scholarly journals Biomechanical Effects of Δ9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD), the Major Constituents of Cannabis, in a Sprague Dawley Rat Achilles Tendon Surgical Repair Model

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0008
Author(s):  
Chris M. Stauch ◽  
Brittany Ammerman ◽  
Diana E. Sepulveda ◽  
Michael C. Aynardi ◽  
Matthew Garner ◽  
...  

Category: Sports; Hindfoot Introduction/Purpose: Use of Cannabis is common amongst athletes and the U.S. population at large. Use of Cannabinoid Oil is being increasingly utilized for a number of different pathologies, injuries, and ailments due to anecdotal evidence of its efficacy. Due to the current United States Opioid crisis, Δ9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD), the two major constituents of cannabis, are currently being evaluated as potential safer alternatives to narcotic pain medicines. The effects of recreational and/or therapeutic THC and CBD on musculoskeletal injury and healing however remain largely unknown. Our purpose was to evaluate the biomechanical effects of THC and CBD on tendon to tendon healing in a Sprague Dawley Achilles Tendon injury and surgical repair model. Methods: 33 Sprague Dawley rats were randomly assigned into control (1 ml/kg/day of vehicle containing 5% Cremaphor, 5% ethanol, and 0.9% saline n=12), THC (3 mg/kg/day n = 12), or CBD (3 mg/kg/day n=9) treatment groups. Surgical transection and repair of the Achilles tendon was performed and all rats began subcutaneous administration of their respective drug treatment the day of surgery and for 4 subsequent days, followed by sacrifice. Load to failure and stiffness were calculated from load displacement data during tensile load testing on a MTS machine. One-way ANOVA with heterogeneous variance was utilized for evaluation. Means and 95% confidence intervals were also determined. Results: The CBD group demonstrated the highest mean load to failure of 17.5 N (15.1-19.8 N), with the THC group having the second highest mean load to failure at 17.3 N (15.3-19.2 N), and the control group reporting the lowest at 15.2 N (12.1-18.3 N). No statistical difference was observed between CBD/control (p = 0.25), THC/control (p = 0.29), or CBD/THC groups (p = 0.92, Figure 1A). The THC group reported the highest mean stiffness of 3.9 N/mm (2.7-5.1 N/mm). The CBD and control groups demonstrated mean stiffness values of 3.5 N/mm (2.9-4.1 N/mm) and 3.5 N (2.7-4.3 N/mm), respectively. No statistically significant differences were observed between THC/control (p = 0.51), THC/CBD (p = 0.50), or CBD/control groups (p = 0.96) for stiffness (Figure 1B). Conclusion: Our investigation demonstrates that subcutaneous administration of CBD resulted in the highest mean load to failure, while THC administration resulted in the highest mean stiffness of the three groups. This did not result however in a statistically significant difference between groups. In our small animal tendon-to-tendon repair model, use of THC or CBD did not result in decreased biomechanical characteristics, and there was a trend toward improved ultimate strength and stiffness as compared to control. Further evaluation with larger numbers of animals, and evaluating the potential synergistic effects of THC and CBD administered together are warranted.

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0039
Author(s):  
Chris Stauch ◽  
Brittany Ammerman ◽  
Michael Aynardi ◽  
Matthew Garner ◽  
Greg Lewis ◽  
...  

Objectives: Use of Cannabis is common amongst athletes and the U.S. population at large. Use of Cannabinoid Oil is being increasingly utilized for a number of different pathologies, injuries, and ailments due to anecdotal evidence of its efficacy. Due to the current United States Opioid crisis, Δ9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD), the two major constituents of cannabis, are currently being evaluated as potential safer alternatives to narcotic pain medicines. The effects of recreational and/or therapeutic THC and CBD on musculoskeletal injury and healing however remain largely unknown. Our purpose was to evaluate the biomechanical effects of THC and CBD on tendon to tendon healing in a Sprague Dawley Achilles Tendon injury and surgical repair model. Methods: 33 Sprague Dawley rats were randomly assigned into control (1 ml/kg/day of vehicle containing 5% Cremaphor, 5% ethanol, and 0.9% saline n=12), THC (3 mg/kg/day n = 12), or CBD (3 mg/kg/day n=9) treatment groups. Surgical transection and repair of the Achilles tendon was performed and all rats began subcutaneous administration of their respective drug treatment the day of surgery and for 4 subsequent days, followed by sacrifice. Load to failure and stiffness were calculated from load displacement data during tensile load testing on a MTS machine. One-way ANOVA with heterogeneous variance was utilized for evaluation. Means and 95% confidence intervals were also determined. Results: The CBD group demonstrated the highest mean load to failure of 17.5 N (15.1-19.8 N), with the THC group having the second highest mean load to failure at 17.3 N (15.3-19.2 N), and the control group reporting the lowest at 15.2 N (12.1-18.3 N). No statistical difference was observed between CBD/control (p = 0.25), THC/control (p = 0.29), or CBD/THC groups (p = 0.92, Figure 1A). The THC group reported the highest mean stiffness of 3.9 N/mm (2.7-5.1 N/mm). The CBD and control groups demonstrated mean stiffness values of 3.5 N/mm (2.9-4.1 N/mm) and 3.5 N (2.7-4.3 N/mm), respectively. No statistically significant differences were observed between THC/control (p = 0.51), THC/CBD (p = 0.50), or CBD/control groups (p = 0.96) for stiffness (Figure 1B). Conclusion: Our investigation demonstrates that subcutaneous administration of CBD resulted in the highest mean load to failure while THC administration resulted in the highest mean stiffness of the three groups. This did not result however in a statistically significant difference between groups. In our small animal tendon-to-tendon repair model, use of THC or CBD did not result in decreased biomechanical characteristics, and there was a trend toward improved ultimate strength and stiffness as compared to control. Further evaluation with larger numbers of animals, and evaluating the potential synergistic effects of THC and CBD administered together are warranted. [Figure: see text]


2021 ◽  
pp. 036354652110168
Author(s):  
Christopher M. Stauch ◽  
Brittany Ammerman ◽  
Diana Sepulveda ◽  
Michael C. Aynardi ◽  
Matthew R. Garner ◽  
...  

Background: The use of cannabis is common among athletes and the US population at large. Cannabinoids are currently being evaluated as alternatives to opioid medications for chronic pain management. However, the effects of recreational and/or medical use of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on musculoskeletal injury and healing remain largely unknown. Hypothesis/Purpose: The purpose of this study was to evaluate the biomechanical effects of CBD and THC on tendon-to-tendon healing in a rat Achilles tendon repair model. The hypothesis was that rats administered CBD would demonstrate decreased tensile load to failure of surgically repaired Achilles tendons compared with the THC and control groups. Study Design: Controlled laboratory study. Methods: A total of 33 Sprague Dawley rats underwent Achilles tendon surgical transection and repair and were randomized to receive subcutaneous injection of THC, CBD, or vehicle once daily starting on the day of surgery and for 5 total days. After sacrifice, biomechanical tensile load-displacement testing was performed to determine Achilles tendon load to failure and stiffness. Data were analyzed by 1-way analysis of variance. Results: The THC group demonstrated the highest median load to failure, 18.7 N (95% CI, 15.3-19.2 N); the CBD group had the second highest at 16.9 N (95% CI, 15.1-19.8 N), and the control group had the lowest at 14.4 N (95% CI, 12.1-18.3 N). Stiffness was highest in the THC group at 4.1 N/mm (95% CI, 2.7-5.1 N/mm) compared with 3.6 N/mm (95% CI, 2.9-4.1 N/mm) for the CBD group and 3.6 N/mm (95% CI, 2.8-4.3 N/mm) for the control group. No statistically significant differences for strength and stiffness were observed between the groups. Conclusion: In this pilot study using an animal tendon-to-tendon repair model, neither THC nor CBD resulted in altered biomechanical characteristics compared to control. Clinical Relevance: Cannabinoids do not appear to adversely affect Achilles tendon healing.


2020 ◽  
Author(s):  
Bo Qin ◽  
Dingsu Bao ◽  
Shengqiang Zeng ◽  
Kai Deng ◽  
Gang Liu ◽  
...  

Abstract Background: Application of platelet-rich plasma (PRP) can improve tendon-bone healing (TBH) after rotator cuff surgical repair. Graphene Oxide (GO) is a steady, controlled, and sustained carrier. The purpose of this study is to determine whether GO/PRP Composite Scaffold enhances the TBH after RC surgical repair in a rabbit model.Methods: A full-thickness tear of the supraspinatus tendon was created and repaired in 36 adult male New Zealand rabbits. They were divided into three groups: Control group, PRP group, and GO/PRP Composite Scaffold group (GO group). The effect of GO/PRP Composite Scaffold on TBH was assessed using histological and biomechanical evaluations at 8 and 12 weeks postoperatively.Results: Histological analysis showed that greater continuity, better orientation, and more density of collagen fiber were detected in the GO group than PRP and Control groups at 8 and 12 weeks, respectively. Results of biomechanical evaluations showed that the load to failure and stiffness of the GO group were statistically higher than those of PRP and Control groups at both 8 and 12 weeks (P<0.05). Compared with 8 weeks in the GO group, there was no significant difference in load to failure at 12 weeks (P>0.05), while the stiffness at 12 weeks was higher than that at 8 weeks (P<0.05). Conclusions: These results demonstrated that GO/PRP Composite Scaffold enhanced the TBH following rotator cuff surgical repair in a rabbit model. The GO may be an effective carrier for PRP into repair sites.


2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0032
Author(s):  
Patrick Kennedy ◽  
Kaitlin Saloky ◽  
Aditya Yadavalli ◽  
Erin Barlow ◽  
Michael Aynardi ◽  
...  

Objectives: The negative effects of smoking have been well documented following orthopedic injury. Though nicotine has been shown to be detrimental to musculoskeletal tissue healing, nicotine in the form of “Vaping” is being increasingly used as a perceived healthier alternative to actual smoking. It may theoretically obviate many of the harmful volatiles and chemicals contained within combusted tobacco that are additionally harmful to musculoskeletal healing, beyond just nicotine. The literature has yet to establish the benefits, or lack thereof, to exposure of e-cigarettes and their effect on tendon healing when compared to traditional combusted tobacco. Our objective was to evaluate the biomechanical and histological effects on Achilles tendon repair between inhaled combusted tobacco versus isolated nicotine exposure via vaping versus a control group in a small animal (Sprague Dawley Rat) model. Methods: 54 Sprague Dawley rats were randomly placed in a control, vaping, or cigarette cohort. Each group contained 17 rats for exposure and they were exposed six days per week. The smoking cohort was exposed to 2 unfiltered University of Kentucky research cigarettes in a smoking chamber (Image 1). The vaping group was exposed to e-cigarette vapor with equivalent nicotine exposure as compared to the cigarette group, over ten minutes at a flow rate of 2.4 L/min. The control group was placed in the smoking chamber with room air flowing through the chamber. All rats received their respective daily exposures for 4 weeks prior to surgery where transection and repair of the Achilles tendon was performed. Following surgery, the rats received 2 additional weeks of smoking vs vaping vs control exposure. After sacrifice, Achilles tendons were harvested and tested with tensile and a load to failure model (Image 2). Histological samples were sent for analysis. Results: Tensile load testing evaluated maximum force to rupture and tissue stiffness amongst the three cohorts. The control group demonstrated highest mean tensile strength of 41.0 N (18.3-55.1 N), with the cigarette cohort having the second highest mean tensile strength at 37.3 N (14.0-54.7 N), and finally the vaping group had the lowest at 32.28 N (17.8-45.1 N). One-way ANOVA with heterogeneous of variance was used for evaluation. There was a significant difference noted in load to failure when comparing controls to e-cigarettes (p=0.026). No statistical difference was seen between controls vs cigarettes (p=0.35). Histological analysis is in progress. Conclusion: Our investigation demonstrates that in a rat model, isolated nicotine exposure via ”vaping” significantly impedes biomechanical healing properties of Achilles tendon surgical repair. Though smoking resulted in a lower maximum force to failure as compared to control, this difference was not significant. While E-cigarettes are often utilized as a perceived “safer” alternative to smoking combusted tobacco, this study suggests that use of e-cigarettes may be more detrimental to tendon healing than combusted tobacco in a rat Achilles model.


2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Dimas Visa Aditya ◽  
Tarmono Djojodimedjo ◽  
Doddy M Soebadi

Objective: To evaluate the protective effects of vitamin E α-tocopherol isomer against the toxicity of cisplatin on sperm motility and morphology in Sprague Dawley rats. Material & Methods: Twenty-four rats were grouped into four groups (n=6). The control group (CN) was injected with normal saline, second group (CP) was injected with cisplatin, the third group (P1) was injected with cisplatin and vitamin E 50 mg/kgBW for 7 weeks P.O, the fourth group (P2) was injected with cisplatin and vitamin E 200 mg/kgBW for 7 weeks P.O. Vitamin E was given from 3 weeks before cisplatin injection and 4 weeks following cisplatin injection. At 7th week, all the samples were undergoing bilateral orchidectomy. Vitamin E that being used in this study was α-tocopherol isomer. Results: Cisplatin decreased motility and morphology of spermatozoa significantly against controls. Vitamin E 50 mg/kgBW and 200 mg/kgBW significantly increased motility of spermatozoa (p<0.05) compared to those in the cisplatin group only. Vitamin E 50 mg/kgBW, and 200 mg/kgBW did not have a significant difference in spermatozoa motility compare to control groups. Vitamin E 50 mg/kgBW and 200 mg/kgBW could increase the spermatozoa morphology significantly compare to those cisplatin only group. Vitamin E 50 mg/kgBW, and 200 mg/kgBW did not have a significant difference in spermatozoa morphology compared to control groups. Conclusion: α-tocopherol 50 mg/kgBW and 200 mg/kgBW provided a same protective effect against spermatozoa damage especially in motility and morphology aspect due to cisplatin exposure. Therefore, in this study it was more recommended to use α-tocopherol in 50 mg/kgBW dose than 200 mg/kgBW.


2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0024
Author(s):  
Patrick Kennedy ◽  
Kaitlin Saloky ◽  
Aditya Yadavalli ◽  
Erin Barlow ◽  
Michael Aynardi ◽  
...  

Category: Basic Sciences/Biologics Introduction/Purpose: The negative effects of smoking have been well documented following orthopedic injury. Though nicotine has been shown to be detrimental to musculoskeletal tissue healing, nicotine in the form of “Vaping” is being increasingly used as a perceived healthier alternative to actual smoking and may theoretically obviate many of the harmful volatiles and chemicals contained within combusted tobacco that are additionally harmful to musculoskeletal healing. Our objective was to evaluate the biomechanical and histological effects on Achilles tendon repair between rats that inhaled combusted tobacco, versus those with isolated nicotine exposure via vaping, versus a control group. Methods: 54 Sprague Dawley rats were randomly placed in a control, vaping, or cigarette cohort. Each group contained 17 rats and exposure occurred six days per week. The smoking cohort was exposed to 2 unfiltered University of Kentucky research cigarettes in a previously validated smoking chamber (Figure 1). The vaping group was exposed to e-cigarette vapor with equivalent nicotine exposure over ten minutes at a flow rate of 2.4 L/min. The control group was placed in the smoking chamber with room air flowing through the chamber. All rats received their respective daily exposures for 4 weeks prior to surgery when surgical transection and repair of the Achilles tendon was performed. Following surgery, the rats continued 2 additional weeks of smoking, vaping, or control exposure. After sacrifice, Achilles tendons were harvested and tested with controlled tension to failure. Histology (n = 2 per group) was performed with a standard H&E protocol. Results: Tensile load testing evaluated maximum force to rupture and tissue stiffness amongst the three cohorts. The control group demonstrated highest mean tensile strength of 41.0 N (18.3-55.1 N), with the cigarette cohort having the second highest mean tensile strength at 37.3 N (14.0-54.7 N), and finally the vaping group had the lowest at 32.28 8 N (17.8-45.1 N). One-way ANOVA with heterogeneity of variance was used for evaluation. There was a significant difference detected in load to failure when comparing controls to e-cigarettes (p=0.026). No statistical difference was seen between controls vs cigarettes (p=0.35). Histological analysis demonstrated no difference among groups. Conclusion: Our investigation demonstrates that, in a rat model, isolated nicotine exposure via ”vaping” significantly impedes biomechanical healing properties of Achilles tendon surgical repair. Though smoking resulted in a lower maximum force to failure as compared to control in these samples, this difference was not significant. While E-cigarettes are often utilized as a perceived “safer” alternative to smoking combusted tobacco, this study suggests that use of e-cigarettes may be more detrimental to tendon healing than combusted tobacco in a rat Achilles model.


2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.


2021 ◽  
pp. 1-9
Author(s):  
Hiroki Ushirozako ◽  
Tomohiko Hasegawa ◽  
Yu Yamato ◽  
Go Yoshida ◽  
Tatsuya Yasuda ◽  
...  

OBJECTIVESurgical site infection (SSI) after posterior spinal surgery is one of the severe complications that may occur despite administration of prophylactic antibiotics and the use of intraoperative aseptic precautions. The use of intrawound vancomycin powder for SSI prevention is still controversial, with a lack of high-quality and large-scale studies. The purpose of this retrospective study using a propensity score–matched analysis was to clarify whether intrawound vancomycin powder prevents SSI occurrence after spinal surgery.METHODSThe authors analyzed 1261 adult patients who underwent posterior spinal surgery between 2010 and 2018 (mean age 62.3 years; 506 men, 755 women; follow-up period at least 1 year). Baseline and surgical data were assessed. After a preliminary analysis, a propensity score model was established with adjustments for age, sex, type of disease, and previously reported risk factors for SSI. The SSI rates were compared between patients with intrawound vancomycin powder treatment (vancomycin group) and those without (control group).RESULTSIn a preliminary analysis of 1261 unmatched patients (623 patients in the vancomycin group and 638 patients in the control group), there were significant differences between the groups in age (p = 0.041), body mass index (p = 0.013), American Society of Anesthesiologists classification (p < 0.001), malnutrition (p = 0.001), revision status (p < 0.001), use of steroids (p = 0.019), use of anticoagulation (p = 0.033), length of surgery (p = 0.003), estimated blood loss (p < 0.001), and use of instrumentation (p < 0.001). There was no significant difference in SSI rates between the vancomycin and control groups (21 SSIs [3.4%] vs 33 SSIs [5.2%]; OR 0.640, 95% CI 0.368–1.111; p = 0.114). Using a one-to-one propensity score–matched analysis, 444 pairs of patients from the vancomycin and control groups were selected. There was no significant difference in the baseline and surgical data, except for height (p = 0.046), between both groups. The C-statistic for the propensity score model was 0.702. In the score-matched analysis, 12 (2.7%) and 24 (5.4%) patients in the vancomycin and control groups, respectively, developed SSIs (OR 0.486, 95% CI 0.243–0.972; p = 0.041). There were no systemic complications related to the use of vancomycin.CONCLUSIONSThe current study showed that intrawound vancomycin powder was useful in reducing the risk of SSI after posterior spinal surgery by half, without adverse events. Intrawound vancomycin powder use is a safe and effective procedure for SSI prevention.


Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1569
Author(s):  
Tomislav Šušnjar ◽  
Ivana Kuzmić Prusac ◽  
Ivan Švagelj ◽  
Anđela Jurišić ◽  
Tomislav Šušnjar ◽  
...  

Background: The aim of this study was to compare consequences in single and triple testicular biopsy by biopty gun in pubertal rats using histological and immunohistochemical analysis. Methods: Thirty-two Sprague-Dawley male rats were used as the experimental model. The rats were randomly divided into three study groups. The rats from the first group (n = 12) received a single-biopsy of upper pole of the left testis, while the rats from the second group (n = 10) received triple-biopsy of upper and lower poles and lateral surface of left testis. The third group (n = 10) was a control group. On the eightieth day after the biopsy in all rats bilateral orchiectomy and funiculectomy were performed to obtain testicular tissue and sperm for analysis. The consequences of the puncture were observed by pathohistology, immunohistochemistry and semen analysis. Results: The results of the study showed lower percentage of sperm count (14.5 mill/mL vs. 16 mill/mL, p = 0.130), sperm motility (24.6% vs. 32.7%, p > 0.05), abnormal sperm (30% vs. 27%, p > 0.05), atrophic tubules (21% vs. 6%, p < 0.001), volume (1.7 mL vs. 2.28 mL, p < 0.01) and apoptotic index (1.56 vs. 1.19, p = 0.650) in the testes with a triple-biopsy compared to the testes with a single-biopsy. Semen analysis showed a borderline significant difference between the group with triple-biopsy where sperm count was lower than it in the control group (14.5 mill/mL vs. 17.5 mill/mL, p = 0.05). A single-biopsy has little effect on the testis, especially on overall fertility. A triple-biopsy showed higher degree of the testicular damage but without a significant impact on overall fertility. Semen analysis showed that single- and triple-biopsies did not have a significant effect on sperm count, motility and morphology. Conclusion: Biopty gun procedure is a cheap, simple and reliable method for testicular biopsy in rats without a significant effect on sperm count, motility and morphology.


Author(s):  
Elif Karatoprak ◽  
Samet Paksoy

AbstractThe aim of this study was to investigate the thyroid functions in children receiving levetiracetam or valproate monotherapy. We retrospectively reviewed the records of children with controlled epilepsy receiving valproic acid (VPA group) or levetiracetam monotherapy (LEV group) for at least 6 months. Free thyroxine 4 levels (fT4) and thyroid stimulating hormone (TSH) levels were compared between VPA group, LEV group, and age- and gender-matched healthy children (control group). A total of 190 children were included in the study: 63 were in the VPA, 60 in the LEV, and 67 in the control group. Although there was no significant difference regarding average fT4 levels, higher TSH levels were found in the VPA group when compared with the LEV and control groups (p < 0.001 and p < 0.001, respectively). There was no significant difference in terms of fT4 and TSH values in the LEV group when compared with the control group (p = 0.56 and p = 0.61, respectively). Subclinical hypothyroidism (defined as a TSH level above 5 uIU/mL with a normal fT4 level was detected in 16% of patients in the VPA group, none in the LEV and control groups. Our study found that VPA therapy is associated with an increased risk of subclinical hypothyroidism while LEV had no effect on thyroid function tests.


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