Prevention of Tendon Adhesion and Preservation of Healing Strength Using a Hydrophobically Modified Alaska Pollock Gelatin Sheet

BACKGROUND: Tendon adhesion after repair remains a major postoperative complication that limits motion and impairs functional recovery. Although various anti-adhesion materials have been investigated, many compromise tendon healing and strength. A novel bioadhesive sealant derived from hydrophobically modified Alaska pollock gelatin (hm-ApGltn) has demonstrated anti-adhesion effect and biocompatibility in previous studies. This study aimed to evaluate the efficacy of an hm-ApGltn sheet in preventing tendon adhesion and preserving tendon healing strength in a rat Achilles tendon partial defect model. METHODS: Fifty-two Wistar rats were randomly assigned to the ApGltn group (n = 26) or the control group (n = 26). After creation of an Achilles tendon defect model, the ApGltn group received circumferential application of an hm-ApGltn sheet around the tendon. Biomechanical traction testing was performed at 2 and 4 weeks to evaluate adhesion strength and tendon tensile strength. Histological assessments were conducted using Masson's trichrome staining. RESULTS: At both 2 and 4 weeks, the ApGltn group showed significantly lower failure loads for adhesion detachment than the control group, indicating reduced adhesion formation. No significant differences in tendon tensile strength were found between the ApGltn and control groups at either time point. Histological examination demonstrated significantly improved adhesion quality in the ApGltn group, with residual hm-ApGltn material observed up to 4 weeks postoperatively. CONCLUSIONS: The hm-ApGltn sheet effectively prevented peritendinous adhesion without impairing tendon healing strength in a rat Achilles tendon partial defect model. This biocompatible sealant represents a promising material for adhesion prevention in tendon repair.Clinical Relevance Statement: This study demonstrates that an ApGltn sealant effectively prevents postoperative tendon adhesion without impairing tendon healing or tensile strength.These findings suggest that ApGltn may serve as a safe and biocompatible barrier material for clinical use in tendon repair surgery.