Quantitative Assessment of Tendon Healing by Using MR T2 Mapping in a Rabbit Achilles Tendon Transection Model Treated with Platelet-rich Plasma

Radiology ◽  
2015 ◽  
Vol 276 (3) ◽  
pp. 748-755 ◽  
Author(s):  
Taisuke Fukawa ◽  
Satoshi Yamaguchi ◽  
Atsuya Watanabe ◽  
Takahisa Sasho ◽  
Ryuichiro Akagi ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Quantitative Assessment ◽  
Platelet Rich Plasma ◽  
T2 Mapping ◽  
Tendon Healing

Response of the Injured Tendon to Growth Factors in the Presence or Absence of the Paratenon

2018 ◽  
Vol 47 (2) ◽  
pp. 462-467 ◽  
Author(s):  
Sebastian A. Müller ◽  
Nicholas P. Quirk ◽  
Julia A. Müller-Lebschi ◽  
Patricia E. Heisterbach ◽  
Lutz Dürselen ◽  
...  
Keyword(s):  
Growth Factors ◽  
Achilles Tendon ◽  
Platelet Rich Plasma ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Cross Sectional ◽  
Autologous Conditioned Serum ◽  
Injured Tendon ◽  
The Right ◽  
Exogenous Growth Factors

Background: The paratenon is important for Achilles tendon healing. There is much interest in the use of exogenous growth factors (GFs) as potential agents for accelerating the healing of damaged Achilles tendons. Purpose/Hypothesis: The present study used a rat model to study the responses of the injured Achilles tendon to GFs in the presence or absence of the paratenon. The hypothesis was that responses of the injured tendon to GFs would be lower in the absence of a paratenon. Study Design: Controlled laboratory study. Methods: A 4-mm defect was created in the right Achilles tendon of 60 skeletally mature rats, which were treated with a validated combination of GFs (bFGF, BMP-12, and TGF-β1). Animals were randomly assigned to the intact paratenon (IP) group or resected paratenon (RP) group. Healing was studied anatomically, mechanically, and histologically after 1, 2, and 4 weeks. Results: IP tendons showed improved healing compared with RP tendons. IP tendons were significantly stronger (32.2 N and 48.9 N, respectively) than RP tendons (20.1 N and 31.1 N, respectively) after 1 and 2 weeks. IP tendons did not elongate as much as RP tendons and had greater cross-sectional areas (18.0 mm2, 14.4 mm2, and 16.4 mm2, respectively) after 1, 2, and 4 weeks compared with RP tendons (10.5 mm2, 8.4 mm2, and 11.9 mm2, respectively). On histology, earlier collagen deposition and parallel orientation of fibrils were found for IP tendons. Conclusion: The paratenon is essential for efficient Achilles tendon healing. Healing with GFs in this Achilles tendon defect model was superior in the presence of the paratenon. Clinical Relevance: Biological approaches to tendon engineering using GFs are in vogue and have been shown to improve healing of the rat Achilles tendon, most likely by inducing progenitor cells located within the paratenon. Clinically, resection or incision of the paratenon has been proposed for wound closure. Our data demonstrate the fundamental importance of the paratenon, which therefore should be preserved during Achilles tendon repair, especially if augmented with products such as platelet-rich plasma or autologous conditioned serum that are rich in GFs.

scholarly journals Real-time sonoelastography evaluation of the Achilles tendon following ultrasound-guided platelet-rich plasma injection and eccentric exercise for the treatment of refractory Achilles tendinopathy

Ultrasound ◽  
2018 ◽  
Vol 27 (3) ◽  
pp. 138-147
Author(s):  
Chin Chin Ooi ◽  
Michal Schneider ◽  
Peter Malliaras ◽  
Meng Ai Png ◽  
Martine Chadwick ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Eccentric Exercise ◽  
Platelet Rich Plasma ◽  
Tendon Healing ◽  
Inverse Correlation ◽  
Strain Ratio ◽  
Achilles Tendinopathy ◽  
Post Treatment ◽  
Tendon Stiffness ◽  
Plasma Injection

The objective of this study was to investigate the feasibility of using sonoelastography to depict Achilles tendon stiffness after platelet-rich plasma injection and eccentric exercise for chronic Achilles tendinopathy, and to correlate sonoelastography findings with clinical outcome up to 12 months after treatment. Forty-five Achilles tendons from 45 patients (33 males, 12 females; mean age 51 years) were examined using sonoelastography and ultrasound at baseline, 4–6 weeks, 6 months and 12 months post-treatment. The strain ratio (between Achilles tendon and Kager's fat) during sonoelastography was obtained. The proportion of tendons with hypoechogenicity and neovascularity were documented. Clinical outcomes were assessed by the Victorian Institute of Sport Assessment-Achilles questionnaire and correlated with sonographic findings. The Victorian Institute of Sport Assessment-Achilles improved significantly from 38.4 (±14.1) at baseline, 77.2 (±12.5) at 6 months ( p < 0.001) to 81.2 (±10.8) at 12 months ( p < 0.001). The strain ratio values were 2.16 (±1.02) at baseline, 2.03 (±0.67) at 4–6 weeks, 1.81 (±0.62) at 6 months and 1.19 (±0.34) at 12 months with a significant reduction observed at 6 months (p = 0.006) and 12 months ( p < 0.001). At 12-month evaluation, none of the tendons regained a normal echotexture. Strain ratio demonstrated a moderately good inverse correlation with Victorian Institute of Sport Assessment-Achilles (r = −0.610, p<0.001) while B-mode and Doppler ultrasound did not show a significant correlation (r = −0.041, p = 0.817, and r = −0.116, p = 0.514). Achilles tendon stiffness shows moderately good correlation with clinical symptom at 12-month post-treatment. Sonoelastography using strain ratio could be a promising ancillary tool for monitoring Achilles tendon healing after treatment.

scholarly journals Effect of platelet-rich plasma on rat Achilles tendon healing is related to microbiota

2017 ◽  
Vol 88 (4) ◽  
pp. 463-463 ◽  
Author(s):  
Franciele Dietrich ◽  
Malin Hammerman ◽  
Parmis Blomgran ◽  
Love Tätting ◽  
Vinicius Faccin Bampi ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Platelet Rich Plasma ◽  
Tendon Healing

Effect of Platelet-Rich Plasma on Nonsurgically Treated Acute Achilles Tendon Ruptures: A Randomized, Double-Blinded Prospective Study

2020 ◽  
Vol 48 (9) ◽  
pp. 2268-2276 ◽  
Author(s):  
Anders Ploug Boesen ◽  
Morten Ilum Boesen ◽  
Rudi Hansen ◽  
Kristoffer Weisskirchner Barfod ◽  
Anders Lenskjold ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Functional Outcomes ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Achilles Tendon Rupture ◽  
Exercise Program ◽  
Tendon Healing ◽  
Functional Improvement ◽  
Level Of Evidence ◽  
Time Points

Background: An acute Achilles tendon rupture (ATR) is a long-lasting and devastating injury. Possible biological augmentation to promote and strengthen tendon healing after an ATR would be desirable. Purpose: To determine whether the application of a platelet-rich plasma (PRP) injection in nonsurgically treated ATRs may promote healing and thereby improve functional outcomes. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 40 men (aged 18-60 years) with an ATR incurred within 72 hours were included, and 38 were followed for 12 months. All patients were treated with an orthosis with 3 wedges for 8 weeks; full weightbearing from day 1 was allowed, combined with either 4 PRP or 4 placebo injections (a few drops of saline, <0.5 mL, under the skin) 14 days apart. All patients received the same instructions on an exercise program starting from week 9. Outcomes included the self-reported Achilles tendon Total Rupture Score (ATRS) as well as heel-rise work, heel-rise height, tendon elongation, calf circumference, and ankle dorsiflexion range of motion. Results: The mean ATRS score improved in both groups at all time points ( P < .001), but there was no difference between the groups at any time points (12 months: 90.1 points in PRP group and 88.8 points in placebo group). No differences in all functional outcomes at any time points were seen between the groups. At 12 months, the injured leg did not reach normal functional values compared with the uninjured leg. Conclusion: The application of PRP in nonsurgically treated ATRs did not appear to show any superior clinical and functional improvement. Registration: NCT02417922 (ClinicalTrials.gov identifier)

scholarly journals The effect of platelet-rich plasma on Achilles tendon healing in a rabbit model

2017 ◽  
Vol 51 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Masaki Takamura ◽  
Toshito Yasuda ◽  
Atsushi Nakano ◽  
Hiroaki Shima ◽  
Masashi Neo
Keyword(s):  
Achilles Tendon ◽  
Platelet Rich Plasma ◽  
Rabbit Model ◽  
Tendon Healing
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