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. 2011 Jun;29(6):880-5.
doi: 10.1002/jor.21327. Epub 2011 Jan 18.

Diabetes mellitus alters the mechanical properties of the native tendon in an experimental rat model

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Diabetes mellitus alters the mechanical properties of the native tendon in an experimental rat model

Alice J S Fox et al. J Orthop Res. 2011 Jun.

Abstract

The purpose of this study was to determine the effect of the diabetic phenotype on the mechanical properties of the native patellar tendon and its enthesis. Diabetes was induced via intraperitoneal injection of streptozotocin in Lewis rats. Control (n = 18) and diabetic animals (n = 20) were killed at 12 and 19 days for analysis. Statistical comparisons were performed using Student's t-tests and a two-tailed Fisher test with significance set at p < 0.05. Pre- and post-injection intraperitoneal glucose tolerance tests demonstrated significant impairment of glycemic control in the diabetic compared to control animals (p = 0.001). Mean serum hemoglobin A1c levels at 19 days was 10.6 ± 2.7% and 6.0 ± 1.0% for the diabetic and control groups, respectively (p = 0.0001). Fifteen of sixteen diabetic animals demonstrated intrasubstance failure of the patellar tendon, while only 7 of 14 control specimens failed within the tendon substance. The Young's modulus of the diabetic tendon was significantly lower than control specimens by 19 days post-induction (161 ± 10 N m(-2) compared to 200 ± 46 N m(-2) , respectively) (p = 0.02). The metabolic condition of poorly controlled diabetes negatively affects the mechanical properties of the native patellar tendon. These altered structural properties may predispose diabetic patients to a greater risk of tendinopathy and/or traumatic rupture.

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Figures

Figure 1
Figure 1
Safranin-O staining of the native patellar tendon enthesis at the tibial tubercle in the control and diabetic group. At 19 days, the area of fibrocartilage was qualitatively less in the diabetic compared to the control group. B, bone; E, enthesis; T, tendon; (×40).
Figure 2
Figure 2
Polarized light microscopy with picrosirius red staining revealed less organized collagen at the tubercle enthesis in the diabetic (B) compared to control (A) specimens at 19 days.
Figure 3
Figure 3
The mean Young’s modulus of the diabetic patellar tendon was significantly lower than control animals at both 12 days (p = 0.04) and 19 days (p = 0.02).

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