Yaşar Mahsut Dincel1, Erdem Can1, Sevil Karabag2

1Department of Orthopedics and Traumatology, Medicine Faculty of Tekirdağ Namık Kemal University, Tekirdağ, Türkiye
2Department of Pathology, Medicine Faculty of Tekirdağ Namık Kemal University, Tekirdağ, Türkiye

Keywords: Achilles, chlorhexidine, irrigation, povidone-iodine, rat, rifampicin, tendon healing.


Objectives: This study aimed to examine the effect of irrigation fluids containing povidone-iodine (PVP-I), rifampicin (RF), and chlorhexidine gluconate (CHG) used during surgery on healing on a rat Achilles tendon model.

Materials and methods: Twenty-eight male Sprague-Dawley rats (range, 300 to 400 g) were used in the experiment carried out between November 2022 and December 2022. The rats were divided into PVP-I, RF, CHG, and control groups, with seven rats in each group. Following the tenotomy and repair of the right Achilles tendon, the surgical site was irrigated using PVP-I, RF, CHG, or normal saline (the control group) for 2 min. All rats were sacrificed on the 21st postoperative day. The samples were evaluated histomorphometrically using the scoring system modified by Svensson, Soslowsky, and Cook and histopathologically using the Bonar and Movin classifications.

Results: The RF group gave better results in all three scoring systems compared to the control, PVP-I, and CHG groups (p=0.008, p=0.002, and p=0.006, respectively). Cellularity, rounding, and tenocyte morphology showed a significant difference in favor of the RF group (p=0.004). While the distribution of ground substance glycosaminoglycans showed a significant difference in favor of the RF group, there was no significant difference among the other groups (p=0.22).

Conclusion: Irrigation solutions containing PVP-I, RF, or CHG show no negative effect on Achilles tendon healing. Moreover, the findings suggest that RF irrigation can accelerate the healing process.

Citation: Dincel YM, Can E, Karabag S. Histopathological and histomorphometric investigation of the effects of different irrigation solutions on Achilles tendon healing in rats. Jt Dis Relat Surg 2024;35(1):186-193. doi: 10.52312/jdrs.2023.1342.

Ethics Committee Approval

The study protocol was approved by the Animal Experiments Local Ethics Committee of Tekirdağ Namık Kemal University (date: 26.09.2022, no: T2022-979). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept, control/supervision, critical review, literature review: Y.M.D.; Design, data collection and processing, literature review, writing the article, references and fundings: E.C; Data collection and processing, analysis and interpretetion, literature review, critical review, materials: S.K.

Conflict of Interest

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

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

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