Summary

Stem cells application in Achilles tendon reconstruction can accelerate rehabilitation programme’s progress resulting in better values of jump parameters after one year.

Abstract

This study was conducted to evaluate results of stem cells application during the Achilles tendon reconstruction. The evaluation was based on the measurements of vertical jump six months and one year after the surgery.
The evaluated group included 60 patients (mean age: 37±5,1 years) who had undergone Achilles tendon reconstruction. Achilles tendon reconstruction procedures aimed at the restoration of the tendon’s three-bundle structure and anatomical rotation of its fibres stemming from the gastrocnemius and soleus muscles. Patients were randomly divided into two groups (30 persons each); one undergoing a standard surgical procedure (G1), in the second group (G2) the same procedure was extended by the direct application of autologous mesenchymal stem cells (MSC) harvested from the subject’s fat tissue. All patients started physiotherapy the next day postop and continued (tri-weekly) for about 6 months (avg. 6,1 months). All patients underwent a uniform rehabilitation protocol including concentric, eccentric and balance exercises.
The objective evaluation was based on unilateral countermovement jumps (CMJ). Maximum Height (HVmax) and maximum Power (Pmax) was recorder on the force plate. Measurements were made six months after the surgery and repeated a year later to establish patients’ progress.
The comparison of differences between the groups was performed with the U Mann-Whitney test. The normality of distribution was evaluated with the Shapiro-Wilk test. For both the test significance was set at p < 0.05. For the analysis of the test results, a statistical package by StatSoft, Inc. (2011) STATISTICA, v.10 was used.
Testing performed 6 months postop has shown lower HVmax and Pmax in the operated limb compared to the healthy leg in both testing groups. After one year, statistically significant differences of both parameters were still visible in G1 group (p <0.05). In G2 group, only HVmax remained significantly lower.
Analysis of the operated limb in both groups conducted one year after surgery in comparison to 6 months results, has shown significantly improved Pmax value in G2 group.
The use of stem cells during the reconstruction of the Achilles tendon increased the maximum power during the vertical jump of the operated limb, indicating that the use of stem cells may improve the tendon function and the patient's faster return to pre-injury activity.