{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:03:59Z","timestamp":1792717439008,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,11,30]],"date-time":"2018-11-30T00:00:00Z","timestamp":1543536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5P30AR069619"],"award-info":[{"award-number":["5P30AR069619"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001279","name":"Orthopaedic Research and Education Foundation","doi-asserted-by":"publisher","award":["17\u2010011"],"award-info":[{"award-number":["17\u2010011"]}],"id":[{"id":"10.13039\/100001279","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Nicotine is harmful to many bodily systems; however, the effects of nicotine on intra\u2010substance tendon healing remain largely unexplored. The purpose of this study was to examine the functional, structural, and biomechanical effects of nicotine on the healing of Achilles tendons in rats after an acute full\u2010thickness injury. Sixty Sprague\u2010Dawley rats were enrolled in this study. Half were exposed to 0.9% saline and half to 61\u2009ng\/mL of nicotine for 3 months via subcutaneous osmotic pumps. At 3 months, all rats underwent blunt full thickness transection of the left Achilles tendon and were immobilized for one week in plantarflexion.\n                      <jats:italic>In\u2010vivo<\/jats:italic>\n                      assays were conducted prior to injury, at 21 days, and at 42 days post\u2010injury and included the following: Functional limb assessment, passive joint mechanics, and vascular evaluation. Rats were sacrificed at 21 and 42 days for biomechanical testing and histologic evaluation. Rats exposed to nicotine demonstrated decreased vascularity, greater alteration in gait mechanics, and increased passive ROM of the ankle joint. Biomechanically, the nicotine tendons failed at lower maximum loads, were less stiff, had smaller cross\u2010sectional areas and had altered viscoelastic properties. Histologically, nicotine tendons demonstrated decreased vessel density at the injury site. This study demonstrates that nicotine leads to worse functional outcomes and biomechanical properties in tendons. The decreased vascularity in the nicotine group may suggest an underlying mechanism for inferior tendon healing. Patients should be counseled that using nicotine products increase their risk of poor tendon healing and may predispose them to tendon re\u2010rupture. \u00a9 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. 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Smoking and Tobacco Use; Fact Sheet; Adult Cigarette Smoking in the United States;2018.https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/adult_data\/cig_smoking\/index.htm. Accessed April 24 2018."},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/tc.9.suppl_2.ii60"},{"key":"e_1_2_7_5_1","unstructured":"Department of Health U Services H for Disease Control C Center for Chronic Disease Prevention N Promotion H on Smoking O. E\u2010Cigarette Use Among Youth and Young Adults: A Report of the Surgeon General.https:\/\/e\u2010cigarettes.surgeongeneral.gov\/documents\/2016_sgr_full_report_non\u2010508.pdf. 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