Collagen-platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament
Collagen-platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament
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DOI：
10.1002/jor.20282
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发表时间：
2007-01-01
影响因子：
2.8
通讯作者：
Connolly, Susan A.
中科院分区：
文献类型：
--
作者：
Murray, Martha M.;Spindler, Kurt P.;Connolly, Susan A.
前交叉韧带（ACL）缝合修复后未能愈合。这种失败的一种假设是关节环境中两个韧带末端之间的纤维蛋白凝块或临时支架过早丢失。为了检验这一假设，在缝合修复时使用胶原蛋白-富血小板血浆（PRP）水凝胶的替代临时支架填充ACL伤口部位，并在术后4周评价愈合组织的结构特性。在5只30 kg约克郡猪中进行双侧ACL横断，并进行缝线修复。在每只动物中，通过在ACL横断部位放置胶原蛋白-PRP水凝胶来增强其中一个修复，而对侧膝关节仅进行缝线修复。此外，将另外3只动物的6个具有完整膝关节的对照膝关节用作对照组。未使用术后固定。4周后，动物进行体内磁共振成像，以评估愈合ACL的大小，然后进行生物力学测试，以确定拉伸性能。用胶原蛋白-PRP水凝胶补充缝线修复导致4周时屈服载荷、最大载荷和线性刚度显著改善。我们得出结论，使用稳定的临时支架，如胶原蛋白-PRP水凝胶，以补充ACL的一期修复，可以在早期时间点改善生物力学性能。需要进一步研究来确定初级修复增强的长期效果。(c)2006骨科研究学会。由威利期刊公司出版
The anterior cruciate ligament (ACL) fails to heal after suture repair. One hypothesis for this failure is the premature loss of the fibrin clot, or provisional scaffolding, between the two ligament ends in the joint environment. To test this hypothesis, a substitute provisional scaffold of collagen-platelet rich plasma (PRP) hydrogel was used to fill the ACL wound site at the time of suture repair and the structural properties of the healing ACLs evaluated 4 weeks after surgery. Bilateral ACL transections were performed in five 30-kg Yorkshire pigs and treated with suture repair. In each animal, one of the repairs was augmented with placement of a collagen-PRP hydrogel at the ACL transection site, while the contralateral knee had suture repair alone. In addition, six control knees with intact ACLs from three additional animals were used as a control group. No postoperative immobilization was used. After 4 weeks the animals underwent in vivo magnetic resonance imaging to assess the size of the healing ACL, followed by biomechanical testing to determine tensile properties. The supplementation of suture repair with a collagen-PRP hydrogel resulted in significant improvements in load at yield, maximum load, and linear stiffness at 4 weeks. We conclude that use of a stabilized provisional scaffold, such as a collagen-PRP hydrogel, to supplement primary repair of the ACL can result in improved biomechanical properties at an early time point. Further studies to determine the long-term effect of primary repair enhancement are needed. (c) 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.