Macro Fat Graft Application for Preventing Tendon Adhesion After Tendon Repair: An Experimental Study in Rats.

Purpose: Tendon adhesion is a common postoperative complication following tendon repair, leading to impaired movement and increased morbidity. This study aimed to evaluate the effect of autologous macro fat grafts on preventing tendon adhesion following Achilles tendon repair in a Wistar rat model. Methods: A laboratory experimental study was conducted using a randomized post-test-only control group design. Thirty-six female Wistar rats were divided into two groups: control (no fat graft) and treatment groups (autologous macro fat graft applied circumferentially around the Achilles tendon after incision and repair). Histopathological evaluation was performed 3 weeks postintervention, assessing tenocyte count, collagen density, and both clinical and microscopic adhesion scores. Data analysis was performed using Mann-Whitney U and χ Results: The treatment group showed a notable reduction in adhesion scores and adhesion grades compared with the control group. Collagen density was also lower in the treatment group than in the control group. However, no meaningful difference was observed in tenocyte count between the two groups, although the treatment group demonstrated a slightly lower mean tenocyte count. Conclusions: The application of autologous macro fat grafts reduced tendon adhesion scores, adhesion grades, and collagen density postrepair, suggesting its potential as an effective strategy for preventing tendon adhesion. However, it did not considerably affect tenocyte proliferation. Clinical relevance: This preclinical study suggests that autologous macro fat grafting may reduce postoperative tendon adhesions and improve surgical outcomes, supporting its potential translation into clinical settings.