Effect of platelet-rich plasma on the biologic activity of the human rotator-cuff fibroblasts: A controlled in vitro study

Sadoghi, Patrick; Lohberger, Birgit; Aigner, Birgit; Kaltenegger, Heike; Friesenbichler, Joerg; Wolf, Matthias; Sununu, Tarek; Leithner, Andreas; Vavken, Patrick

doi:10.1002/jor.22360

Cited by 52 publications

(48 citation statements)

References 28 publications

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“…Sadoghi et al treated human tenocytes with PRP of varying platelet concentrations (1-, 5-, and 10-fold). All PRP treatments increased proliferation, DNA levels, and GAG levels, although lower concentrations were more effective [74]. Jo et al found that PRP significantly increased the production of matrix, GAGs, and Col-1 and III in human tenocytes in a dose-dependant manner [75].…”

Section: Platelet-rich Plasmamentioning

confidence: 99%

Biologic and Tissue Engineering Strategies for Tendon Repair

Sigal

Grande

Dines

et al. 2016

Regen. Eng. Transl. Med.

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This review summarizes recent developments in biologic treatments-including growth factors, platelet-rich plasma (PRP), stem cells, and cell-seeded scaffolds-for tendon repair. Growth and differentiation faction-5 (GDF-5), insulin-related growth factor-1 (IGF-1), and basic fibroblast growth factor (bFGF) all improved extracellular matrix (ECM) production and tensile strength of treated tendons; however, no clinical trials were done on GDF-5. Platelet-derived growth factor-BB (PDGF-BB) improved proliferation and ECM production, but did not consistently improve mechanical properties. The literature was mixed on the efficacy of PRP for the treatment of chronic and acute tendinopathies. However, PRP did cause any complications, and its benefits may be enhanced once an ideal, standardized composition is developed. Therefore, PRP may be a valid treatment, especially once nonsurgical management options have failed. Mesenchymal stem cells (MSCs) significantly and substantially improved the quality of tendon repairs and demonstrated the ability to regenerate an enthesis. Adipose-derived stem cells (ADSCs) have similar effects and are easier to harvest. The periosteum may also regenerate the tendon-bone attachment. Tenocytes, meanwhile, may be ideal for midsubstance tendon repairs. Cell-seeded scaffolds-especially ECMderived scaffolds-were demonstrated to improve ECM production, enhancing the healing abilities of tenocytes or stem cells while providing early mechanical support to healing tendons.Each of these treatments demonstrated enhanced healing compared to common surgical techniques; moreover, patient outcomes may be enhanced by combining these treatments. Lay SummaryTendon injuries are very prevalent and can be debilitating. Tendon heals poorly, and the scar tissue that forms is weak and susceptible to reinjury. A major focus of orthopedic research is regenerative medicine, encouraging the formation of healthy tendon rather than mechanically inferior scar tissue. This review summarizes the recent scientific literature on biologic treatments for tendon repair, such as growth factors, platelet-rich plasma, and stem cells. The purpose of which is to show which treatments are promising candidates for clinical use and research, helping to guide physicians and to lay out a path for future research.

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Section: Platelet-rich Plasmamentioning

confidence: 99%

Biologic and Tissue Engineering Strategies for Tendon Repair

Sigal

Grande

Dines

et al. 2016

Regen. Eng. Transl. Med.

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“…Recent studies [58,59,110,114,137] and metaanalyses described no consistent effect on re-tear rates or at least uncertainty about the evidence [17,119]. Possible explanations for these contradicting findings are that stimulating effects of PRP may turn into the opposite beyond an ideal dosage [13].…”

Section: Rotator Cuff Repair and Growth Factors: Are We Really Doing mentioning

confidence: 99%

Advances in biology and mechanics of rotator cuff repair

Lorbach

Baums

Kostuj

et al. 2015

Knee Surg Sports Traumatol Arthrosc

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“…Limitations of this study include the possibility that the measured force that caused failure of the un-operated tendons may have been underestimated due to the design of the mechanical testing apparatus [27]. Sadoghi et al [28] studied whether rotator cuff fibroblasts isolated from human subjects would have dosedependent increased proliferation when exposed to PRP. They showed that a concentration of platelets five times that of plasma had an effect on increasing human rotator cuff fibroblast proliferation, specifically, increasing the DNA to glycosaminoglycan ratio (the latter being one of the markers for tendon degeneration).…”

Section: Basic Sciencementioning

confidence: 99%

PRP: review of the current evidence for musculoskeletal conditions

Malanga

Goldin

2014

Curr Phys Med Rehabil Rep

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Injection of platelet-rich plasma (PRP) is an evolving treatment option for various musculoskeletal injuries. There is basic scientific evidence that suggests that the various growth factors present in PRP can help to augment the body's natural healing. There are also clinical studies suggesting efficacy for several conditions, particularly tendinopathy and osteoarthritis. This article reviews the definition and first uses of PRP, the basic scientific rationale for its use, and the basic science and evidence for its use in the treatment of tendon, joint, ligament, and muscle injuries. There are varying levels of evidence for and against the use of PRP for these types of injuries, and this article reviews studies that support as well as studies that refute the use of this new treatment. There are several studies that have assessed the basic science supportive of PRP treatments, as well as the clinical efficacy of this treatment in vivo. While the current evidence is mixed, several recent studies have demonstrated therapeutic benefit in the treatment of various tendinopathies and degenerative joint diseases of the knee. There are several factors that need to be addressed to elucidate whether PRP is truly effective. These include fully defining the PRP mixture (e.g. concentration, growth factor levels, presence of white cells and red cells, etc.), determining the optimal preparation and delivery of the PRP graft, calculating the appropriate number of injections for each specific pathologic process, and defining optimal post-procedure rehabilitation.

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Effect of platelet-rich plasma on the biologic activity of the human rotator-cuff fibroblasts: A controlled in vitro study

Cited by 52 publications

References 28 publications

Biologic and Tissue Engineering Strategies for Tendon Repair

Biologic and Tissue Engineering Strategies for Tendon Repair

Advances in biology and mechanics of rotator cuff repair

PRP: review of the current evidence for musculoskeletal conditions

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