Abstract
BACKGROUND: Post-surgical tendon adhesion formation is a frequent clinical complication with limited treatment options. The aim of this study is to investigate safety and efficacy of orally administration of crocin in attenuating post-operative tendon-sheath adhesion bands in an Achilles tendon rat model. METHODS: Structural, mechanical, histological, and biochemical properties of Achilles tendons were analyzed in the presence and absence of crocin. Inflammation and total fibrosis of tendon tissues were graded between groups using macroscopic and histological scoring methods. RESULTS: Crocin significantly alleviated the severity, length, and density of Achilles tendon adhesions. Moreover, the recruitment of inflammatory cells and inflammation were significantly decreased in post-operative tissue samples of the crocin-treated group, as quantified with Moran scoring system. Histological results showed that crocin elicited a potent anti-fibrotic effect on tendon tissue samples as visualized by decreasing quantity, quality, grading of fibers, and collagen deposition at the site of surgery when scored either by Tang or Ishiyama grading systems. The H&E staining showed no histo-pathological changes or damage to heart, kidney, and liver tissues of treated rats. CONCLUSION: Our results showed that crocin is a safe effective therapeutic candidate with potent anti-inflammatory and anti-fibrotic properties for adhesion band therapy post tendon surgery.