Hapa Onur, Çakici Hüsamettin, Yüksel Halil Yalçin, Fırat Tülin, Kükner Aysel, Aygün Hayati
Department of Orthopedics and Traumatology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey.
Acta Orthop Traumatol Turc. 2013;47(3):201-7. doi: 10.3944/aott.2013.2928.
The purpose of the present study was to compare the effectiveness of platelet-rich plasma (PRP) + microfracture and microfracture treatments in the healing of chronic focal chondral defects.
The study included 57 adult male Sprague-Dawley rats. Forty-two rats were divided into three groups of 14 rats with a chondral defect (control, microfracture only, PRP+microfracture). The remaining 15 rats were used to produce the PRP preparation. The rats were then euthanatized at 3 and 6 weeks after treatment and examined. Histological analysis using the modified Pineda scoring system and immunohistochemical staining for Type 2 collagen were performed.
At both time intervals, control group histological scores (Week 3: 8.8±1.2, Week 6: 8.5±0.7) were higher than microfracture (Week 3: 6.8±1.0, Week 6: 7.1±0.6) and PRP+microfracture (Week 3: 6.4±1.3, Week 6: 5.7±1.2) scores (p<0.05). The microfracture group score was higher at Week 6 than the PRP+microfracture group (p<0.05). The degree of Type 2 collagen staining was higher at Week 6 in the PRP+microfracture group and was unique in showing staining at the cell membrane.
The addition of PRP application to microfracture treatment appears to enhance cartilage healing in chronic focal chondral defects.
本研究旨在比较富血小板血浆（PRP）+微骨折与单纯微骨折治疗慢性局限性软骨缺损愈合的有效性。
本研究纳入57只成年雄性Sprague-Dawley大鼠。42只大鼠被分为三组，每组14只，均制造软骨缺损（对照组、单纯微骨折组、PRP+微骨折组）。其余15只大鼠用于制备PRP。然后在治疗后3周和6周对大鼠实施安乐死并进行检查。采用改良的皮内达评分系统进行组织学分析，并对Ⅱ型胶原进行免疫组化染色。
在两个时间点，对照组的组织学评分（第3周：8.8±1.2，第6周：8.5±0.7）均高于微骨折组（第3周：6.8±1.0，第6周：7.1±0.6）和PRP+微骨折组（第3周：6.4±1.3，第6周：5.7±1.2）（p<0.05）。微骨折组在第6周的评分高于PRP+微骨折组（p<0.05）。PRP+微骨折组在第6周时Ⅱ型胶原染色程度更高，且在细胞膜处出现独特染色。
在微骨折治疗中添加PRP应用似乎可促进慢性局限性软骨缺损的软骨愈合。
