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富血小板血浆在骨-肌腱整合中的作用。

The effect of platelet-rich plasma in bone-tendon integration.

作者信息

Ağır İsmail, Aytekin Mahmut Nedim, Küçükdurmaz Fatih, Kocaoğlu Barış, Çetinel Sule, Karahan Mustafa

机构信息

Faculty of Medicine, Adiyaman University, Adıyaman, Turkey.

Department of Orthopedics and Traumatology, Yıldırım Beyazıt University, Ankara, Turkey.

出版信息

Adv Clin Exp Med. 2017 Mar-Apr;26(2):193-199. doi: 10.17219/acem/61384.

Abstract

BACKGROUND

The operative reconstruction of a torn or insufficient anterior cruciate ligament has become a routine surgical procedure in orthopedics. The long-term success of an anterior cruciate ligament reconstruction depends on the ability of the graft to heal adequately in a bone tunnel. Investigators studying reconstructions described healing within a tunnel as osseous ingrowth and incorporation. In particular, helping the healing using autologous material for the best integration process was a new idea that helped us to set up this study.

OBJECTIVES

The purpose of this study is to show the effect of platelet-rich plasma on bone-tendon healing.

MATERIAL AND METHODS

Ten New Zealand rabbits were used. The study had 2 groups: (1) a study group including the right extremities of rabbits in which tendon-bone integration was strengthened by plateletrich plasma and (2) a control group including the left extremities of rabbits in which tendon-bone integration was without platelet-rich plasma. On the 56th day postoperatively, the portion of the distal femur containing the tunnel was amputated following the euthanization process for histological evaluation.

RESULTS

In the histological evaluation of the tendon-integrated bone segments with platelet-rich plasma, the integration of tendon in the bone was successful without any necrosis formation in most of the tissues. However, in the control group without platelet-rich plasma, the integration was distorted in many zones and some cystic morphologies were present.

CONCLUSIONS

The findings of this study showed that using platelet-rich plasma during tendon-to-bone implantation has positive effects histologically. In the literature, many studies are available that have investigated the effect of platelet-rich plasma on anterior cruciate surgery radiologically. However, the histological findings are more reliable than radiological findings because bone-tendon integration is a biological process.

摘要

背景

前交叉韧带撕裂或功能不全的手术重建已成为骨科的常规手术。前交叉韧带重建的长期成功取决于移植物在骨隧道中充分愈合的能力。研究重建的研究者将隧道内的愈合描述为骨长入和融合。特别是,使用自体材料促进愈合以实现最佳整合过程是一个新想法,这促使我们开展了这项研究。

目的

本研究的目的是展示富血小板血浆对骨 - 肌腱愈合的影响。

材料与方法

使用10只新西兰兔。本研究分为2组:(1) 研究组,包括通过富血小板血浆加强肌腱 - 骨整合的兔右肢;(2) 对照组,包括未使用富血小板血浆进行肌腱 - 骨整合的兔左肢。术后第56天,在安乐死处理后,切除包含隧道的股骨远端部分用于组织学评估。

结果

在对使用富血小板血浆的肌腱整合骨段进行组织学评估时,肌腱在骨中的整合成功,大多数组织中未形成任何坏死。然而,在未使用富血小板血浆的对照组中,许多区域的整合出现扭曲,并且存在一些囊性形态。

结论

本研究结果表明,在肌腱 - 骨植入过程中使用富血小板血浆在组织学上具有积极作用。在文献中,有许多研究从放射学角度研究了富血小板血浆对前交叉韧带手术的影响。然而,由于骨 - 肌腱整合是一个生物学过程,组织学发现比放射学发现更可靠。

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