Role of Autogenous Fat Grafting in Prevention of Tendon Adhesion After Repair of Tendoachilles in Male Albino Rats

Document Type : Original Article

Authors

1 Professor of plastic and reconstructive surgery, Faculty of Medicine, Zagazig University, Egypt

2 Lecturer of plastic and reconstructive Surgery, Faculty of Medicine, Zagazig University, Egypt

3 Department of Plastic and Reconstructive surgery, Faculty of Medicine, Zagazig University, Egypt

Abstract

Background: Tendon injuries are common musculoskeletal disorders, often requiring surgical intervention. Postoperative adhesions are a major complication, hindering tendon function. Autogenous fat grafting has gained attention for its potential anti-inflammatory and regenerative effects in tendon repair. This study aimed to evaluate the role of autogenous fat grafting in preventing postoperative tendon adhesion and enhancing tendon healing following Achilles tendon repair in male albino rats. Methods: This prospective study included 26 male albino rats (52 Achilles tendons). The right tendon was repaired using the Modified Kessler technique with autogenous fat grafting (Group A), while the left tendon was repaired without grafting (Group B, control). Rats were followed for six weeks, and tendons were harvested on day 45 for histopathological and morphometric analysis. Results: Two rats died during anesthesia; 24 completed the study. Clinically, gait recovery and healing time showed no statistically significant differences between groups, although fat-grafted tendons demonstrated consistently better recovery trends. Histologically, Group A exhibited marked reparative processes with parallel collagen fiber orientation, reduced fibroplasia, and minimal adhesions. Morphometric analysis revealed a significant reduction in polymorphonuclear and macrophage counts in Group A compared to Group B(p<0.001), while lymphocyte counts showed no significant difference. Collagen analysis demonstrated significantly higher type I collagen deposition in Group A(50±7%) compared with Group B (31±4%;p<0.001). Conclusion: Autogenous fat grafting offers significant biological benefits in tendon repair. The reduction in inflammatory infiltration, particularly of neutrophils and macrophages, suggests that fat grafts may help modulate the immune response, potentially leading to a more favorable healing environment.

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Zagazig University Medical Journal
Volume 31, Issue 11
November 2025
Pages 5588-5600

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