Yu Tung-Yang, Pang Jong-Hwei S, Lin Li-Ping, Cheng Ju-Wen, Liu Shih-Jung, Tsai Wen-Chung
Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.
Orthop J Sports Med. 2021 Apr 20;9(4):2325967121990377. doi: 10.1177/2325967121990377. eCollection 2021 Apr.
Acute tendon injury can limit motion and thereby inhibit tendon healing. Positive results have been found after the use of platelet-rich plasma (PRP) to treat tendon injury; however, the early effects of PRP on tendon regeneration are not known.
PURPOSE/HYPOTHESIS: The purpose of this study was to evaluate the effects of PRP releasate (PRPr) on the early stages of tendon healing in a rat partial tenotomy model. It was hypothesized that PRPr can promote early healing of an Achilles tendon in rats.
Controlled laboratory study.
PRP was prepared by a 2-step method of manual platelet concentration from 10 rats. PRPr was isolated from the clotted preparation after activation by thrombin and was applied to an Achilles tendon on 1 side of 30 rats on the second day after partial tenotomy, with normal saline used as the control on the other side. Achilles tendon samples were harvested 5 and 10 days after tenotomy. At each time point, 15 Achilles tendon samples were obtained, of which 5 samples were evaluated by Masson trichrome staining, apoptosis, and cell proliferation, while the other 10 samples were tested for tensile strength using a material testing machine.
Compared with saline-treated control tendons, the PRPr-treated tendons showed increased collagen synthesis near the cut edge and fewer apoptotic cells ( = .01). An immunohistochemical analysis revealed more Ki-67-positive cells but fewer cluster of differentiation (CD) 68 (ED1) macrophages in PRPr tendons compared with saline-treated tendons ( < .01). Tendons treated with PRPr also showed higher ultimate tensile strength than those treated with saline ( = .03).
PRPr treatment promotes tissue recovery in the early phase of tendon healing by stimulating tendon cell proliferation and collagen production while inhibiting cell apoptosis and CD68 (ED1) macrophage infiltration.
These findings suggest that with PRPr treatment, higher loads can be applied to the healing tendon at an earlier time, which can help the patient resume activity earlier.
急性肌腱损伤会限制活动，从而抑制肌腱愈合。使用富血小板血浆（PRP）治疗肌腱损伤已取得积极效果；然而，PRP对肌腱再生的早期影响尚不清楚。
目的/假设：本研究的目的是在大鼠部分肌腱切断模型中评估PRP释放物（PRPr）对肌腱愈合早期阶段的影响。假设PRPr可促进大鼠跟腱的早期愈合。
对照实验室研究。
通过两步手动血小板浓缩法从10只大鼠制备PRP。PRPr在经凝血酶激活后从凝块制剂中分离出来，并在部分肌腱切断术后第二天应用于30只大鼠一侧的跟腱，另一侧用生理盐水作为对照。在肌腱切断术后5天和10天采集跟腱样本。在每个时间点，获取15个跟腱样本，其中5个样本通过Masson三色染色、细胞凋亡和细胞增殖进行评估，另外10个样本使用材料试验机测试拉伸强度。
与生理盐水处理的对照肌腱相比，PRPr处理的肌腱在切口边缘附近显示出胶原合成增加，凋亡细胞减少（P = 0.01）。免疫组织化学分析显示，与生理盐水处理的肌腱相比，PRPr处理的肌腱中Ki-67阳性细胞更多，但分化簇（CD）68（ED1）巨噬细胞更少（P < 0.01）。PRPr处理的肌腱也显示出比生理盐水处理的肌腱更高的极限拉伸强度（P = 0.03）。
PRPr治疗通过刺激肌腱细胞增殖和胶原产生，同时抑制细胞凋亡和CD68（ED1）巨噬细胞浸润，促进肌腱愈合早期阶段的组织恢复。
这些发现表明，通过PRPr治疗，可以在更早的时间对愈合的肌腱施加更高的负荷，这有助于患者更早恢复活动。
