title: Combined intra-tendinous injection of Platelet Rich Plasma and bevacizumab accelerates and improves healing compared to Platelet Rich Plasma in tendinosis: comprehensive assessment on a rat model.
abstract: OBJECTIVE
  the aim of our study was to assess the potential of combined intratendinous injection of an anti-angiogenic drug: bevacizumab (AA) and Platelet Rich Plasma (PRP) to treat tendinopathy in a murine model of patellar and Achilles tendinopathy, and to evaluate its local toxicity.
  
  
  METHODS
  twenty rats (80 patellar and Achilles tendons) were used for the study. We induced tendinosis (T+) in 80 tendons (patellar=40 and Achilles=40) by injecting under ultrasonography (US) guidance Collagenase 1® (day 0 = D0). Clinical examination was performed at D3, immediately followed by either PRP and AA (AAPRPT+, n=40) or PRP (PRPT+ n=40, control) US-guided intratendinous injection. Follow-up at D6, D18 and D25 using clinical, US and histology, and comparison between the 2 groups were performed. To study AA+PRP toxicity, we looked for necrosis or rupture on the 40 AAPRPT+.
  
  
  RESULTS
  all AAPRPT+ showed better joint mobilization compared to PRPT+ at D6 (p=0.03), D18 (p=0.04) and D25 (p=0.02). Similar results were found regarding US and histology, with smaller collagen fiber diameters (D6, p≤0.017, D25, p≤0.015), less disorganization and fewer neovessels (D25, p=0.004) in AAPRPT+ compared to PRPT+. No AA+PRP local toxicity was discovered in histology assessment.
  
  
  CONCLUSIONS
  our study suggests that combined injection of AA and PRP in tendinosis accelerates and improves tendon's healing compared PRP used alone, with no local toxicity.
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux-Mérignac Département d'Imagerie Musculo-squeletrique, Centre Hospitalier Universitaire Pellegrin Bordeaux, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Dallaudiere
authors.affiliation: Département d'Imagerie Musculo-squeletrique, Centre Hospitalier Universitaire Bichat, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Zurlinden
authors.affiliation: Unité de recherche Clinique, Paris Nord, Centre Hospitalier Universitaire Bichat, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Perozziello
authors.affiliation: Département d'Anatomopathologie, Centre Hospitalier Universitaire Bichat, Paris, France.
authors.forename: Lydia
authors.initials: L
authors.lastname: Deschamps
authors.affiliation: Département d'Imagerie Musculo-squeletrique, Cliniques Universitaires Saint Luc, Bruxelles, Belgium.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Larbi
authors.affiliation: Unité INSERM U698,Centre Hospitalier Universitaire Bichat, Paris, France.
authors.forename: Liliane
authors.initials: L
authors.lastname: Louedec
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux-Mérignac Département d'Imagerie Musculo-squeletrique, Centre Hospitalier Universitaire Pellegrin Bordeaux, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Pesquer
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux-Mérignac Département d'Imagerie Musculo-squeletrique, Centre Hospitalier Universitaire Pellegrin Bordeaux, France.
authors.forename: Yohan
authors.initials: Y
authors.lastname: Benayoun
authors.affiliation: Centre d'Imagerie Ostéo-articulaire, Clinique du Sport de Bordeaux-Mérignac Département d'Imagerie Musculo-squeletrique, Centre Hospitalier Universitaire Pellegrin Bordeaux, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Silvestre
authors.affiliation: Unité INSERM U698,Centre Hospitalier Universitaire Bichat, Paris, France.
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Serfaty
keywords: PRP; US; anti-angiogenic; rat; tendinosis; tendon