title: No midterm advantages in the middle term using small intestinal submucosa and human amniotic membrane in Achilles tendon transverse tenotomy.
abstract: BACKGROUND
  The study was aimed to compare the effects of small intestinal submucosa (SIS) and human amniotic membrane (HAM) on Achilles tendon healing.
  
  
  METHODS
  A total of 48 New Zealand white rabbits were divided into two groups. A full-thickness transverse tenotomy was made at the right leg of the rabbits. Then, the laceration site was wrapped with HAM (P/A group) or SIS (P/S group). The ultimate stress (US) and Young's modulus (E) of the tendons were detected for biomechanical analysis. Histological evaluation was performed using hematoxylin and eosin, immunohistochemical, and immunofluorescent stain. Expression of collagen I was detected by western blot analysis, and levels of inflammatory cytokines IL-1β, IL-6, and TNF-α were measured. Finally, adhesion formation was evaluated.
  
  
  RESULTS
  There were no significant differences in filamentous adhesion, cross-sectional areas of the laceration sites, levels of inflammatory response, and collagen type I expression between the P/A and P/S groups (p > 0.05). Compared with the P/A group, the US and E values were significantly higher in the P/S group at day 7 (p < 0.05) and at day 14 (p < 0.05). In addition, vascularity was significantly higher in the P/S group than that in the P/A group at day 3 (p < 0.05), day 7 (p < 0.01), and day 9 (p < 0.05).
  
  
  CONCLUSIONS
  SIS showed superior biomechanical properties and neovascularization over HAM in treatment of Achilles tendon injury in the early stage of healing.
authors.affiliation: Department of Burns and Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Mohe Road, No. 280, Baoshan District, Shanghai, 201900, People's Republic of China.
authors.forename: Yushu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Burns and Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Mohe Road, No. 280, Baoshan District, Shanghai, 201900, People's Republic of China.
authors.forename: Yinbo
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Burns and Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Mohe Road, No. 280, Baoshan District, Shanghai, 201900, People's Republic of China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Burns and Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Mohe Road, No. 280, Baoshan District, Shanghai, 201900, People's Republic of China.|Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA.
authors.forename: Min
authors.initials: M
authors.lastname: Yao
authors.affiliation: Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Redmond
authors.affiliation: Department of Burns and Plastic Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Mohe Road, No. 280, Baoshan District, Shanghai, 201900, People's Republic of China. nitao6666@yeah.net.
authors.forename: Tao
authors.initials: T
authors.lastname: Ni
mesh_terms: D000125:Achilles Tendon / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D000650:Amnion / Q000637:transplantation*; D000818:Animals; D001696:Biomechanical Phenomena / Q000502:physiology; D006801:Humans; D007413:Intestinal Mucosa / Q000637:transplantation*; D007421:Intestine, Small / Q000637:transplantation; D011817:Rabbits; D013552:Swine; D013708:Tendon Injuries / Q000473:pathology / Q000601:surgery*; D058971:Tenotomy / Q000379:methods*; D014945:Wound Healing / Q000502:physiology
keywords: Achilles tendon injury; Human amniotic membrane; Small intestinal submucosa