The Effect of Platelet-Rich Plasma on Muscle Contusion Healing in a Rat Model
The Effect of Platelet-Rich Plasma on Muscle Contusion Healing in a Rat Model
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DOI：
10.1177/0363546514540272
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发表时间：
2014-09-01
影响因子：
4.8
通讯作者：
Rodeo, Scott Alan
中科院分区：
文献类型：
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作者：
Delos, Demetris;Leineweber, Matthew J.;Rodeo, Scott Alan
背景：目前肌肉挫伤的治疗通常仅限于非甾体抗炎药和/或使用 RICE 原则（休息、冰敷、压迫、抬高）；因此，其他可能加速愈合速度的治疗形式是可取的。假设：与对照组相比，局部注射富含血小板的血浆（PRP）将导致加速愈合速度；此外，与立即治疗相比，延迟施用 PRP 会导致反应迟钝。研究设计：对照实验室研究。方法：46 只雄性 Lewis 大鼠通过落锤技术对腓肠肌进行单次钝性非穿透性冲击，随后在损伤后立即向损伤区域注射生理盐水（对照，n = 11）或大鼠 PRP（损伤后立即[PRP 第 0 天，n = 12]、受伤后第一天 [PRP 第 1 天，n = 12] 或受伤后第三天 [PRP 第 3 天，n = 11]）。主要结果是受伤肌肉的最大等长扭矩强度，在受伤前以及受伤后第 1、4、7、10 和 14 天进行评估。在受伤后第 15 天处死所有动物。处死后对每组的 6 个标本进行组织学和免疫组织化学分析。结果：PRP 中的平均血小板浓度为 2.19 x 10(6) (2.69 x 10(5))/L。 PRP 中的平均白细胞计数为 22.54 x 10(3)/L。与受伤前水平相比，每组在受伤后最大等长扭矩强度均出现统计学上显着下降，随后在受伤后第 14 天显着增加回到基线值（对照组，90.6% 7.90%；PRP 第 0 天，105.0% +/- 7.60%；PRP 第 1 天，92.4% +/- 7.60%；PRP 第 3 天，77.8% +/- 7.90%）（P = .121）。治疗组和对照组在任何时间点都没有统计学上的显着差异。任何组之间的中心核纤维百分比也没有统计学上的显着差异（对照组，3.31% +/- 5.10%；PRP 第 0 天，0.62% +/- 1.59%；PRP 第 1 天，3.24% +/- 5.77%；PRP 第 3 天，2.13% +/- 3.26%）（P = .211）或存在结论：在该大鼠挫伤模型中，将 PRP 局部注射到受伤的腓肠肌中，功能或组织学结果没有显着差异，表明对愈合可能没有好处。此外，立即或延迟施用 PRP 之间没有显着差异。 临床相关性：在推荐 PRP 治疗肌肉挫伤之前，需要进行进一步的转化和临床研究。
Background: Current therapy for muscle contusions is usually limited to nonsteroidal anti-inflammatory drugs and/or use of the RICE principle (rest, ice, compression, elevation); thus, other forms of treatment that can potentially accelerate the rate of healing are desirable.Hypotheses: A local injection of platelet-rich plasma (PRP) would lead to accelerated healing rates compared with controls; also, delayed administration of PRP would lead to a blunted response compared with immediate treatment.Study Design: Controlled laboratory study.Methods: Forty-six male Lewis rats each underwent a single blunt, nonpenetrating impact to the gastrocnemius muscle via a drop-mass technique and subsequently received either a single injection of saline into the area of injury immediately after injury (controls, n = 11) or rat PRP (either immediately after injury [PRP day 0, n = 12], the first day after injury [PRP day 1, n = 12], or the third day after injury [PRP day 3, n = 11]). The primary outcome was maximal isometric torque strength of the injured muscle, which was assessed before injury as well as on postinjury days 1, 4, 7, 10, and 14. All animals were sacrificed on postinjury day 15. Histological and immunohistochemical analyses were performed on 6 specimens from each group after sacrifice.Results: The mean platelet concentration in the PRP was 2.19 x 10(6) (2.69 x 10(5))/L. The mean white blood cell count in the PRP was 22.54 x 10(3)/L. Each group demonstrated statistically significant decreases in maximal isometric torque strength after injury when compared with preinjury levels, followed by significant increases back toward baseline values by postinjury day 14 (controls, 90.6% 7.90%; PRP day 0, 105.0% +/- 7.60%; PRP day 1, 92.4% +/- 7.60%; PRP day 3, 77.8% +/- 7.90%) (P = .121). There were no statistically significant differences between the treatment and control groups at any of the time points. There were also no statistically significant differences between any of the groups in the percentage of centronucleated fibers (controls, 3.31% +/- 5.10%; PRP day 0, 0.62% +/- 1.59%; PRP day 1, 3.24% +/- 5.77%; PRP day 3, 2.13% +/- 3.26%) (P = .211) or the presence of inflammatory cells and macrophages.Conclusion: In this rat contusion model, a local injection of PRP into the injured gastrocnemius muscle resulted in no significant differences in functional or histological outcomes, indicating no likely benefit to healing. Additionally, there was no significant difference between immediate or delayed administration of PRP.Clinical Relevance: Before PRP can be recommended for the treatment of muscle contusion injuries, further translational and clinical investigations need to be performed.