The Healing Effects of Aquatic Activities and Allogenic Injection of Platelet-Rich Plasma (PRP) on Injuries of Achilles Tendon in Experimental Rat

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Abstract

BACKGROUND

Clinical tendon injuries represent serious and unresolved issues of the case on how the injured tendons could be improved based on natural structure and mechanical strength. The aim of this studies the effect of aquatic activities and alogenic platelet rich plasma (PRP) injection in healing Achilles tendons of rats.

METHODS

Forty rats were randomly divided into 5 equal groups. Seventy two hours after a crush lesion on Achilles tendon, group 1 underwent aquatic activity for 8 weeks (five sessions per week), group 2 received intra-articular PRP (1 ml), group 3 had aquatic activity together with injection PRP injection after an experimental tendon injury, group 4 did not receive any treatment after tendon injury and the control group with no tendon injuries. of 32 rats. After 8 weeks, the animals were sacrificed and the tendons were transferred in 10% formalin for histological evaluation.

RESULTS

There was a significant increase in number of fibroblast and cellular density, and collagen deposition in group 3 comparing to other groups denoting to an effective healing in injured tendons. However, there was no significant difference among the studied groups based on their tendons diameter.

CONCLUSION

Based on our findings on the number of fibroblast, cellular density, collagen deposition, and tendon diameter, it was shown that aquatic activity together with PRP injection was the therapeutic measure of choice enhance healing in tendon injuries that can open a window in treatment of damages to tendons.

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Most cited references 40

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Treatment of chronic elbow tendinosis with buffered platelet-rich plasma.

T Pavelko, Allan Mishra (2006)

Elbow epicondylar tendinosis is a common problem that usually resolves with nonoperative treatments. When these measures fail, however, patients are interested in an alternative to surgical intervention. Treatment of chronic severe elbow tendinosis with buffered platelet-rich plasma will reduce pain and increase function in patients considering surgery for their problem. Cohort study; Level of evidence, 2. One hundred forty patients with elbow epicondylar pain were evaluated in this study. All these patients were initially given a standardized physical therapy protocol and a variety of other nonoperative treatments. Twenty of these patients had significant persistent pain for a mean of 15 months (mean, 82 of 100; range, 60-100 of 100 on a visual analog pain scale), despite these interventions. All patients were considering surgery. This cohort of patients who had failed nonoperative treatment was then given either a single percutaneous injection of platelet-rich plasma (active group, n = 15) or bupivacaine (control group, n = 5). Eight weeks after the treatment, the platelet-rich plasma patients noted 60% improvement in their visual analog pain scores versus 16% improvement in control patients (P =.001). Sixty percent (3 of 5) of the control subjects withdrew or sought other treatments after the 8-week period, preventing further direct analysis. Therefore, only the patients treated with platelet-rich plasma were available for continued evaluation. At 6 months, the patients treated with platelet-rich plasma noted 81% improvement in their visual analog pain scores (P =.0001). At final follow-up (mean, 25.6 months; range, 12-38 months), the platelet-rich plasma patients reported 93% reduction in pain compared with before the treatment (P <.0001). Treatment of patients with chronic elbow tendinosis with buffered platelet-rich plasma reduced pain significantly in this pilot investigation. Further evaluation of this novel treatment is warranted. Finally, platelet-rich plasma should be considered before surgical intervention.

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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.

I D Bruijn, Taco Gosens, Joost Peerbooms … (2010)

Platelet-rich plasma (PRP) has shown to be a general stimulation for repair. Purpose To determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis. Randomized controlled trial; Level of evidence, 1. The trial was conducted in 2 teaching hospitals in the Netherlands. One hundred patients with chronic lateral epicondylitis were randomly assigned in the PRP group (n = 51) or the corticosteroid group (n = 49). A central computer system carried out randomization and allocation to the trial group. Patients were randomized to receive either a corticosteroid injection or an autologous platelet concentrate injection through a peppering technique. The primary analysis included visual analog scores and DASH Outcome Measure scores (DASH: Disabilities of the Arm, Shoulder, and Hand). Successful treatment was defined as more than a 25% reduction in visual analog score or DASH score without a reintervention after 1 year. The results showed that, according to the visual analog scores, 24 of the 49 patients (49%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful, which was significantly different (P <.001). Furthermore, according to the DASH scores, 25 of the 49 patients (51%) in the corticosteroid group and 37 of the 51 patients (73%) in the PRP group were successful, which was also significantly different (P = .005). The corticosteroid group was better initially and then declined, whereas the PRP group progressively improved. Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection. Future decisions for application of the PRP for lateral epicondylitis should be confirmed by further follow-up from this trial and should take into account possible costs and harms as well as benefits.

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Platelet-Rich Plasma: Support for Its Use in Wound Healing

Kathleen M. Lacci, Alan Dardik (2010)

Previous topical growth factor studies have shown that recombinant human platelet-derived growth factor-BB isomer (rhPDGF-BB) is an efficacious treatment of chronic diabetic foot ulceration. A newer treatment, autologous platelet-rich plasma (PRP), represents a greater similarity to the natural healing process as a composite of multiple growth factors, is safe due to its autologous nature, and is produced as needed from patient blood. A review of the literature shows few studies performed with scientific rigor, although the safety of PRP appears to be validated. As the use of PRP increases, additional studies may establish PRP as an efficacious treatment modality and guide future treatment of chronic diabetic foot ulceration.

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Author and article information

Journal

Journal ID (nlm-ta): World J Plast Surg

Journal ID (iso-abbrev): World J Plast Surg

Journal ID (publisher-id): WJPS

Title: World Journal of Plastic Surgery

Publisher: Iranian Society for Plastic Surgeons (Tehran, Iran )

ISSN (Print): 2228-7914

ISSN (Electronic): 2252-0724

Publication date (Print): January 2015

Volume: 4

Issue: 1

Pages: 66-73

Affiliations

[1 ]Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Kharazmei University, Tehran, Iran;

[2 ]Stem Cell and Transgenic Technology Research Center, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran;

[3 ]Department of Veterinary Surgery, School of Veterinary Medicine, Shiraz University, Shiraz, Iran

Author notes

[* ]Co-corresponding Authors: Homa Sheikhani Shahin, PhD Candiadate; Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Kharazmei University, Tehran, Iran. Telfax: +98-71-32341025, E-mail: hsheikhani@yahoo.com ,Davood Mehrabani, PhD; Stem Cell and Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Tel/Fax: +98-71-32341025, E-mail: mehrabad@sums.ac.ir

Article

Publisher ID: wjps-4-066

PMC ID: 4298867

PubMed ID: 25606479

SO-VID: ee8312a8-d9d7-4342-b5a2-9d62551dc1e9

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 9 September 2014

Date accepted : 8 November 2014

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The Healing Effects of Aquatic Activities and Allogenic Injection of Platelet-Rich Plasma (PRP) on Injuries of Achilles Tendon in Experimental Rat

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Abstract

BACKGROUND

METHODS

RESULTS

CONCLUSION

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Animal models of intrauterine growth restriction (IUGR)

Most cited references 40

Treatment of chronic elbow tendinosis with buffered platelet-rich plasma.

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.

Platelet-Rich Plasma: Support for Its Use in Wound Healing

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Cited by 17