Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
J Orthop Surg Res. 2023 Mar 25;18(1):238. doi: 10.1186/s13018-023-03709-5.
In knee arthroscopic surgery, fibrin clot (FC) and leukocyte-rich platelet-rich fibrin (L-PRF) may be used in augmentation for meniscal repair. Studies have investigated growth factors released from FC and L-PRF; however, it is difficult to compare FC and L-PRF between different studies. Direct comparison of growth factors that may support meniscal healing released from FC and L-PRF may be beneficial in deciding whether to use FC or L-PRF. If no significant difference is seen, the surgeon may decide to use FC which is easier to prepare compared to L-PRF. The purpose of this pilot study is to investigate the release amount and pattern of basic fibroblast growth factor (bFGF), platelet-derived growth factor AB (PDGF-AB), transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF), and stromal cell-derived factor 1 (SDF-1) from FC and L-PRF.
Twenty milliliters (ml) of whole blood was collected from each of the four volunteers. Ten milliliters of whole blood was allocated for preparation of FC and 10 ml for L-PRF. FC and L-PRF were separately placed in 5 ml of culture media. Five milliliters of the culture media was sampled and refilled at 15 min, 1 day, 3 days, 1 week and 2 weeks. The collected culture was used to quantify bFGF, PDGF-AB, TGF-β1, VEGF, and SDF-1 release by Enzyme-linked immune-sorbent assay (ELISA). Mann-Whitney U test was performed to assess significance of differences in amount of each growth factor released between FC and L-PRF. Significance was accepted at P value less than 0.05.
At two weeks, the cumulative release of TGF-β1 was the highest among all the growth factors in both FC and L-PRF (FC:19,738.21 pg/ml, L-PRF: 16,229.79 pg/ml). PDGF-AB (FC: 2328 pg/ml, L-PRF 1513.57 pg/ml) had the second largest amount, followed by VEGF (FC: 702.06 pg/ml, L-PRF 595.99 pg/ml) and bFGF (FC: 23.48 pg/ml, L-PRF 18.2 pg/ml), which order was also common in both FC and L-PRF. No significant difference in final release amount and pattern was seen between FC and L-PRF.
The current pilot study showed that cumulative release amount and release pattern of PDGF-AB, VEGF, TGF-β1, and bFGF did not significantly differ between FC and L-PRF during the two weeks of observation.
在膝关节镜手术中，纤维蛋白凝块（FC）和富含白细胞的富血小板纤维蛋白（L-PRF）可用于半月板修复的增强。已有研究调查了从 FC 和 L-PRF 释放的生长因子；然而，很难在不同的研究中比较 FC 和 L-PRF。直接比较从 FC 和 L-PRF 释放的可能支持半月板愈合的生长因子可能有助于决定是否使用 FC 或 L-PRF。如果没有看到显著差异，外科医生可能会决定使用 FC，因为与 L-PRF 相比，FC 更容易准备。本初步研究的目的是调查纤维蛋白凝块（FC）和富含白细胞的富血小板纤维蛋白（L-PRF）中碱性成纤维细胞生长因子（bFGF）、血小板衍生生长因子 AB（PDGF-AB）、转化生长因子 β1（TGF-β1）、血管内皮生长因子（VEGF）和基质细胞衍生因子 1（SDF-1）的释放量和释放模式。
从四名志愿者每人采集 20 毫升（ml）全血。将 10 毫升全血分配用于制备 FC 和 10 毫升用于 L-PRF。FC 和 L-PRF 分别放置在 5 毫升的培养基中。在 15 分钟、1 天、3 天、1 周和 2 周时取样并补充 5 毫升培养物。收集的培养物用于通过酶联免疫吸附测定（ELISA）定量 bFGF、PDGF-AB、TGF-β1、VEGF 和 SDF-1 的释放。采用曼-惠特尼 U 检验评估 FC 和 L-PRF 之间释放的每种生长因子量的差异的显著性。接受 P 值小于 0.05 的显著性。
在两周时，TGF-β1 的累积释放量在 FC 和 L-PRF 中所有生长因子中最高（FC：19738.21pg/ml，L-PRF：16229.79pg/ml）。PDGF-AB（FC：2328pg/ml，L-PRF 1513.57pg/ml）含量第二大，其次是 VEGF（FC：702.06pg/ml，L-PRF 595.99pg/ml）和 bFGF（FC：23.48pg/ml，L-PRF 18.2pg/ml），这一顺序在 FC 和 L-PRF 中也很常见。FC 和 L-PRF 之间在最终释放量和释放模式上没有显著差异。
本初步研究表明，在两周的观察期内，FC 和 L-PRF 之间 PDGF-AB、VEGF、TGF-β1 和 bFGF 的累积释放量和释放模式没有显著差异。
