Effects of montelukast on tendon healing in a murine model
Kutay E. Özturan
Received: 22 July 2016 /Accepted: 22 January 2017 /Published online: 8 March 2017
Springer-Verlag Berlin Heidelberg 2017
Background Tendon injury induces a local inflammatory re-
sponse characterized by the production of pro-inflammatory
cytokines. The aim of this study is to investigate the effects of
montelukast sodium on the healing of tendons through histo-
logical and biomechanical evaluations.
Methods Forty-eight female Wistar albino rats were randomly
assigned to an experimental group that received montelukast
sodium (n = 24) and a control group (n = 24) that did not.
Tendon injury was created in the Achilles tendon. The experi-
mental group was injected intraperitoneally (IP) with 1 ml of
1 mg/kg montelukast sodium solution once a day prior to the
surgery and during the experimental research. The control
group was injected with saline solution. Two weeks later, eight
rats in each group underwent a histological evaluation. In the
fourth week, eight rats underwent a histological evaluation and
the other eight rats went through a biomechanical evaluation.
Results Based on the histological evaluation in the second week,
it was observed that the severity of the inflammation was less in
the experimental group that received montelukast sodium
(p < 0.05). In terms of the formation of collagen, no significant
difference was observed between the groups in the second and
fourth weeks. Tendon breaking loads were 33.2 ± 10.95 and
38.8 ± 10.90 N for the montelukast group and the control group,
respectively. However, the difference between the groups was
found to be statistically insignificant (p > 0.05).
Conclusions There was no negative effect on the healing of
tendons due to injection of montelukast sodium. In addition,
observing less inflammation in the experimental group in the
earlier phase suggests that montelukast sodium may help in
preventing tendon adhesion after reconstructive treatment.
Level of Evidence: Not ratable.
Tendon injury induces a local inflammatory response charac-
terized by the production of pro-inflammatory cytokines
[1–3]. Blood-derived leukocytes attracted by trauma and re-
leased into the tissue might be an important exogenic source
of these cytokines [4, 5]. In tendon healing, tendon cell pro-
liferation and synthesis of neomatrixes are primary factors .
The synthesized irregular collagen fibers construct the main
structure of the extracellular tendon matrix during the early
phase of healing. The realignment of these collagen fibers and
tenocytes between them should be reestablished in the tendon
at the remodeling phase, which might be further influenced in
a posttraumatic inflammatory microenvironment [3, 7].
Arachidonic acid is the precursor of prostaglandins and
leukotrienes, which are lipid-signaling molecules. The cyclo-
oxygenase enzyme is involved in the conversion of
* İbrahim Sağlam
Aesthetic, Plastic and Reconstructive Surgery Clinic, Dr. Lütfi Kırdar
Kartal Education and Research Hospital, Istanbul, Turkey
Department of Orthopaedic Surgery, Abant İzzet Baysal University,
Department of Orthopaedic Surgery, Mustafa Kemal University,
Faculty of Mechanical Engineering, Istanbul Technical University,
Department of Pathology, Abant İzzet Baysal University,
Department of Aesthetic, Plastic and Reconstructive Surgery, Faculty
of Medicine, Harran University, 63100 Şanlıurfa, Turkey
Eur J Plast Surg (2017) 40:171–176