Archives of Orthopaedic and Trauma Surgery

, Volume 137, Issue 10, pp 1417–1422 | Cite as

Leukocyte-reduced platelet-rich plasma increases proliferation of tenocytes treated with prednisolone: a cell cycle analysis

  • Franz Hilber
  • Markus Loibl
  • Siegmund Lang
  • Maximilian Kerschbaum
  • Gero Brockhoff
  • Peter Angele
  • Johannes Zellner
  • Paul Schmitz
  • Michael Nerlich
  • Michael WorlicekEmail author
Arthroscopy and Sports Medicine



The purpose of this study was to evaluate the effect of allogenic leukocyte-reduced platelet-rich plasma on human tenocytes after treatment with prednisolone and to develop a standardization of its application for clinical practice.


A leukocyte-reduced PRP was produced using the Arthrex Double Syringe (Arthrex, Inc., Naples, FL, USA), in a modified single-spin separation method. Human tenocytes were isolated from discarded rotator cuff segments. Tenocytes were cultured in the presence of PRP and prednisolone, both alone and in combination. Control samples were treated in media containing 2% FCS for 72 h. After 72 h of incubation, cell cycle kinetics of tenocytes were analyzed to assess proliferation.


Incubation of the tenocytes with PRP alone for 48 h led to high proliferation rate (10% PRP, 28.0 ± 10.5%; 20% PRP, 40.9 ± 3.3%). Incubation in the presence of prednisolone led to a significant decrease of the proliferation rate (5.2 ± 3.1%; p < 0.05). Treatment with PRP for 48 h significantly increased the proliferation of tenocytes in a dose-dependent manner (10% PRP, 28.0 ± 10.5%; 20% PRP, 40.9 ± 3.3%; p < 0.05). The presence of prednisolone resulted in a decreased tenocyte proliferation (5.2 ± 3.1%; p < 0.05), whereas addition of PRP for 24 and 48 h after prednisolone exposure did not show any compensating effect independent of PRPs concentration (10% PRP, 3.7 ± 3.0%; 20% PRP, 2.5 ± 2.5%). However, a significantly increased cell proliferation of tenocytes was evident when PRP was applied 24 h after prednisolone incubation for 48 h (31.0 ± 3.4 and 34.3 ± 4.7%).


The use of leukocyte-reduced PRP stimulates the proliferation of tenocytes and antagonizes the negative effect of prednisolone 24 h after treatment. Addition of PRP 48 h after treatment with prednisolone has no positive effect on the proliferation rate of tenocytes.


Tenocytes Platelet-rich plasma Corticosteroids 



The authors thank Elke Gerstl and Rudolf Jung for their excellent technical assistance. We would like to acknowledge Arthrex Inc. (Naples, FL, USA) for contributing to the sampling material. We also thank Monika Schöll for proofreading the manuscript.

Author contributions

FH and MW drafted the manuscript and evaluated data. ML evaluated the data and helped to draft the manuscript. SL performed the statistical analysis. GB, PA, and JZ participated in the coordination of the study and evaluated data; PS and MN were the performing surgeons and helped with data collection and interpretation of data for the work. ML conceived of the study and developed its design. MK contributed in revising the manuscript and implemented the reviewers’ suggestions. MW and FH were responsible for coordination, data collection/interpretation, and proofreading of the final manuscript. All authors read and approved the final manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they do not have any conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Franz Hilber
    • 1
  • Markus Loibl
    • 1
  • Siegmund Lang
    • 1
  • Maximilian Kerschbaum
    • 1
  • Gero Brockhoff
    • 2
  • Peter Angele
    • 1
  • Johannes Zellner
    • 1
  • Paul Schmitz
    • 1
  • Michael Nerlich
    • 1
  • Michael Worlicek
    • 1
    Email author
  1. 1.Department of Trauma SurgeryUniversity of RegensburgRegensburgGermany
  2. 2.Department of Obstetrics and GynecologyUniversity Medical Center RegensburgRegensburgGermany

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