The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing.
BACKGROUND
The poor vascularity of tendons is a major factor in their limited healing capacity. The aim of this study was to assess the effect of Platelet Rich Plasma (PRP) on angiogenesis during tendon healing.


METHODS
Forty-eight skeletally mature New Zealand White rabbits were used. The Achilles tendon was transected transversely and 0.5 ml of PRP was injected into the tendon mass on each side of the incision on both limbs. The injection in the control group consisted of saline. Six animals from each group (12 tendons each) were sacrificed after 1, 2, 3, and 4 weeks following treatment. Three sections from each Achilles were stained with hematoxylinosin for microscopic examination. Further three sections were immunostained with a monoclonal antibody against CD31 (Daco Co), followed by image analysis to count new vessel numbers and statistical analysis was performed.


RESULTS
There was significantly more angiogenesis in the PRP group compared to the control group during the first two weeks of the healing process, i.e., inflammatory and proliferative phase (p < 0.0001). The orientation of collagen fibers in the PRP group was better organized. The number of the newly formed vessels in the PRP group were significantly reduced at 4 weeks compared to the controls (p < 0.0001) suggesting the healing process was shortened.


CONCLUSIONS
PRP seems to enhance neovascularization which may accelerate the healing process and promote scar tissue of better histological quality.


CONCLUSIONS
Although these results need replication and further biomechanical research, PRP may promote tendon healing acceleration.
Lyras
Dimitrios N
DN
Democritus University of Thrace, Dept of Orthopaedics, Dragana, Alexandroupolis, Greece. dimitrislyras@yahoo.gr
Kazakos
Konstantinos
K
Verettas
Dionysios
D
Polychronidis
Alekos
A
Tryfonidis
Marios
M
Botaitis
Sotirios
S
Agrogiannis
George
G
Simopoulos
Constantinos
C
Kokka
Anna
A
Patsouris
Efstratios
E
D000125:Achilles Tendon / Q000293:injuries; D000818:Animals; D001696:Biomechanical Phenomena; D003094:Collagen / Q000096:biosynthesis; D004195:Disease Models, Animal; D007150:Immunohistochemistry; D018919:Neovascularization, Physiologic / Q000502:physiology*; D053657:Platelet-Rich Plasma / Q000502:physiology*; D011817:Rabbits; D012421:Rupture; D013708:Tendon Injuries / Q000503:physiopathology*; D014945:Wound Healing / Q000502:physiology*
D003094:Collagen