Burak Kuşcu1, Ökkeş Bilal2, Fatih Doğar2, Duran Topak2, Kaan Gürbüz3, Kadir İsmail Dere2, Mikail Telek2, Ali Aydın Karadeniz2, Muhammed Seyithanoğlu4, Sezen Koçaslan5

1Department of Orthopedics and Traumatology, Kahramanmaraş Pazarcık State Hospital, Kahramanmaraş, Türkiye
2Department of Orthopedics and Traumatology, Kahramanmaraş Sütçü Imam University Faculty of Medicine, Kahramanmaraş, Türkiye
3Department of Orthopedics and Traumatology, Kayseri City Training and Research Hospital, Kayseri, Türkiye
4Medical Biochemistry, Kahramanmaraş Sütçü Imam University Faculty of Medicine, Kahramanmaraş, Türkiye
5Medical Pathology, Kahramanmaraş Sütçü Imam University Faculty of Medicine, Kahramanmaraş, Türkiye

Keywords: Achilles, biomechanical, levocarnitine, matrix metalloproteinase, rat, tendon, tendon healing.


Objectives: In this experimental study, we aimed to analyze the effects of levocarnitine (L-carnitine) on tendon healing after surgical repair of Achilles tendon rupture in a rat model.

Materials and methods: The study included 40 Wistar Albino rats divided into four groups: Group 1, neither surgical intervention nor substance applications were performed for the Achilles tendons. In the other groups, the right Achilles tendons were cut using a scalpel and repaired with a modified Kessler-type technique with 3/0 monofilament polydioxanone suture. In Group 2, the rats did not receive any additional treatment, except for surgical repair. In Group 3, the same volume similar to Group 4 of saline solution was administered intraperitoneally for seven days. In Group 4, each rat received 300 mg/kg of L-carnitine intraperitoneally for seven days. At Week 6, all rats were sacrificed. All right Achilles tendons were used for biomechanical tests and histopathological evaluations. Biochemical analysis of the matrix metalloproteinase was also performed using the blood specimens.

Results: There were no significant differences among the groups in terms of the histopathological parameters. Although the mean matrix metalloproteinase level was low in the L-carnitine group, it did not reach statistical significance. A significant increase in maximum force, tensile strength, and strength to 2-mm gap was observed in the L-carnitine group.

Conclusion: The significant effects of L-carnitine on biomechanical parameters may indicate favorable effects on Achilles tendon healing in rats by reducing matrix metalloproteinase 2 and 9. To improve Achilles tendon healing, further investigation for these markers is needed. Since the effects of L-carnitine on the Achilles tendon cannot be clearly distinguished histopathologically, further studies involving L-carnitine-induced effects are warranted.

This study was presented as an oral presentation at the Virtual EFORT 2021 Congress on June 30th to July 02th, 2021.

Citation: Kuşcu B, Bilal Ö, Doğar F, Topak D, Gürbüz K, Dere Kİ, et al. Effects of L-carnitine on healing of Achilles tendon in rats. Jt Dis Relat Surg 2023;34(1):84-91. doi: 10.52312/jdrs.2023.853

Ethics Committee Approval

The study protocol was approved by the Kahramanmaraş Sütçü Imam University Faculty of Medicine Animal Experiments Local Ethics Committee with the approval number 2018/07-04.

Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.

Author Contributions

Conceptualization, methodology, software, data curation, writing, original draft: B.K.; Methodology, project administration: Ö.B.; Data curation: F.D.; Software: D.T.; Writing, original draft, formal analysis: K.G.; Investigation: K.İ.D.; Resources: M.T.; Validation: A.A.K.; Data curation, software: S.K.; Data curation, software: M.S.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

This study was funded by Kahramanmaras Sutcu Imam University Scientific Researchs Projects unit (Research Project Approval Number 2020/1-13 D).


Thanks for Kahramanmaraş Sütçü Imam University Scientific Research Projects (Research Project Approval Number 2020/1-13 D) to funded this study.