Enhancement of Rotator Cuff Tendon-bone Healing with Graphene Oxide/PRP Composite Scaffold in a Rabbit Model: A Histological and Biomechanical Study

Abstract

Background: Application of platelet-rich plasma (PRP) can improve tendon-bone healing (TBH) after rotator cuff surgical repair. Graphene Oxide (GO) is a steady, controlled, and sustained carrier. The purpose of this study is to determine whether GO/PRP Composite Scaffold enhances the TBH after RC surgical repair in a rabbit model.Methods: A full-thickness tear of the supraspinatus tendon was created and repaired in 36 adult male New Zealand rabbits. They were divided into three groups: Control group, PRP group, and GO/PRP Composite Scaffold group (GO group). The effect of GO/PRP Composite Scaffold on TBH was assessed using histological and biomechanical evaluations at 8 and 12 weeks postoperatively.Results: Histological analysis showed that greater continuity, better orientation, and more density of collagen fiber were detected in the GO group than PRP and Control groups at 8 and 12 weeks, respectively. Results of biomechanical evaluations showed that the load to failure and stiffness of the GO group were statistically higher than those of PRP and Control groups at both 8 and 12 weeks (P<0.05). Compared with 8 weeks in the GO group, there was no significant difference in load to failure at 12 weeks (P>0.05), while the stiffness at 12 weeks was higher than that at 8 weeks (P<0.05). Conclusions: These results demonstrated that GO/PRP Composite Scaffold enhanced the TBH following rotator cuff surgical repair in a rabbit model. The GO may be an effective carrier for PRP into repair sites.