The biomechanical and histologic effects of platelet-rich plasma on rat rotator cuff repairs.
The biomechanical and histologic effects of platelet-rich plasma on rat rotator cuff repairs.
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DOI：
10.1177/0363546512453300
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发表时间：
2012-09
期刊：
影响因子：
--
通讯作者：
Callaci JJ
中科院分区：
文献类型：
--
作者：
Beck J;Evans D;Tonino PM;Yong S;Callaci JJ
肩袖撕裂是常见的损伤，通常通过手术修复来治疗。由于血小板内含有高浓度的生长因子，富血小板血浆 (PRP) 具有增强肩袖修复愈合的潜力。富含血小板的血浆会改变急性损伤反应期间肩袖修复的生物力学和组织学特性。受控实验室研究。富含血小板的血浆由近交供体大鼠产生。通过手术造成冈上肌腱骨撕裂，并立即进行经骨修复。对照组仅进行修复。 PRP 组接受了 PRP 增强修复。各组大鼠于第7、14、21天处死。手术修复的肌腱接受了生物力学测试，包括失效载荷、刚度、失效应变和应力松弛特性。组织学分析评估了修复组织的细胞特征。在 7 天和 21 天期间，用 PRP 增强对修复的大鼠冈上肌撕裂的生物力学特性显示出统计上显着的影响，但在 7 天、14 天或 21 天期间，破坏负荷没有增加（P 分别为 0.688、0.209 和 0.477）。对照组在 21 天时的硬度显着较高 (P = .006)。对照组在 7 天时具有较高的失效应变 (P = .02)，而 PRP 组在 21 天时具有较高的失效应变 (P = .008)。组织学上，PRP 组在每个时间点都显示出成纤维细胞反应和血管增殖增加。第 21 天时，PRP 组的胶原纤维以更线性的方式朝向肌腱足迹。在这项受控的大鼠模型研究中，PRP 改变了冈上肌腱的组织特性，而不影响结构的失效载荷。在用 PRP 增强肩袖修复之前，应考虑肌腱组织硬度急剧下降以及无法增强肌腱至骨骼修复愈合的情况。需要进一步的研究来确定 PRP 在临床实践中的作用。
Rotator cuff tears are common injuries that are often treated with surgical repair. Because of the high concentration of growth factors within platelets, platelet-rich plasma (PRP) has the potential to enhance healing in rotator cuff repairs. Platelet-rich plasma would alter the biomechanical and histologic properties of rotator cuff repair during an acute injury response. Controlled laboratory study. Platelet-rich plasma was produced from inbred donor rats. A tendon-from-bone supraspinatus tear was created surgically and an immediate transosseous repair performed. The control group underwent repair only. The PRP group underwent a repair with PRP augmentation. Rats in each group were sacrificed at 7, 14, and 21 days. The surgically repaired tendons underwent biomechanical testing, including failure load, stiffness, failure strain, and stress relaxation characteristics. Histological analysis evaluated the cellular characteristics of the repair tissue. At 7- and 21-day periods, augmentation with PRP showed statistically significant effects on the biomechanical properties of the repaired rat supraspinatus tear, but failure load was not increased at the 7-, 14-, or 21-day periods (P = .688, .209, and .477, respectively). The control group had significantly higher stiffness at 21 days (P = .006). The control group had higher failure strain at 7 days (P = .02), whereas the PRP group had higher failure strain at 21 days (P = .008). Histologically, the PRP group showed increased fibroblastic response and vascular proliferation at each time point. At 21 days, the collagen fibers in the PRP group were oriented in a more linear fashion toward the tendon footprint. In this controlled, rat model study, PRP altered the tissue properties of the supraspinatus tendon without affecting the construct’s failure load. The decreased tendon tissue stiffness acutely and failure to enhance tendon-to-bone healing of repairs should be considered before augmenting rotator cuff repairs with PRP. Further studies will be necessary to determine the role of PRP in clinical practice.