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Platelet concentrate vs. saline in a rat patellar tendon healing model

  • Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate single centrifuge platelet concentrate as additive for improved tendon healing. Platelet-rich plasma has been reported to improve tendon healing. Single centrifuge platelet concentration may increase platelet concentration enough to positively affect tendon healing.

A single centrifuge process will lead to a blood product with increased platelet concentrations which, when added to a surgically created tendon injury, will improve tendon healing when compared with a saline control.

Methods

Lewis rats had a surgical transection of the patellar tendon that was subsequently stabilized with a cerclage suture. Prior to skin closure, the tendon was saturated with either a concentrated platelet solution or saline. At 14 days, all animals were killed, and the extensor mechanism was isolated for testing. Biomechanical testing outputs included ultimate tensile load, stiffness, and energy absorbed.

Results

Comparisons between the control group and the concentrated platelet group revealed no differences. A subgroup of the concentrated platelet group consisting of specimens in whom the concentration process was most successful showed significantly higher ultimate tensile load (P < 0.05) and energy absorbed to failure (P < 0.05) when compared to the control group.

Conclusion

When successful, single centrifuge platelet concentration yields a solution that improves tendon healing when compared with a saline control. Single-spin platelet concentration may yield a biologically active additive that may improve tendon healing, but more studies must be undertaken to ensure that adequate platelet concentration is possible.

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References

  1. Anitua E (1999) Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants 14:529–535

    CAS  PubMed  Google Scholar 

  2. Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves achilles tendon repair in rats. Acta Orthop Scand 75:93–99

    Article  PubMed  Google Scholar 

  3. Berghoff WJ, Pietrzak WS, Rhodes RD (2006) Platelet-rich plasma application during closure following total knee arthroplasty. Orthopedics 29:590–598

    PubMed  Google Scholar 

  4. Bielecki T, Gazdzik TS, Szczepanski T (2008) Benefit of percutaneous injection of autologous platelet-leukocyte-rich gel in patients with delayed union and nonunion. Eur Surg Res 40:289–296

    Article  CAS  PubMed  Google Scholar 

  5. Bogatov VB, Weinhold P, Dahners LE (2003) The influence of a cyclooxygenase-1 inhibitor on injured and uninjured ligaments in the rat. Am J Sports Med 31:574–576

    Article  PubMed  Google Scholar 

  6. Borzini P, Mazzucco L (2005) Tissue regeneration and in loco administration of platelet derivatives: clinical outcome, heterogeneous products, and heterogeneity of the effector mechanisms. Transfusion 45:1759–1767

    Article  CAS  PubMed  Google Scholar 

  7. Bosch G, van Schie HT, de Groot MW, Cadby JA, van de Lest CH, Barneveld A, van Weeren PR (2010) Effects of platelet-rich plasma on the quality of repair of mechanically induced core lesions in equine superficial digital flexor tendons: a placebo-controlled experimental study. J Orthop Res 28:211–217

    CAS  PubMed  Google Scholar 

  8. de Mos M, van der Windt AE, Jahr H, van Schie HT, Weinans H, Verhaar JA, van Osch GJ (2008) Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med 36:1171–1178

    Article  PubMed  Google Scholar 

  9. DeFranco MJ, Bershadsky B, Ciccone J, Yum JK, Iannotti JP (2007) Functional outcome of arthroscopic rotator cuff repairs: a correlation of anatomic and clinical results. J Shoulder Elbow Surg 16:759–765

    Article  PubMed  Google Scholar 

  10. DelRossi AJ, Cernaianu AC, Vertrees RA, Wacker CJ, Fuller SJ, Cilley JH Jr, Baldino WA (1990) Platelet-rich plasma reduces postoperative blood loss after cardiopulmonary bypass. J Thorac Cardiovasc Surg 100:281–286

    CAS  PubMed  Google Scholar 

  11. Everts PA, Devilee RJ, Brown Mahoney C, Eeftinck-Schattenkerk M, Box HA, Knape JT, van Zundert A (2006) Platelet gel and fibrin sealant reduce allogeneic blood transfusions in total knee arthroplasty. Acta Anaesthesiol Scand 50:593–599

    Article  CAS  PubMed  Google Scholar 

  12. Ferry ST, Dahners LE, Afshari HM, Weinhold PS (2007) The effects of common anti-inflammatory drugs on the healing rat patellar tendon. Am J Sports Med 35:1326–1333

    Article  PubMed  Google Scholar 

  13. Gardner MJ, Demetrakopoulos D, Klepchick PR, Mooar PA (2007) The efficacy of autologous platelet gel in pain control and blood loss in total knee arthroplasty. An analysis of the haemoglobin, narcotic requirement and range of motion. Int Orthop 31:309–313

    Article  PubMed  Google Scholar 

  14. Griffin XL, Smith CM, Costa ML (2008) The clinical use of platelet-rich plasma in the promotion of bone healing: a systematic review. Injury 40:158–162

    Article  PubMed  Google Scholar 

  15. Hakimi M, Jungbluth P, Sager M, Betsch M, Herten M, Becker J, Windolf J, Wild M (2010) Combined use of platelet-rich plasma and autologous bone grafts in the treatment of long bone defects in mini-pigs. Injury 41:811–817

    Article  Google Scholar 

  16. Hanson CA, Weinhold PS, Afshari HM, Dahners LE (2005) The effect of analgesic agents on the healing rat medial collateral ligament. Am J Sports Med 33:674–679

    Article  PubMed  Google Scholar 

  17. Hartmann EK, Heintel T, Morrison RH, Weckbach A (2009) Influence of platelet-rich plasma on the anterior fusion in spinal injuries: a qualitative and quantitative analysis using computer tomography. Arch Orthop Trauma Surg 130:909–914

    Article  PubMed  Google Scholar 

  18. Hee HT, Majd ME, Holt RT, Myers L (2003) Do autologous growth factors enhance transforaminal lumbar interbody fusion? Eur Spine J 12:400–407

    Article  PubMed  Google Scholar 

  19. Kajikawa Y, Morihara T, Sakamoto H, Matsuda K, Oshima Y, Yoshida A, Nagae M, Arai Y, Kawata M, Kubo T (2008) Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol 215:837–845

    Article  CAS  PubMed  Google Scholar 

  20. Kannus P, Jozsa L (1991) Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients. J Bone Joint Surg Am 73:1507–1525

    CAS  PubMed  Google Scholar 

  21. Kovacevic D, Rodeo SA (2008) Biological augmentation of rotator cuff tendon repair. Clin Orthop Relat Res 466:622–633

    Article  PubMed  Google Scholar 

  22. Lyras DN, Kazakos K, Verettas D, Botaitis S, Agrogiannis G, Kokka A, Pitiakoudis M, Kotzakaris A (2009) The effect of platelet-rich plasma gel in the early phase of patellar tendon healing. Arch Orthop Trauma Surg 129:1577–1582

    Article  PubMed  Google Scholar 

  23. Margolis DJ, Kantor J, Santanna J, Strom BL, Berlin JA (2001) Effectiveness of platelet releasate for the treatment of diabetic neuropathic foot ulcers. Diabetes Care 24:483–488

    Article  CAS  PubMed  Google Scholar 

  24. Mishra A, Pavelko T (2006) Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 34:1774–1778

    Article  PubMed  Google Scholar 

  25. Paavola M, Jarvinen TA (2005) Paratendinopathy. Foot Ankle Clin 10:279–292

    Article  PubMed  Google Scholar 

  26. Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T (2010) Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 38:255–262

    Article  PubMed  Google Scholar 

  27. Randelli PS, Arrigoni P, Cabitza P, Volpi P, Maffulli N (2008) Autologous platelet rich plasma for arthroscopic rotator cuff repair. A pilot study. Disabil Rehabil 30:1584–1589

    Article  PubMed  Google Scholar 

  28. Rodeo SA (2007) Biologic augmentation of rotator cuff tendon repair. J Shoulder Elbow Surg 16:S191–S197

    Article  PubMed  Google Scholar 

  29. Sanchez M, Anitua E, Azofra J, Andia I, Padilla S, Mujika I (2007) Comparison of surgically repaired achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med 35:245–251

    Article  PubMed  Google Scholar 

  30. Scott A, Ashe MC (2006) Common tendinopathies in the upper and lower extremities. Curr Sports Med Rep 5:233–241

    PubMed  Google Scholar 

  31. Virchenko O, Aspenberg P (2006) How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks? Interplay between early regeneration and mechanical stimulation. Acta Orthop 77:806–812

    Article  PubMed  Google Scholar 

  32. Virchenko O, Grenegard M, Aspenberg P (2006) Independent and additive stimulation of tendon repair by thrombin and platelets. Acta Orthop 77:960–966

    Article  PubMed  Google Scholar 

  33. Xu Y, Murrell GA (2008) The basic science of tendinopathy. Clin Orthop Relat Res 466:1528–1538

    Article  PubMed  Google Scholar 

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Acknowledgments

Materials for this project were purchased with a research grant provided by Arthex GmbH, Karlsfeld, Germany.

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Authors and Affiliations

  1. Department of Orthopaedics, University of North Carolina, Chapel Hill, NC, USA

    Jeffrey T. Spang

  2. Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technical University Munich, Conolly Str 32, 80809, Munich, Germany

    Gian M. Salzmann, Gabriele Wexel & Andreas B. Imhoff

  3. Department of Orthopaedics and Traumatology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany

    Thomas Tischer

  4. Biomechanical Lab, Department of Orthopaedics and Traumatology, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany

    Tobias Winkler & Rainer Burgkart

Authors
  1. Jeffrey T. Spang
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  2. Thomas Tischer
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  3. Gian M. Salzmann
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  4. Tobias Winkler
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  7. Andreas B. Imhoff
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Correspondence to Andreas B. Imhoff.

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Spang, J.T., Tischer, T., Salzmann, G.M. et al. Platelet concentrate vs. saline in a rat patellar tendon healing model. Knee Surg Sports Traumatol Arthrosc 19, 495–502 (2011). https://doi.org/10.1007/s00167-010-1291-1

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  • DOI: https://doi.org/10.1007/s00167-010-1291-1

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