Effect of cilostazol on healing of achilles tendon ruptures: an experimental study on rats

ABSTRACT

Purpose

This study aimed to evaluate whether cilostazol (phosphodiesterase III inhibitor) could enhance the healing of Achilles tendon ruptures in rats.

Materials and methods

The Achilles tendons of 24 healthy male adult rats were incised and repaired. The rats were randomly allocated to cilostazol and control groups. The cilostazol group received daily intragastric administration of 50 mg/kg cilostazol for 28 days, while the control group did not receive any medication. The rats were sacrificed on the 30th day, and the Achilles tendon was evaluated for biomechanical properties, histopathological characteristics, and immunohistochemical analysis.

Results

All rats completed the experiment. The Movin sum score of the control group was significantly higher (p = 0.008) than that of the cilostazol group, with means of 11 ± 0.63 and 7.50 ± 1.15, respectively. Similarly, the mean Bonar score was significantly higher (p = 0.026) in the control group compared to the cilostazol group (8.33 ± 1.50 vs. 5.5 ± 0.54, respectively). Moreover, the Type I/Type III Collagen ratio was notably higher (p = 0.016) in the cilostazol group (52.2 ± 8.4) than in the control group (34.6 ± 10.2). The load to failure was substantially higher in the cilostazol group than in the control group (p = 0.034), suggesting that the tendons in the cilostazol group were stronger and exhibited greater resistance to failure.

Conclusions

The results of this study suggest that cilostazol treatment significantly improves the biomechanical and histopathological parameters of the healing Achilles tendon in rats. Cilostazol might be a valuable supplementary therapy in treating Achilles tendon ruptures in humans. Additional clinical studies are, however, required to verify these outcomes.

KEYWORDS:

• Achilles tendon
• cilostazol
• phosphodiesterase III inhibitor
• Bonar score
• Movin score

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contribution

Study conception and design: BY, NK, OK, GO Acquisition of data: BY, NK, ES, GT, MBE, Analysis and interpretation of data: GT, OK, MBE, BY, Drafting of the manuscript: BY, OK, NK, GT, GO, ES, Critical revision: BY, OK, NK, GT, GO, ES, MBE (Initials of authors’ names)

Ethical approval

The Institutional Review Board approved the study protocol (Date/Issue: 2015/16). Acibadem University Animal Experiments Local Ethics Committee (ACU-HADYEK).

Data availability statement

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

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.