Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2016

01-12-2016 | Ankle

Effects of boric acid on the healing of Achilles tendons of rats

Authors: Burak Kaymaz, Umut Hatay Gölge, Gulzade Ozyalvaclı, Erkam Kömürcü, Ferdi Goksel, Musa Ugur Mermerkaya, Mahmut Nedim Doral

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2016

Login to get access

Abstract

Purpose

Tendinous lesions are among the most frequent pathologies encountered in sportsmen. The objectives of new treatments are to improve the healing process and reduce the recovery time. Boron plays an important role in the wound repair process by increasing components of extracellular matrix and angiogenesis. This animal study aimed to investigate the effect of boric acid on healing of the Achilles tendon.

Methods

The right Achilles tendons of 40 rats were completely sectioned, and the rats were randomly divided into five groups. Each group consisted of eight rats. Groups 1 and 2 were oral boric acid groups with the doses of 4 and 8 mg/kg/day boric acid, respectively. Group 3 was the local boric acid group (8 mg/kg boric acid intratendinous injection). Group 4 was administered both oral and local boric acid (8 mg/kg/day orally and 8 mg/kg boric acid intratendinous injection), and group 5 was the control group with no boric acid application. At the end of the fourth week, all the rats were killed and histopathological examination of the Achilles tendon repair site was made.

Results

Histopathological examination of the tissue sections revealed more properly oriented collagen fibres, more normal cellular distribution of tenocytes and more properly organized vascular bundles in group 1 and group 2, which were the groups administered oral boric acid. Pathological sum scores of groups 1 and 2 were less than those of the other groups, and the differences between the oral boric acid groups (group 1 and group 2) and the other three groups (groups 3, 4 and 5) were statistically significant (p = 0.001).

Conclusion

As boric acid is safe and toxicity even after very high doses is unusual, oral boric acid may be used as an agent to improve the healing process of tendon injuries. However, biomechanical tests should also be performed to show the effect of boric acid on strength and endurance of the tendon before it can be used in clinical practice.
Literature
1.
go back to reference Aras MH, Sezer U, Erkilic S, Demir T, Dagli SN (2013) Effect of dietary boron on 5-fluorouracil induced oral mucositis in rats. Eur J Dent 7(3):310–314CrossRefPubMedPubMedCentral Aras MH, Sezer U, Erkilic S, Demir T, Dagli SN (2013) Effect of dietary boron on 5-fluorouracil induced oral mucositis in rats. Eur J Dent 7(3):310–314CrossRefPubMedPubMedCentral
2.
go back to reference Aspenberg P, Forslund C (1999) Enhanced tendon healing with GDF 5 and 6. Acta Orthop Scand 70:51–54CrossRefPubMed Aspenberg P, Forslund C (1999) Enhanced tendon healing with GDF 5 and 6. Acta Orthop Scand 70:51–54CrossRefPubMed
3.
go back to reference Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand 75:93–99CrossRefPubMed Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand 75:93–99CrossRefPubMed
4.
go back to reference Benderdour M, Hess K, Dzondo-Gadet M, Nabet P, Belleville F, Dousset B (1998) Boron modulates extracellular matrix and TNF alpha synthesis in human fibroblasts. Biochem Biophys Res Commun 246(3):746–751CrossRefPubMed Benderdour M, Hess K, Dzondo-Gadet M, Nabet P, Belleville F, Dousset B (1998) Boron modulates extracellular matrix and TNF alpha synthesis in human fibroblasts. Biochem Biophys Res Commun 246(3):746–751CrossRefPubMed
5.
go back to reference Benderdour M, Hess K, Gadet MD, Dousset B, Nabet P, Belleville F (1997) Effect of boric acid solution on cartilage metabolism. Biochem Biophys Res Commun 234(1):263–268CrossRefPubMed Benderdour M, Hess K, Gadet MD, Dousset B, Nabet P, Belleville F (1997) Effect of boric acid solution on cartilage metabolism. Biochem Biophys Res Commun 234(1):263–268CrossRefPubMed
6.
go back to reference Blech MF, Martin C, Borrelly J, Hartemann P (1990) Traitement des plates profondes avec perte de substance; Interet d’une solution d’acide borique 3 %. Presse Medicale 19:1050–1052 Blech MF, Martin C, Borrelly J, Hartemann P (1990) Traitement des plates profondes avec perte de substance; Interet d’une solution d’acide borique 3 %. Presse Medicale 19:1050–1052
7.
go back to reference Blech MF, Martin C, Pichon C, Borrelly J, Hartemann P (1990) The clinical and bacteriologic outcome of wounds using different local antiseptics. J Orthop Surg B 4:123–129 Blech MF, Martin C, Pichon C, Borrelly J, Hartemann P (1990) The clinical and bacteriologic outcome of wounds using different local antiseptics. J Orthop Surg B 4:123–129
8.
go back to reference Cao J, Jiang L, Zhang X, Yao X, Geng C, Xue X (2008) Boric acid inhibits LPS-induced TNF-alpha formation through a thiol-dependent mechanism in THP-1 cells. J Trace Elem Med Biol 22:189–195CrossRefPubMed Cao J, Jiang L, Zhang X, Yao X, Geng C, Xue X (2008) Boric acid inhibits LPS-induced TNF-alpha formation through a thiol-dependent mechanism in THP-1 cells. J Trace Elem Med Biol 22:189–195CrossRefPubMed
9.
go back to reference Carmont MR, Maffulli N (2008) Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16:199–203CrossRefPubMed Carmont MR, Maffulli N (2008) Modified percutaneous repair of ruptured Achilles tendon. Knee Surg Sports Traumatol Arthrosc 16:199–203CrossRefPubMed
10.
go back to reference Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons: a prospective randomized study. Clin Orthop Relat Res 308:155–165 Cetti R, Henriksen LO, Jacobsen KS (1994) A new treatment of ruptured Achilles tendons: a prospective randomized study. Clin Orthop Relat Res 308:155–165
11.
go back to reference Chong AK, Ang AD, Goh JC, Hui JH, Lim AY, Lee EH, Lim BH (2007) Bone marrow-derived mesenchymal stem cells influence early tendon-healing in a rabbit Achilles tendon model. J Bone Joint Surg Am 89:74–81PubMed Chong AK, Ang AD, Goh JC, Hui JH, Lim AY, Lee EH, Lim BH (2007) Bone marrow-derived mesenchymal stem cells influence early tendon-healing in a rabbit Achilles tendon model. J Bone Joint Surg Am 89:74–81PubMed
12.
go back to reference Devirian TA, Volpe SL (2003) The physiological effects of dietary boron. Crit Rev Food Sci Nutr 43(2):219–231CrossRefPubMed Devirian TA, Volpe SL (2003) The physiological effects of dietary boron. Crit Rev Food Sci Nutr 43(2):219–231CrossRefPubMed
13.
go back to reference Doral MN (2013) What is the effect of the early weight-bearing mobilisation without using any support after endoscopy-assisted Achilles tendon repair? Knee Surg Sports Traumatol Arthrosc 21(6):1378–1384CrossRefPubMed Doral MN (2013) What is the effect of the early weight-bearing mobilisation without using any support after endoscopy-assisted Achilles tendon repair? Knee Surg Sports Traumatol Arthrosc 21(6):1378–1384CrossRefPubMed
14.
go back to reference Doral MN, Bozkurt M, Turhan E, Ayvaz M, Atay OA, Uzumcugil A, Leblebicioglu G, Kaya D, Aydog T (2009) Percutaneous suturing of the ruptured Achilles tendon with endoscopic control. Arch Orthop Trauma Surg 129:1093–1101CrossRefPubMed Doral MN, Bozkurt M, Turhan E, Ayvaz M, Atay OA, Uzumcugil A, Leblebicioglu G, Kaya D, Aydog T (2009) Percutaneous suturing of the ruptured Achilles tendon with endoscopic control. Arch Orthop Trauma Surg 129:1093–1101CrossRefPubMed
16.
go back to reference Forslund C, Bylander B, Aspenberg P (2003) Indomethacin and celecoxib improve tendon healing in rats. Acta Orthop Scand 74:465–469CrossRefPubMed Forslund C, Bylander B, Aspenberg P (2003) Indomethacin and celecoxib improve tendon healing in rats. Acta Orthop Scand 74:465–469CrossRefPubMed
17.
go back to reference Gelberman RH, Amifl D, Gonsalves M, Woo S, Akeson WH (1981) The influence of protected passive mobilization on the healing of flexor tendons: a biochemical and microangiographic study. Hand 13:120–128CrossRefPubMed Gelberman RH, Amifl D, Gonsalves M, Woo S, Akeson WH (1981) The influence of protected passive mobilization on the healing of flexor tendons: a biochemical and microangiographic study. Hand 13:120–128CrossRefPubMed
18.
go back to reference Gigante A, Moschini A, Verdenelli A, Del Torto M, Ulisse S, de Palma L (2008) Open versus percutaneous repair in the treatment of acute Achilles tendon rupture: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc 16:204–209CrossRefPubMed Gigante A, Moschini A, Verdenelli A, Del Torto M, Ulisse S, de Palma L (2008) Open versus percutaneous repair in the treatment of acute Achilles tendon rupture: a randomized prospective study. Knee Surg Sports Traumatol Arthrosc 16:204–209CrossRefPubMed
19.
go back to reference Goren D, Ayalon M, Nyska M (2005) Isokinetic strength and endurance after percutaneous and open surgical repair of Achilles tendon ruptures. Foot Ankle Int 26:286–290PubMed Goren D, Ayalon M, Nyska M (2005) Isokinetic strength and endurance after percutaneous and open surgical repair of Achilles tendon ruptures. Foot Ankle Int 26:286–290PubMed
20.
go back to reference Hunt CD (1994) The biochemical effects of physiologic amounts of dietary boron in animal nutrition models. Environ Health Perspect 102(Suppl. 7):35–43CrossRefPubMedPubMedCentral Hunt CD (1994) The biochemical effects of physiologic amounts of dietary boron in animal nutrition models. Environ Health Perspect 102(Suppl. 7):35–43CrossRefPubMedPubMedCentral
21.
go back to reference Kaya D, Doral MN, Nyland J, Toprak U, Turhan E, Donmez G, Citaker S, Atay OA, Callaghan MJ (2013) Proprioception level after endoscopically guided percutaneous Achilles tendon. Knee Surg Sports Traumatol Arthrosc 21(6):1238–1244CrossRefPubMed Kaya D, Doral MN, Nyland J, Toprak U, Turhan E, Donmez G, Citaker S, Atay OA, Callaghan MJ (2013) Proprioception level after endoscopically guided percutaneous Achilles tendon. Knee Surg Sports Traumatol Arthrosc 21(6):1238–1244CrossRefPubMed
22.
go back to reference Khan KM, Maffulli N (1998) Tendinopathy: an Achilles’ heel for athletes and clinicians. Clin J Sport Med 8:151–154CrossRefPubMed Khan KM, Maffulli N (1998) Tendinopathy: an Achilles’ heel for athletes and clinicians. Clin J Sport Med 8:151–154CrossRefPubMed
23.
24.
go back to reference Maffuli N, Longo UG, Franceschi F, Rabitti C, Denaro V (2008) Movin and Bonar scores assess the same characteristics of tendon histology. Clin Orthop Relat Res 466(7):1605–1611CrossRef Maffuli N, Longo UG, Franceschi F, Rabitti C, Denaro V (2008) Movin and Bonar scores assess the same characteristics of tendon histology. Clin Orthop Relat Res 466(7):1605–1611CrossRef
25.
go back to reference Maffulli N, Wong J, Almekinders LC (2003) Types and epidemiology of tendinopathy. Clin Sports Med 22:675–692CrossRefPubMed Maffulli N, Wong J, Almekinders LC (2003) Types and epidemiology of tendinopathy. Clin Sports Med 22:675–692CrossRefPubMed
26.
go back to reference Movin T (1998) Aspects of aetiology, pathoanatomy and diagnostic methods in chronic mid-portion achillodynia. Karolinska Institute, Stockholm, pp 1–51 Movin T (1998) Aspects of aetiology, pathoanatomy and diagnostic methods in chronic mid-portion achillodynia. Karolinska Institute, Stockholm, pp 1–51
27.
go back to reference Nielsen FH, Hunt CD, Mullen LM, Hunt JR (1987) Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J 1:394–397PubMed Nielsen FH, Hunt CD, Mullen LM, Hunt JR (1987) Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J 1:394–397PubMed
28.
go back to reference Nzietchueng RM, Dousset B, Franck P, Benderdour M, Nabet P, Hess K (2002) Mechanisms implicated in the effects of boron on wound healing. J Trace Elem Med Biol 16(4):239–244CrossRefPubMed Nzietchueng RM, Dousset B, Franck P, Benderdour M, Nabet P, Hess K (2002) Mechanisms implicated in the effects of boron on wound healing. J Trace Elem Med Biol 16(4):239–244CrossRefPubMed
29.
go back to reference Omeroglu S, Peker T, Turkozkan N, Omeroglu H (2009) High-dose vitamin C supplementation accelerates the Achilles tendon healing in healthy rats. Arch Orthop Trauma Surg 129:281–286CrossRefPubMed Omeroglu S, Peker T, Turkozkan N, Omeroglu H (2009) High-dose vitamin C supplementation accelerates the Achilles tendon healing in healthy rats. Arch Orthop Trauma Surg 129:281–286CrossRefPubMed
30.
go back to reference Pawa S, Ali S (2006) Boron ameliorates fulminant hepatic failure by counteracting the changes associated with the oxidative stress. Chem Biol Interact 160:89–98CrossRefPubMed Pawa S, Ali S (2006) Boron ameliorates fulminant hepatic failure by counteracting the changes associated with the oxidative stress. Chem Biol Interact 160:89–98CrossRefPubMed
31.
go back to reference Rainey C, Nyquist L (1998) Multicountry estimation of dietary boron intake. Biol Trace Elem Res 66:79–86CrossRefPubMed Rainey C, Nyquist L (1998) Multicountry estimation of dietary boron intake. Biol Trace Elem Res 66:79–86CrossRefPubMed
32.
go back to reference Thomopoulos S, Soslowsky LJ, Flanagan CL, Tun S, Keefer CC, Mastaw J (2002) The effect of fibrin clot on healing rat supraspinatus tendon defects. J Shoulder Elbow Surg 11:239–247CrossRefPubMed Thomopoulos S, Soslowsky LJ, Flanagan CL, Tun S, Keefer CC, Mastaw J (2002) The effect of fibrin clot on healing rat supraspinatus tendon defects. J Shoulder Elbow Surg 11:239–247CrossRefPubMed
33.
go back to reference Tuzuner S, Ozkan O, Erin N, Ozkaynak S, Cinpolat A, Ozkan O (2015) Effects of botulinum toxin A injection on healing and tensile strength of ruptured rabbit Achilles tendons. Ann Plast Surg 74:496–500CrossRefPubMed Tuzuner S, Ozkan O, Erin N, Ozkaynak S, Cinpolat A, Ozkan O (2015) Effects of botulinum toxin A injection on healing and tensile strength of ruptured rabbit Achilles tendons. Ann Plast Surg 74:496–500CrossRefPubMed
34.
go back to reference Williams IF, Nicholls JS, Goodship AE, Silver IA (1986) Experimental treatment of tendon injury with heparin. Br J Plast Surg 39:367–372CrossRefPubMed Williams IF, Nicholls JS, Goodship AE, Silver IA (1986) Experimental treatment of tendon injury with heparin. Br J Plast Surg 39:367–372CrossRefPubMed
36.
go back to reference Zhang F, Liu H, Stile F, Lei MP, Pang Y, Oswald TM, Beck J, Dorsett-Martin W, Lineaweaver WC (2003) Effect of vascular endothelial growth factor on rat Achilles tendon healing. Plast Reconstr Surg 112:1613–1619CrossRefPubMed Zhang F, Liu H, Stile F, Lei MP, Pang Y, Oswald TM, Beck J, Dorsett-Martin W, Lineaweaver WC (2003) Effect of vascular endothelial growth factor on rat Achilles tendon healing. Plast Reconstr Surg 112:1613–1619CrossRefPubMed
Metadata
Title
Effects of boric acid on the healing of Achilles tendons of rats
Authors
Burak Kaymaz
Umut Hatay Gölge
Gulzade Ozyalvaclı
Erkam Kömürcü
Ferdi Goksel
Musa Ugur Mermerkaya
Mahmut Nedim Doral
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3617-5

Other articles of this Issue 12/2016

Knee Surgery, Sports Traumatology, Arthroscopy 12/2016 Go to the issue