EFFECT OF PLATELET-RICH PLASMA INJECTION ON EARLY HEALING OF Achilles TENDON RUPTURE IN RATS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

XIONG Xiaolong , WU Liang , XIANG Dayong , NI Guoxin , ZHAO Peiran , YU Bin.

Department of Trauma and Orthopaedics,Nanfang Hospital, Southern Medical University, Guangzhou Guangdong, 510515, P.R.China;

Corresponding author：

Keywords：

Platelet-rich plasma; Achilles tendon rupture; Achilles tendon healing; Collagen type I; Rat

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Objective Platelet-rich plasma (PRP) can promote wound heal ing. To observe the effect of PRP injection on the early heal ing of rat’s Achilles tendon rupture so as to provide the experimental basis for cl inical practice. Methods Forty-six Sprague Dawley rats were included in this experiment, female or male and weighing 190-240 g. PRP and platelet-poor plasma (PPP) were prepared from the heart arterial blood of 10 rats; other 36 rats were made the models of Achilles tendon rupture, and were randomly divided into 3 groups (control group, PPP group, and PRP group), 12 rats for each group. In PPP and PRP groups, PPP and PRP of 100 μL were injected around the tendons once a week, respectively; in the control group, nothing was injected. The tendon tissue sample was harvested at 1, 2, 3, and 4 weeks after operation for morphology, histology, and immunohistochemistry observations. The content of collagen type I fibers also was measured. Specimens of each group were obtained for biomechanical test at 4 weeks. Results All the animals survived till the end of the experiment. Tendon edema gradually decreased and sliding improved with time. The tendon adhesion increased steadily from 1 week to 3 weeks postoperatively, and it was relieved at 4 weeks in 3 groups. There was no significant ifference in the grading of tendon adhesion among 3 groups at 1 week and at 4 weeks (P gt; 0.05), respectively. The inflammatory cell infiltration, angiogenesis, and collagen fibers were more in PRP group than in PPP group and control group at 1 week; with time, inflammatory cell infiltration and angiogenesis gradually decreased. Positive staining of collagen type I fibers was observed at 1-4 weeks postoperatively in 3 groups. The positive density of collagen type I fibers in group PRP was significantly higher than that in control group and PPP group at 1, 2, and 3 weeks (P lt; 0.05), but no significant difference was found among 3 groups at 4 weeks (P gt; 0.05). The biomechanical tests showed that there was no significant difference in the maximal gl iding excursion among 3 groups at 4 weeks postoperatively (P gt; 0.05); the elasticity modulus and the ultimate tensile strength of PRP group were significantly higher than those of control group and PPP group at 4 weeks (P lt; 0.05). Conclusion PRP injection can improve the healing of Achilles tendon in early repair of rat’s Achilles tendon rupture.

Citation： XIONG Xiaolong,WU Liang,XIANG Dayong,NI Guoxin,ZHAO Peiran,YU Bin.. EFFECT OF PLATELET-RICH PLASMA INJECTION ON EARLY HEALING OF Achilles TENDON RUPTURE IN RATS. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(4): 466-471. doi: Copy

1.	and radiographic animal study on the use of autogenous scaffolds and platelet-rich plasma. Int J Oral Maxillofac Surg, 2002, 31(3): 281-286.
2.	Assoian RK, Grotendorst GR, Miller DM, et al. Cellular transformation by coordinated action of three peptide growth factors from human platelets. Nature, 1984, 309(5971): 804-806.
3.	Fennis JP, Stoelinga PJ, Jansen JA. Mandibular reconstruction: a clinical.
4.	Foster TE, Puskas BL, Mandelbaum BR, et al. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med, 2009, 37(11): 2259-2272.
5.	Lyras DN, Kazakos K, Verettas D, et al. The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int, 2009, 30(11): 1101-1106.
6.	Camargo PM, Lekovic V, Weinlaender M, et al. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res, 2002, 37(4): 300-306.
7.	Schmitz JP, Hollinger JO. The biology of platelet-rich plasma. J Oral Maxillofac Surg, 2001, 59(9): 1119-1121.
8.	刘骥, 袁霆, 张长青. 富血小板血浆治疗慢性组织损伤的研究进展. 中国修复重建外科杂志, 2010, 24(6): 754-757.
9.	耿震, 王宸, 周海洋. 富血小板血浆对肌腱愈合影响的实验研究. 中国修复重建外科杂志, 2011, 25(3): 344-348.
10.	Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand, 2004, 75(1): 93-99.
11.	Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg, 2000, 58(3): 297-300.
12.	汤锦波, 侍德, 石井清一. 各种伤情下屈肌腱的愈合及粘连形成: 肌腱愈合新理论系统的探讨. 手外科杂志, 1992, 8(1): 31-35.
13.	Möller A, Astron M, Westlin N. Increasing incidence of Achilles tendon rupture. Acta Orthop Scand, 1996, 67(5): 479-481.
14.	Bhattacharyya M, Gerber B. Mini-invasive surgical repair of the Achilles tendon—does it reduce post-operative morbidity? Int Orthop, 2009, 33(1): 151-156.
15.	商晓军, 朱亚平, 韦兆祥. 闭合性跟腱断裂微创腱皮缝合的远期疗效观察. 中国矫形外科杂志, 2007, 15(18): 1371-1373.
16.	Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment. Injury, 2007, 38(7): 839-844.
17.	Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg (Am), 2010, 92(17): 2767-2775.
18.	Carter CA, Jolly DG, Worden CE Sr, et al. Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. Exp Mol Pathol, 2003, 74(3): 244-255.
19.	Kajikawa Y, Morihara T, Sakamoto H, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol, 2008, 215(3): 837-845.
20.	Kajikawa Y, Morihara T, Watanabe N, et al. GFP chimeric models exhibited a biphasic pattern of mesenchymal cell invasion in tendon healing. J Cell Physiol, 2007, 210(3): 684-691.
21.	盛加根, 曾炳芳, 姜佩珠, 等. 外源性碱性成纤维细胞生长因子对鞘内肌腱愈合和粘连的影响. 中国修复重建外科杂志, 2007, 21(7): 733-737.
22.	余利鹏, 罗永湘. 跟腱损伤治疗进展. 中国修复重建外科杂志, 2003, 17(4): 343-345.
23.	Spindler KP, Murray MM, Detwiler KB, et al. The biomechanical response to doses of TGF-beta 2 in the healing rabbit medial collateral ligament. J Orthop Res, 2003, 21(2): 245-249.
24.	Taylor DW, Petrera M, Hendry M, et al. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med, 2011, 21(4): 344-352.
25.	Schepull T, Kvist J, Norrman H, et al. Autologous platelets have no effect on the healing of human achilles tendon ruptures: a randomized single-blind study. Am J Sports Med, 2011, 39(1): 38-47.

1. and radiographic animal study on the use of autogenous scaffolds and platelet-rich plasma. Int J Oral Maxillofac Surg, 2002, 31(3): 281-286.
2. Assoian RK, Grotendorst GR, Miller DM, et al. Cellular transformation by coordinated action of three peptide growth factors from human platelets. Nature, 1984, 309(5971): 804-806.
3. Fennis JP, Stoelinga PJ, Jansen JA. Mandibular reconstruction: a clinical.
4. Foster TE, Puskas BL, Mandelbaum BR, et al. Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med, 2009, 37(11): 2259-2272.
5. Lyras DN, Kazakos K, Verettas D, et al. The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int, 2009, 30(11): 1101-1106.
6. Camargo PM, Lekovic V, Weinlaender M, et al. Platelet-rich plasma and bovine porous bone mineral combined with guided tissue regeneration in the treatment of intrabony defects in humans. J Periodontal Res, 2002, 37(4): 300-306.
7. Schmitz JP, Hollinger JO. The biology of platelet-rich plasma. J Oral Maxillofac Surg, 2001, 59(9): 1119-1121.
8. 刘骥, 袁霆, 张长青. 富血小板血浆治疗慢性组织损伤的研究进展. 中国修复重建外科杂志, 2010, 24(6): 754-757.
9. 耿震, 王宸, 周海洋. 富血小板血浆对肌腱愈合影响的实验研究. 中国修复重建外科杂志, 2011, 25(3): 344-348.
10. Aspenberg P, Virchenko O. Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand, 2004, 75(1): 93-99.
11. Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg, 2000, 58(3): 297-300.
12. 汤锦波, 侍德, 石井清一. 各种伤情下屈肌腱的愈合及粘连形成: 肌腱愈合新理论系统的探讨. 手外科杂志, 1992, 8(1): 31-35.
13. Möller A, Astron M, Westlin N. Increasing incidence of Achilles tendon rupture. Acta Orthop Scand, 1996, 67(5): 479-481.
14. Bhattacharyya M, Gerber B. Mini-invasive surgical repair of the Achilles tendon—does it reduce post-operative morbidity? Int Orthop, 2009, 33(1): 151-156.
15. 商晓军, 朱亚平, 韦兆祥. 闭合性跟腱断裂微创腱皮缝合的远期疗效观察. 中国矫形外科杂志, 2007, 15(18): 1371-1373.
16. Lansdaal JR, Goslings JC, Reichart M, et al. The results of 163 Achilles tendon ruptures treated by a minimally invasive surgical technique and functional aftertreatment. Injury, 2007, 38(7): 839-844.
17. Willits K, Amendola A, Bryant D, et al. Operative versus nonoperative treatment of acute Achilles tendon ruptures: a multicenter randomized trial using accelerated functional rehabilitation. J Bone Joint Surg (Am), 2010, 92(17): 2767-2775.
18. Carter CA, Jolly DG, Worden CE Sr, et al. Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. Exp Mol Pathol, 2003, 74(3): 244-255.
19. Kajikawa Y, Morihara T, Sakamoto H, et al. Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol, 2008, 215(3): 837-845.
20. Kajikawa Y, Morihara T, Watanabe N, et al. GFP chimeric models exhibited a biphasic pattern of mesenchymal cell invasion in tendon healing. J Cell Physiol, 2007, 210(3): 684-691.
21. 盛加根, 曾炳芳, 姜佩珠, 等. 外源性碱性成纤维细胞生长因子对鞘内肌腱愈合和粘连的影响. 中国修复重建外科杂志, 2007, 21(7): 733-737.
22. 余利鹏, 罗永湘. 跟腱损伤治疗进展. 中国修复重建外科杂志, 2003, 17(4): 343-345.
23. Spindler KP, Murray MM, Detwiler KB, et al. The biomechanical response to doses of TGF-beta 2 in the healing rabbit medial collateral ligament. J Orthop Res, 2003, 21(2): 245-249.
24. Taylor DW, Petrera M, Hendry M, et al. A systematic review of the use of platelet-rich plasma in sports medicine as a new treatment for tendon and ligament injuries. Clin J Sport Med, 2011, 21(4): 344-352.
25. Schepull T, Kvist J, Norrman H, et al. Autologous platelets have no effect on the healing of human achilles tendon ruptures: a randomized single-blind study. Am J Sports Med, 2011, 39(1): 38-47.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECT OF PLATELET-RICH PLASMA INJECTION ON EARLY HEALING OF Achilles TENDON RUPTURE IN RATS

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