Comparison of Leukocyte-Rich Platelet-Rich Plasma and Leukocyte-Poor Platelet-Rich Plasma on Achilles Tendinopathy at an Early Stage in a Rabbit Model
| Autor: | Gang Feng, Sihao Li, Jiahong Meng, Ruijian Yan, Yifan Wu, Zhiyuan Cheng, Fengfeng Wu, Mu Lin, Jianqiao Hong, Weishan Chen, Guangyao Jiang, Shigui Yan, Xin Gao |
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| Rok vydání: | 2020 |
| Předmět: |
030222 orthopedics
0303 health sciences Pathology medicine.medical_specialty Platelet-Rich Plasma business.industry Physical Therapy Sports Therapy and Rehabilitation medicine.disease Achilles Tendon Clinical Practice 03 medical and health sciences 0302 clinical medicine Platelet-rich plasma Tendinopathy Leukocytes Rabbit model medicine Animals Orthopedics and Sports Medicine Collagenases Rabbits Stage (cooking) business 030304 developmental biology |
| Zdroj: | The American Journal of Sports Medicine. 48:1189-1199 |
| ISSN: | 1552-3365 0363-5465 |
| DOI: | 10.1177/0363546520906142 |
| Popis: | Background:Tendinopathy is still a great challenge in clinical practice, and the role of platelet-rich plasma (PRP) is controversial. The influence of leukocytes on tendinopathy at an early stage has not been defined so far.Purpose:To compare the effects of leukocyte-rich PRP (Lr-PRP) and leukocyte-poor PRP (Lp-PRP) on Achilles tendinopathy when applied at an early stage.Study Design:Controlled laboratory study.Methods:A rabbit Achilles tendinopathy model was induced by a collagenase injection. A week later, treatments were applied randomly on local Achilles tendon lesions: (1) 200 μL of Lr-PRP (16 legs), (2) 200 μL of Lp-PRP (16 legs), and (3) 200 μL of saline (16 legs). At 3 and 6 weeks after the collagenase injection, outcomes were evaluated by histology, magnetic resonance imaging (MRI), real-time polymerase chain reaction analysis, immunohistochemistry, and transmission electron microscopy (TEM).Results:The Lr-PRP group had a lower T2 signal intensity ( P = .0377) and smaller diameter ( P = .0193) and cross-sectional area ( P = .0194) than the Lp-PRP group on MRI. Histologically, the Lr-PRP group had better scores than the Lp-PRP group ( P = .0284 and P = .0188, respectively). Compared with the Lp-PRP group, higher gene expression and more protein synthesis of collagen I ( P = .0160 and P = .0309, respectively) and CD163 ( P < .0001 and P = .0411, respectively) were found in the Lr-PRP group. Considering TEM and biomechanical testing, the Lr-PRP group demonstrated more mature collagen fibers ( P < .0001), a larger fiber diameter ( P = .0005), a higher failure load ( P = .00417), and higher tensile stress ( P < .0001) than the Lp-PRP group.Conclusion:Lr-PRP had more beneficial effects than Lp-PRP when delivered at an early stage during tendon repair.Clinical Relevance:Here, we showed that tendinopathy influenced the curative effects of PRP in vivo. An early-stage application of Lr-PRP had more benefits for the repair of tendinopathy than Lp-PRP in a rabbit model, which will supplement guidelines of PRP treatment on tendinopathy clinically. |
| Databáze: | OpenAIRE |
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