Effect of systemic anticoagulants on fracture healing in rats tibia

This study aimed to evaluate the effects of the systemic anticoagulants Apixaban, Rivaroxaban, Edoxaban, and Dabigatran on fracture healing. 48 female Spraque Dawley rats were divided into 6 groups with 8 rats in each group. Healthy Control group (n=8): no procedure was applied during the four-week experimental setup. Sham group (n=8): fractures were created in the right tibias of the subjects by surgical methods and the fractures were fixed with Kirshner wires in this group and all anticoagulant groups. No additional procedure was applied during the four (4) week to yhe sham group experimental setup. Throughout the 4-week experimental period, the animals were administered the following treatments via oral gavage three times per week: the Apixaban Group (n=8) received 5 mg/kg of apixaban; the Rivaroxaban Group (n=8) received 3 mg/kg of rivaroxaban; the Edoxaban Group (n=8) received 3 mg/kg of edoxaban; and the Dabigatran Group (n=8) received 10 mg/kg of dabigatran. At the end of the four-week experimental period, all rats were euthanized. Bone tissues were harvested, decalcified, and processed for histological analysis. A statistically significant difference was observed among the groups (P < 0.05). Post hoc analysis revealed that the Apixaban group (M = 55.75, SD= 3.41) and the Rivaroxaban group (M = 55.38, SD = 3.89) had significantly higher mean values compared to the Control group (M = 41.75, SD = 5.57) (P < 0.05). Additionally, the Dabigatran group (M = 44.00, SD = 4.66) and the Edoxaban group (M = 48.63, SD = 5.55) also differed significantly from the Control, with Edoxaban showing a statistically significant difference compared to Dabigatran (P < 0.05). No significant difference was observed between Apixaban and Rivaroxaban.The histopathological evaluations revealed that the administration of these anticoagulants had statistically significant effects on new bone formation compared to the control group.