Lyras Dimitrios N, Kazakos Konstantinos, Verettas Dionysios, Polychronidis Alekos, Tryfonidis Marios, Botaitis Sotirios, Agrogiannis George, Simopoulos Constantinos, Kokka Anna, Patsouris Efstratios
Democritus University of Thrace, Dept of Orthopaedics, Dragana, Alexandroupolis, Greece.
Foot Ankle Int. 2009 Nov;30(11):1101-6. doi: 10.3113/FAI.2009.1101.
The poor vascularity of tendons is a major factor in their limited healing capacity. The aim of this study was to assess the effect of Platelet Rich Plasma (PRP) on angiogenesis during tendon healing.
Forty-eight skeletally mature New Zealand White rabbits were used. The Achilles tendon was transected transversely and 0.5 ml of PRP was injected into the tendon mass on each side of the incision on both limbs. The injection in the control group consisted of saline. Six animals from each group (12 tendons each) were sacrificed after 1, 2, 3, and 4 weeks following treatment. Three sections from each Achilles were stained with hematoxylinosin for microscopic examination. Further three sections were immunostained with a monoclonal antibody against CD31 (Daco Co), followed by image analysis to count new vessel numbers and statistical analysis was performed.
There was significantly more angiogenesis in the PRP group compared to the control group during the first two weeks of the healing process, i.e., inflammatory and proliferative phase (p < 0.0001). The orientation of collagen fibers in the PRP group was better organized. The number of the newly formed vessels in the PRP group were significantly reduced at 4 weeks compared to the controls (p < 0.0001) suggesting the healing process was shortened.
PRP seems to enhance neovascularization which may accelerate the healing process and promote scar tissue of better histological quality.
Although these results need replication and further biomechanical research, PRP may promote tendon healing acceleration.
肌腱血管分布不佳是其愈合能力有限的主要因素。本研究旨在评估富血小板血浆（PRP）对肌腱愈合过程中血管生成的影响。
使用48只骨骼成熟的新西兰白兔。将跟腱横向切断，在双下肢切口两侧的肌腱块中各注射0.5毫升PRP。对照组注射生理盐水。治疗后1、2、3和4周，每组处死6只动物（每组12条肌腱）。将每条跟腱的三个切片用苏木精伊红染色进行显微镜检查。另外三个切片用抗CD31单克隆抗体（Daco公司）进行免疫染色，随后进行图像分析以计数新血管数量并进行统计分析。
在愈合过程的前两周，即炎症和增殖期，PRP组的血管生成明显多于对照组（p < 0.0001）。PRP组中胶原纤维的排列更有序。与对照组相比，PRP组在4周时新形成的血管数量显著减少（p < 0.0001），表明愈合过程缩短。
PRP似乎能增强新生血管形成，这可能加速愈合过程并促进组织学质量更好的瘢痕组织形成。
尽管这些结果需要重复验证和进一步的生物力学研究，但PRP可能促进肌腱愈合加速。
