The effect of the platelet-rich plasma and ozone therapy on tendon-to-bone healing in the rabbit rotator cuff repair model

Abstract

Background The aim of this study is to histologically and biomechanically investigate the effects of local PRP and ozone therapy (O2O3) on tendon-to-bone healing in a rabbit model of the supraspinatus tendon tear. Methods Four groups were formed to have seven rabbits in each group: repair, R; repair + PRP, RP; repair + ozone, RO; and repair + PRP + ozone, RPO. The supraspinatus tendon was detached by sharp dissection from the footprint and an acute tear pattern was created. Thereafter, tendon repair was performed with the transosseous technique. In the RP group, PRP, and in the RPO group, PRP + O2O3 mixture was injected to the tendon repair site. In the RO group, O2O3 gas mixture was injected into subacromial space three times a week for a total of 4 weeks. The study was ended at postoperative 6th week. Results When compared with the R group, a statistically significant increase was observed in the biomechanical strength of the RP and RPO groups. The highest increase in biomechanical strength was detected in the RPO group. The histology of the RO and RPO groups showed better collagen fiber continuity and orientation than the R and RP groups. Conclusions The results obtained from this study show that the ozonized PRP can be used as biological support to increase tendon-to-bone healing. However, these results need to be supported by clinical studies.

Updated Review on Ozone Therapy in Pain Medicine

“…Brina and Villani (2004) have published the utility of ultrasound-guided O 2 /O 3 infiltrations in patients with non-surgical lesions of the rotator cuff. Medical ozone can increase the efficacy of other substances, as it was shown in paper of Moretti (2011) with hyaluronic acid and in paper of Gurger et al (2021) with platelet-rich plasma (PRP); this last paper verifies the collaborative effect of ozone and PRP from a histological point of view.…”

Initial Healing Effects of Platelet-Rich Plasma (PRP) Gel and Platelet-Rich Fibrin (PRF) in the Deep Corneal Wound in Rabbits

“…Two hundred microliters of blood was collected into EDTA tubes for CBC examination (mean concentration of platelets in whole blood: 43.36 ± 4.63 × 10 4 /µL). The conical tube was then centrifuged twice using a tabletop centrifuge according to previously described protocols with some modifications [ 23 , 25 ]. Briefly, whole-blood centrifugation was performed at 1600 rpm for 12 min.…”

Large animal models for the study of tendinopathy

“…Hyman et al presented a detailed architectural and physiological analysis of chronic tear and repair compared with age-matched control rabbit supraspinatus muscles (Hyman et al, 2021). Previous studies have used rabbit supraspinatus tendon or infraspinatus tendon tear models to analyze the tendon-bone healing effects of platelet-rich plasma and ozone therapy (Gurger et al, 2021), microfracture apertures (Sun et al, 2020), decellularized tendon sheets (Liu et al, 2018), preservation of native enthesis (Su et al, 2018) and nano-calcium silicate mineralized fish scale scaffolds (Han et al, 2023) (Yildiz et al, 2019). Xu et al explored the in vivo biomechanical and histological processes of the rerouting biceps tendon to treat chronic irreparable rotator cuff tears in a rabbit model (Xu et al, 2022).…”