeneration or rupture after injection of triamcinolone acetonide (TA) or prednisolone (PSL). Forty-two rats were divided into 3 groups: A normal saline injection group (control group), a TA injection group, and a PSL injection group; the normal saline or corticosteroid was injected around the Achilles tendon. One or 3 weeks after injection, the tendons were subjected to biomechanical testing and histological analysis. At 1 week, the biomechanical strength was significantly lower in the corticosteroid groups. Histological analysis, at 1-week post-injection, showed collagen attenuation, increased expression of MMP-3 and apoptotic cells in the corticosteroid groups. The histological changes and biomechanical weaknesses of the tendon were not seen at 3 weeks. These alterations appeared to be involved in tendon degeneration or rupture after corticosteroid injection.
authors.affiliation: Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Muto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kokubu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Mifune
authors.forename: Atsuyuki
authors.initials: A
authors.lastname: Inui
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Harada
authors.lastname: Yoshifumi
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Takase
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Kuroda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kurosaka
mesh_terms: D000125:Achilles Tendon / Q000187:drug effects / Q000473:pathology; D000818:Animals; D017209:Apoptosis / Q000187:drug effects* / Q000235:genetics; D001696:Biomechanical Phenomena; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D007270:Injections, Intra-Articular / Q000009:adverse effects; D008297:Male; D019278:Matrix Metalloproteinase 3 / Q000096:biosynthesis / Q000235:genetics*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012422:Rupture, Spontaneous / Q000139:chemically induced / Q000201:enzymology; D013708:Tendon Injuries / Q000139:chemically induced* / Q000201:enzymology; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D005938:Glucocorticoids; D014221:Triamcinolone; D011239:Prednisolone; D019278:Matrix Metalloproteinase 3
keywords: Achilles tendon; MMP-3; apoptosis; prednisolone; triamcinolone acetonide