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This Article Full Text Full Text (PDF) All Versions of this Article: 36/6/1171    most recent 0363546508314430v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Google Scholar Articles by de Mos, M. Articles by van Osch, G. J. V. M. PubMed PubMed Citation Articles by de Mos, M. Articles by van Osch, G. J. V. M. Related Collections Muscle

Can Platelet-Rich Plasma Enhance Tendon Repair?

A Cell Culture Study

Marieke de Mos, MD^,*,, Anna E. van der Windt, MSc^,, Holger Jahr, PhD, Hans T. M. van Schie, DVM, PhD^,, Harrie Weinans, PhD, Jan A. N. Verhaar, MD, PhD and Gerjo J. V. M. van Osch, PhD^,||

From the Department of Orthopaedics, Erasmus MC University Medical Center, Rotterdam, the Netherlands, the Faculty of Veterinary Medicine, Department of Equine Sciences, Utrecht University, Utrecht, the Netherlands, and the ^|| Department of Otorhinolaryngology, Erasmus MC University Medical Center, Rotterdam, the Netherlands

^* Address correspondence to Marieke de Mos, MD, Erasmus MC, University Medical Center Rotterdam, Departments of Orthopaedics and Otorhinolaryngology, Room Ee1614, PO Box 2040, 3000 CA Rotterdam, the Netherlands (e-mail: m.demos{at}erasmusmc.nl).

Background: Autologous platelet-rich plasma (PRP) application appears to improve tendon healing in traumatic tendon injuries, but basic knowledge of how PRP promotes tendon repair is needed.

Hypothesis: Platelet-rich plasma has a positive effect on cell proliferation and collagen production and induces the production of matrix-degrading enzymes and endogenous growth factors by human tenocytes.

Study Design: Controlled laboratory study.

Methods: Human tenocytes were cultured 14 days in 2% fetal calf serum medium complemented with 0%, 10%, or 20% vol/vol platelet-rich clot releasate ([PRCR] the active releasate of PRP) or platelet-poor clot releasate (PPCR). At day 4, 7, and 14, cell amount, total collagen, and gene expression of collagen I1 (COL1) and III1 (COL3), matrix metalloproteinases ([MMPs] MMP1, MMP3, and MMP13), vascular endothelial-derived growth factor (VEGF)-A, and transforming growth factor (TGF)-β1 were analyzed.

Results: Platelet numbers in PRP increased to 2.55 times baseline. Growth-factor concentrations of VEGF and platelet-derived growth factor (PDGF)-BB were higher in PRCR than PPCR. Both PRCR and PPCR increased cell number and total collagen, whereas they decreased gene expression of COL1 and COL3 without affecting the COL3/COL1 ratio. PRCR, but not PPCR, showed upregulation of MMP1 and MMP3 expression. Matrix metalloproteinase 13 expression was not altered by either treatment. PRCR increased VEGF-A expression at all time points and TGF-β1 expression at day 4.

Conclusion: In human tenocyte cultures, PRCR, but also PPCR, stimulates cell proliferation and total collagen production. PRCR, but not PPCR, slightly increases the expression of matrix-degrading enzymes and endogenous growth factors.

Clinical Relevance: In vivo use of PRP, but also of PPP to a certain extent, in tendon injuries might accelerate the catabolic demarcation of traumatically injured tendon matrices and promote angiogenesis and formation of a fibrovascular callus. Whether this will also be beneficial for degenerative tendinopathies remains to be elucidated.

Key Words: platelet-rich plasma • tendon • growth factors • collagen • matrix metalloproteinases