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Archives of Orthopaedic and Trauma Surgery

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01-03-2014 | Arthroscopy and Sports Medicine

Platelet-rich plasma for enhancing surgical rotator cuff repair: evaluation and comparison of two application methods in a rat model

Authors: Ali Ersen, M. Demirhan, A. C. Atalar, M. Kapicioğlu, Gokhan Baysal

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2014

Abstract

Purpose

Platelet-rich plasma (PRP) is a natural concentrate of autologous growth factors now being widely tested in different fields of medicine for its potential in enhancing the regeneration of tissue with low healing potential. However, studies of PRP in enhancing rotator cuff repair have been contradictory, perhaps because of how PRP is administered. The purpose of this study is to evaluate the effect of PRP and compare two different application methods of PRP on rotator cuff healing.

Methods

The supraspinatus tendons of 48 mature, male Wistar–Albino rats were detached from their insertion on the humerus. The animals were divided into four groups: (1) no repair, (2) primary repair, (3) repair plus PRP injections into the tendon–bone interface, and (4) repair plus PRP absorbed from a sponge carrier to the tendon–bone interface. The tendons were evaluated biomechanically and histologically at week 8.

Results

Cuffs repaired with PRP had significantly greater mean (SD) load-to-failure rates [11.1 (6.5) and 11.6 (3.9) N; P < 0.05] and stiffness [3.5 (2.3) and 1.6 (0.75) N; P < 0.05] than did cuffs repaired without PRP. The groups receiving PRP did not differ significantly on these variables. Histological evaluation showed no significant differences among the four groups.

Conclusions

The application of PRP, independent of the application method, significantly improved biomechanical properties at the rotator cuff tendon–bone interface. The type of application, injection or absorption from a sponge did not influence the effect of PRP on rotator cuff healing.

Kim KC et al (2011) Repair integrity and functional outcome after arthroscopic rotator cuff repair: double-row versus suture-bridge technique. Am J Sports Med 40(2):294–299PubMedCrossRef

Lubowitz JH, Provencher MT, Poehling GG (2011) Single-row versus double-row rotator cuff repair: the controversy continues. Arthroscopy 27(7):880–882PubMedCrossRef

Ozbaydar M et al (2008) A comparison of single-versus double-row suture anchor techniques in a simulated repair of the rotator cuff: an experimental study in rabbits. J Bone Joint Surg Br 90(10):1386–1391PubMedCrossRef

Lafosse L et al (2008) The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. Surgical technique. J Bone Joint Surg Am 90(Suppl 2 Pt 2):275–286PubMed

Anderson K et al (2006) Outcome and structural integrity after arthroscopic rotator cuff repair using 2 rows of fixation: minimum 2-year follow-up. Am J Sports Med 34(12):1899–1905PubMedCrossRef

Galatz LM et al (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86(A (2)):219–224PubMed

Keener JD et al (2010) Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome. J Bone Joint Surg Am 92(3):590–598PubMedCrossRef

Hettrich CM et al (2011) The effect of rhPTH on the healing of tendon to bone in a rat model. J Orthop Res 30(5):769–774PubMedCrossRef

Gulotta LV et al (2011) Bone marrow-derived mesenchymal stem cells transduced with scleraxis improve rotator cuff healing in a rat model. Am J Sports Med 39(6):1282–1289PubMedCrossRef

10.

Gulotta LV et al (2010) Stem cells genetically modified with the developmental gene MT1-MMP improve regeneration of the supraspinatus tendon-to-bone insertion site. Am J Sports Med 38(7):1429–1437PubMedCrossRef

11.

Sanchez M et al (2003) Plasma rich in growth factors to treat an articular cartilage avulsion: a case report. Med Sci Sports Exerc 35(10):1648–1652PubMedCrossRef

12.

Sanchez M et al (2009) Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports Med 39(5):345–354PubMedCrossRef

13.

Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand 75(1):93–99PubMedCrossRef

14.

Gandhi A et al (2006) The effects of local platelet rich plasma delivery on diabetic fracture healing. Bone 38(4):540–546PubMedCrossRef

15.

Filardo G et al (2011) Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc 19(4):528–535PubMedCrossRef

16.

Kon E et al (2010) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18(4):472–479PubMedCrossRef

17.

Anitua E et al (2005) Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res 23(2):281–286PubMedCrossRef

18.

Ksander GA et al (1990) The effect of platelet releasate on wound healing in animal models. J Am Acad Dermatol 22(5 Pt 1):781–791PubMedCrossRef

19.

Anitua E et al (2006) Autologous fibrin matrices: a potential source of biological mediators that modulate tendon cell activities. J Biomed Mater Res A 77(2):285–293PubMedCrossRef

20.

Ranly DM et al (2007) Platelet-rich plasma inhibits demineralized bone matrix-induced bone formation in nude mice. J Bone Joint Surg Am 89(1):139–147PubMedCrossRef

21.

Castricini R et al (2011) Platelet-rich plasma augmentation for arthroscopic rotator cuff repair: a randomized controlled trial. Am J Sports Med 39(2):258–265PubMedCrossRef

22.

Randelli P et al (2011) Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Should Elb Surg 20(4):518–528CrossRef

23.

Kon E et al (2009) Platelet-rich plasma: new clinical application: a pilot study for treatment of jumper’s knee. Injury 40(6):598–603PubMedCrossRef

24.

Chudik S et al (2007) The influence of femoral technique for graft placement on anterior cruciate ligament reconstruction using a skeletally immature canine model with a rapidly growing physis. Arthroscopy 23(12):1309–1319 e1PubMedCrossRef

25.

Taylor DW et al (2011) 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 21(4):344–352PubMedCrossRef

26.

Galatz LM et al (2006) Nicotine delays tendon-to-bone healing in a rat shoulder model. J Bone Joint Surg Am 88(9):2027–2034PubMedCrossRef

27.

Peerbooms JC et al (2010) Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 38(2):255–262PubMedCrossRef

28.

Gosens T et al (2011) Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 39(6):1200–1208PubMedCrossRef

29.

Filardo G et al (2010) Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop 34(6):909–915PubMedCentralPubMedCrossRef

30.

Sanchez M et al (2007) Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med 35(2):245–251PubMedCrossRef

31.

Sanchez M et al (2010) The future: optimizing the healing environment in anterior cruciate ligament reconstruction. Sports Med Arthrosc 18(1):48–53PubMedCrossRef

32.

Sanchez M et al (2008) Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol 26(5):910–913PubMed

33.

Lopez-Vidriero E et al (2010) The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment. Arthroscopy 26(2):269–278PubMedCrossRef

34.

Radice F et al (2010) Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy 26(1):50–57PubMedCrossRef

35.

Seijas R et al (2013) Magnetic resonance imaging evaluation of patellar tendon graft remodelling after anterior cruciate ligament reconstruction with or without platelet-rich plasma. J Orthop Surg (Hong Kong) 21(1):10–14

36.

Harryman DT 2nd et al (1991) Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am 73(7):982–989PubMed

37.

Seeherman HJ et al (2008) rhBMP-12 accelerates healing of rotator cuff repairs in a sheep model. J Bone Joint Surg Am 90(10):2206–2219PubMedCrossRef

38.

Weibrich G et al (2004) Effect of platelet concentration in platelet-rich plasma on peri-implant bone regeneration. Bone 34(4):665–671PubMedCrossRef

39.

Fernandez-Sarmiento JA et al (2013) Histological study of the influence of plasma rich in growth factors (PRGF) on the healing of divided Achilles tendons in sheep. J Bone Joint Surg Am 95(3):246–255PubMedCrossRef

Title: Platelet-rich plasma for enhancing surgical rotator cuff repair: evaluation and comparison of two application methods in a rat model
Authors: Ali Ersen
M. Demirhan
A. C. Atalar
M. Kapicioğlu
Gokhan Baysal
Publication date: 01-03-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 3/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-013-1914-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Platelet-rich plasma for enhancing surgical rotator cuff repair: evaluation and comparison of two application methods in a rat model

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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