The effect of autologous platelet rich plasma on tenocytes of the human rotator cuff

Abstract

BackgroundPlatelet rich plasma (PRP) is widely used in rotator cuff repairs but its effect on the healing process is unclear. Several cell culture studies on the effect of allogenic PRP have reported promising results but are not transferable to clinical practice.The aim of the present study is to assess the possible effect of autologous PRP on rotator cuff tendon cells. The amount of growth factors involved with tendon-bone healing (PDGF-AB, IGF-1, TGF-β1, BMP-7 and -12) is quantified.MethodsRotator cuff tissue samples were obtained from (n = 24) patients grouped by age (>/< 65 years) and sex into four groups and cells were isolated and characterized. Later, autologous PRP preparations were obtained and the effect was analyzed by means of cell proliferation, collagen I synthesis and expression of collagen I and III. Furthermore, the PRPs were quantified for growth factor content by means of platelet-derived growth factor (PDGF-AB), insulin-like growth factor (IGF-1), transforming growth factor (TGF-β1), as well as bone morphogenetic protein (BMP) -7 and − 12.ResultsCell proliferation and absolute synthesis of collagen I were positively affected by PRP exposure compared to controls (p < 0.05), but expression and relative synthesis of collagen I (normalized to cell proliferation) were significantly reduced.PRP contained high amounts of IGF-1 and lower levels of TGF-β1 and PDGF-AB. The amounts of BMP-7 and -12 were below the detection limits.ConclusionsPRP is a source of growth factors such involved with tendon-bone healing. PRP had an anabolic effect on the human rotator cuff tenocytes of the same individual in vitro by means of cell proliferation and absolute, but not relative collagen I synthesis.These results encourage further studies on clinical outcomes with more comparable standards in terms of preparation and application methods.Level of evidenceControlled laboratory study.

The blood cells count in leukocyte and leukocyte-poor platelet-concentrated plasma in patients with musculoskeletal disorders

“…However, Weibrich G. [44] showed that age has almost no effect on platelet counts in PRP. In addition, Pauly S. [38], who used the blood of patients with tendopathies to prepare PRP, are comparable to data from another study [35] that used blood from healthy individuals. Both studies used the same commercial blood processing technique.…”

“…Since many methods of LP-PCP preparation use single centrifugation, it significantly reduces the number of platelets compared with L-PCP [6,34,38]. The efficiency of platelet isolation for both methods of obtaining concentrates is also comparable and is 76.5 ± 23.4 % and 83 ± 24.9 % for LP-PCP and L-PCP, respectively.…”

“…Platelet concentrates also contain other types of circulating blood cells. The number of leukocytes is one of the most important indicators for such products, as they can significantly affect its properties [37,38]. According to their content, platelet concentrates are divided into leukocyte and leukocyte-poor ones [17].…”

Clinical outcomes after common calcanean tendon rupture repair in dogs with a loop‐suture tenorrhaphy technique and autogenous leukoreduced platelet‐rich plasma

“…In studies in laboratory animals, there was increased tendon callus production and increased force to failure of tendon healing when the tendon repair sites were treated with PRP . Growth factors found in PRP, including transforming growth factor β1, platelet‐derived growth factor, vascular endothelial growth factor, and epidermal growth factor, increase type I collagen production and tenocyte proliferation …”

“…29 Growth factors found in PRP, including transforming growth factor β1, platelet-derived growth factor, vascular endothelial growth factor, and epidermal growth factor, increase type I collagen production and tenocyte proliferation. 30 Reports on the efficacy of PRP in surgical repair of the CCT in man are mixed. In a prospective study of 12 athletes treated surgically for acute CCT rupture, 6 athletes treated with surgery and PRP had a faster return to function than those treated with surgery alone.…”