The Effect of Platelet-Rich Plasma on Achilles Tendon Healing in a Rabbit Model

Takamura, Masaki

doi:10.3944/aott.2016.16.0045

Cited by 10 publications

(22 citation statements)

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“…The possible reasons for intergroup differences of FSS and CSA may be that PRP offers abundant growth factors for neurogenesis and nerve regeneration. Furthermore, PRP has an anti‐inflammatory effect, which could contribute to early pain relief and further reduce swelling of the flexor tendon/subsynovial connective tissue with accompanying reduction of intracarpal tunnel (Osterman et al, ; Takamura, Yasuda, Nakano, Shima, & Neo, ; Wu et al, ). Although the relative short‐term follow‐up may be insufficient for distinguishing symptom severity after nerve regeneration between groups, the tendencies of intergroup differences in electrophysiological studies and CSA became more apparent over time (Table ; Figure and ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of perineural platelet‐rich plasma and dextrose injections for moderate carpal tunnel syndrome: A prospective randomized, single‐blind, head‐to‐head comparative trial

Shen

Chou

et al. 2019

J Tissue Eng Regen Med

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Recent studies demonstrated the utility of perineural injection with platelet-rich plasma (PRP) and 5% dextrose (D5W) as novel strategies for treatment of carpal tunnel syndrome (CTS). The present study comprised a prospective, randomized, singleblind, head-to head comparative trial to compare the 6-month outcome of perineural injection with PRP or D5W in patients with moderate CTS. Fifty-two patients with unilateral moderate CTS were enrolled and randomized into two groups: The PRP group received a single 3-cc perineural injection of PRP under ultrasound guidance, and dextrose group received a single 3-cc perineural injection of D5W under ultrasound guidance. The Boston Carpal Tunnel Syndrome Questionnaire score was used as the primary outcome. Secondary outcomes included cross-sectional area (CSA) of the median nerve and electrophysiological assessments. Evaluations were performed at baseline and at 1, 3, and 6 months postinjection. All patients (26 patients per group) completed the study. Compared with the dextrose group, the PRP group demonstrated significant reductions in Boston Carpal Tunnel Syndrome Questionnaire function at 3 months (p = .044), distal motor latency at 6 months (p = .028), and CSA at 3 and 6 months (p = .010 and.018, respectively). A single perineural injection of PRP reduced the CSA of the median nerve more effectively than injection of D5W at 3 and 6 months postinjection for patients with moderate CTS. KEYWORDS carpal tunnel syndrome, dextrose, perineural injection, peripheral nerve entrapment, platelet-rich plasma, regenerative

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Section: Discussionmentioning

confidence: 99%

Comparison of perineural platelet‐rich plasma and dextrose injections for moderate carpal tunnel syndrome: A prospective randomized, single‐blind, head‐to‐head comparative trial

Shen

Chou

et al. 2019

J Tissue Eng Regen Med

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“…The tendon ages utilized in this study were based on predicate Achilles tendon rabbit models and weight. 7,14,36 Another limitation was that during the initial design of the study, it was not anticipated that PEP would have such a significant effect on adhesions; therefore, adhesion-specific mechanical testing to assess tendon gliding resistance was not performed. This study was performed in an Achilles tendon model that has different properties regarding adhesions compared with the more common flexor tendon model to evaluate adhesions.…”

Section: Discussionmentioning

confidence: 99%

“…7,28 It has been shown that the transition from type 3 to type 1 collagen does not begin until the remodeling stage (6-10 weeks), which supports the selected time points. 28,36…”

Section: Methodsmentioning

confidence: 99%

“…7,28 It has been shown that the transition from type 3 to type 1 collagen does not begin until the remodeling stage (6-10 weeks), which supports the selected time points. 28,36 Group 1 was the control group in which an Achilles tenotomy was performed, followed by standard suture repair. Group 2 underwent an Achilles tenotomy, followed by standard suture repair with a type 1 collagen scaffold applied at the repair site.…”

Section: Methodsmentioning

confidence: 99%

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Intrinsic Tendon Regeneration After Application of Purified Exosome Product: An In Vivo Study

Wellings

Huang

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: Tendons are primarily acellular, limiting their intrinsic regenerative capabilities. This limited regenerative potential contributes to delayed healing, rupture, and adhesion formation after tendon injury. Purpose: To determine if a tendon’s intrinsic regenerative potential could be improved after the application of a purified exosome product (PEP) when loaded onto a collagen scaffold. Study Design: Controlled laboratory study. Methods: An in vivo rabbit Achilles tendon model was used and consisted of 3 groups: (1) Achilles tenotomy with suture repair, (2) Achilles tenotomy with suture repair and collagen scaffold, and (3) Achilles tenotomy with suture repair and collagen scaffold loaded with PEP at 1 × 1012 exosomes/mL. Each group consisted of 15 rabbits for a total of 45 specimens. Mechanical and histologic analyses were performed at both 3 and 6 weeks. Results: The load to failure and ultimate tensile stress were found to be similar across all groups ( P ≥ .15). The tendon cross-sectional area was significantly smaller for tendons treated with PEP compared with the control groups at 6 weeks, which was primarily related to an absence of external adhesions ( P = .04). Histologic analysis confirmed these findings, demonstrating significantly lower adhesion grade both macroscopically ( P = .0006) and microscopically ( P = .0062) when tendons were treated with PEP. Immunohistochemical staining showed a greater intensity for type 1 collagen for PEP-treated tendons compared with collagen-only or control tendons. Conclusion: Mechanical and histologic results suggested that healing in the PEP-treated group favored intrinsic healing (absence of adhesions) while control animals and animals treated with collagen only healed primarily via extrinsic scar formation. Despite a smaller cross-sectional area, treated tendons had the same ultimate tensile stress. This pilot investigation shows promise for PEP as a means of effectively treating tendon injuries and enhancing intrinsic healing. Clinical Relevance: The production of a cell-free, off-the-shelf product that can promote tendon regeneration would provide a viable solution for physicians and patients to enhance tendon healing and decrease adhesions as well as shorten the time required to return to work or sports.

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“…Several mechanisms were postulated to explain the effect of PRP on CTS relief: PRP could promote angiogenesis, neurogenesis, and regeneration via direct effects on the median nerve, PRP could reduce the flexors tenosynovitis, which would result in reduction of intracarpal pressure exerted on the median nerve, and finally, the hydrodissection could have some benefits [36][37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of platelet-rich plasma injection in mild and moderate carpal tunnel syndrome: randomized control study

Gado

El-Banna

2020

Egypt Rheumatol Rehabil

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Background: Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Typical symptoms and signs include numbness, tingling, pain, or burning sensation in the digits supplied by the median nerve and/or nocturnal paresthesia. Treatments of CTS range from conservative measures to surgical decompression of the median nerve. Results: The PRP group showed a statistically significant reduction in the visual analog scale, Boston Carpal Tunnel Syndrome Questionnaire, for the severity and the functional capacity scores, and cross-sectional area of the median nerve compared to those of control group 3 months post-treatment (p < 0.05). Conclusions: Platelet-rich plasma injection in CTS relieves pain and symptom severity and improves functional status but not significantly improve the electrophysiological parameters.

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The Effect of Platelet-Rich Plasma on Achilles Tendon Healing in a Rabbit Model

Cited by 10 publications

References 0 publications

Comparison of perineural platelet‐rich plasma and dextrose injections for moderate carpal tunnel syndrome: A prospective randomized, single‐blind, head‐to‐head comparative trial

Comparison of perineural platelet‐rich plasma and dextrose injections for moderate carpal tunnel syndrome: A prospective randomized, single‐blind, head‐to‐head comparative trial

Intrinsic Tendon Regeneration After Application of Purified Exosome Product: An In Vivo Study

Efficacy of platelet-rich plasma injection in mild and moderate carpal tunnel syndrome: randomized control study

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