Oryan Ahmad, Moshiri Ali, Meimandi-Parizi Abdolhamid, Maffulli Nicola
Department of Pathology, School of Veterinary Medicine, Shiraz University, Shiraz, 71345, Iran.
Division of Surgery and Radiology, Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, 71345, Iran
Exp Biol Med (Maywood). 2015 Feb;240(2):194-210. doi: 10.1177/1535370214554532. Epub 2014 Oct 22.
Surgical reconstruction of large Achilles tendon defects is demanding. Platelet concentrates may be useful to favor healing in such conditions. The characteristics of bovine platelet-gel embedded within a collagen-implant were determined in vitro, and its healing efficacy was examined in a large Achilles tendon defect in rabbits. Two cm of the left Achilles tendon of 60 rabbits were excised, and the animals were randomly assigned to control (no implant), collagen-implant, or bovine-platelet-gel-collagen-implant groups. The tendon edges were maintained aligned using a Kessler suture. No implant was inserted in the control group. In the two other groups, a collagen-implant or bovine-platelet-gel-collagen-implant was inserted in the defect. The bioelectricity and serum platelet-derived growth factor levels were measured weekly and at 60 days post injury, respectively. After euthanasia at 60 days post injury, the tendons were tested at macroscopic, microscopic, and ultrastructural levels, and their dry matter and biomechanical performances were also assessed. Another 60 rabbits were assigned to receive no implant, a collagen-implant, or a bovine-platelet-gel-collagen-implant, euthanized at 10, 20, 30, and 40 days post injury, and their tendons were evaluated grossly and histologically to determine host-graft interactions. Compared to the control and collagen-implant, treatment with bovine-platelet-gel-collagen-implant improved tissue bioelectricity and serum platelet-derived growth factor levels, and increased cell proliferation, differentiation, and maturation. It also increased number, diameter, and density of the collagen fibrils, alignment and maturation of the collagen fibrils and fibers, biomechanical properties and dry matter content of the injured tendons at 60 days post injury. The bovine-platelet-gel-collagen-implant also increased biodegradability, biocompatibility, and tissue incorporation behavior of the implant compared to the collagen-implant alone. This treatment also decreased tendon adhesion, muscle fibrosis, and atrophy, and improved the physical activity of the animals. The bovine-platelet-gel-collagen-implant was effective in neotenon formation in vivo, which may be valuable in the clinical setting.
大的跟腱缺损的手术重建颇具挑战性。血小板浓缩物可能有助于在这种情况下促进愈合。对嵌入胶原植入物中的牛血小板凝胶的特性进行了体外测定，并在兔的大跟腱缺损中检查了其愈合效果。切除60只兔左跟腱2厘米，将动物随机分为对照组（无植入物）、胶原植入物组或牛血小板凝胶 - 胶原植入物组。使用凯斯勒缝合法使肌腱边缘保持对齐。对照组不插入植入物。在另外两组中，在缺损处插入胶原植入物或牛血小板凝胶 - 胶原植入物。每周和伤后60天分别测量生物电和血清血小板衍生生长因子水平。伤后60天实施安乐死后，在宏观、微观和超微结构水平对肌腱进行检测，并评估其干物质和生物力学性能。另外60只兔被分配接受无植入物、胶原植入物或牛血小板凝胶 - 胶原植入物，在伤后10、20、30和40天实施安乐死，并对其肌腱进行大体和组织学评估以确定宿主 - 移植物相互作用。与对照组和胶原植入物相比，牛血小板凝胶 - 胶原植入物治疗改善了组织生物电和血清血小板衍生生长因子水平，并增加了细胞增殖、分化和成熟。它还增加了伤后60天时受损肌腱的胶原原纤维数量、直径和密度、胶原原纤维和纤维的排列及成熟度、生物力学性能和干物质含量。与单独的胶原植入物相比，牛血小板凝胶 - 胶原植入物还增加了植入物的生物降解性、生物相容性和组织整合行为。这种治疗还减少了肌腱粘连、肌肉纤维化和萎缩，并改善了动物的身体活动。牛血小板凝胶 - 胶原植入物在体内新腱形成方面有效，这在临床环境中可能具有重要价值。
