The effect of thermosensitive hydrogel platelet–rich–plasma complex in the treatment of partial tear of anterior cruciate ligament in rat model

Abstract

Background/Objective The treatment of anterior cruciate ligament (ACL) partial tear is controversial. The reconstructive surgery is invasive while the prevalence of subsequent insufficiency after conservative treatment has been reported to range from 11% to 62%. Therefore, a new method that promotes tissue regeneration is needed. The aim of this study was to observe the healing of ACL partial tear biomechanically and histologically after the administration of a thermosensitive hydrogel platelet-rich-plasma (PRP) complex. Methods The complex was prepared according to a previously published protocol. One hundred and fifty 12-week-old male Sprague-Dawley rats were included and they were allocated into 4 groups. Lesion control group (Group 1), treatment group (Group 2), gel-only group (Group 3) and intact group (Group 4). Biomechanical testing, histological analysis (H&E and immunohistochemical staining) and scoring was performed. Results On gross observation, the treatment group showed a continuous ACL with slightly thickened synovium or a partially healed ACL at 6-week follow up. In the biomechanical testing at 6 weeks after surgery, the failure load of the treatment group was significantly superior when compared with the lesion control group (52.7±10.8N vs. 41.6±7.8N, p<0.01), but the failure load was not restored to level of the intact group (52.7±10.8N vs. 61.5±9.1N, p=0.037). The maturity index of wound sites showed no significant inter-group differences at any timepoints. However, an increased expression of vascular endothelial growth factor (VEGF) and pro-collagen I was detected. Conclusion The thermosensitive hydrogel-PRP was shown to be effective in enhancing the healing of ACL partial tear in the rat model, and potentially this complex can be used as a treatment for patients with ACL partial tear. The translational potential of this article The thermosensitive hydrogel-PRP is potentially translated to clinical use to treat patients with ACL partial tear by injection under arthroscopy or ultrasound guiding.

Interpenetrating Hydrogel Networks Enhance Mechanical Stability, Rheological Properties, Release Behavior and Adhesiveness of Platelet-Rich Plasma

“…Physical thermosensitive hydrogels based on PEG-poly(ethylene glycol) polymers were used in vivo in combination with PRP for the treatment of anterior cruciate ligament partial tear. The study showed increased expression of vascular endothelial growth factor and pro-collagen I was detected after PRP-hydrogel treatment [34].…”

Clinical Use of Platelet-Rich Plasma to Promote Tendon–Bone Healing and Graft Maturation in Anterior Cruciate Ligament Reconstruction—A Randomized Controlled Study

“…However, for IAG, P = 0.06; therefore, with an increased sample size or prolonged follow-up time, the difference may be significant. Therefore, it is possible that PRP promotes graft maturation, which has been supported by the findings of some studies [ 19 ].…”

Platelet-rich plasma pretreatment protects anterior cruciate ligament fibroblasts correlated with PI3K-Akt-mTOR pathway under hypoxia condition

“…Each group would be analyzed 6 weeks after surgical intervention. The anesthesia and surgical technique were used according to our previous study [ 11 ].…”

“…Immunofluorescence staining was performed according to the method described by Li et al. [ 11 ]. The sections were incubated with the primary antibodies of HIF-1α (Affinity, AF1009, China), cleaved-caspase 3 (CUSABIO, CSB-PA000004, Wuhan, China), type I (Abcam, Ab260043, Cambridge, UK) and III (BOSTER, A00788-3, California, USA), TNF-α (Proteintech, 60291-1-Ig, Jiangsu, China), IL-1β (Abcam, Ab283818, Cambridge, UK), collagen at 4 ​°C overnight and with Alexa Fluor 488-conjugated secondary antibody (ZSGB-BIO, ZF-0511, Beijing, China) 1 ​h at RT.…”

“…These bio-active factors released by PRP can clinically encourage tissues healing by serving as stimulators for cell proliferation after ACLR [ [6] , [7] , [8] ]. At the same time, many studies found that PRP significantly facilitated healing process in animal model of ACL injury [ [9] , [10] , [11] ]. In addition, the use of PRP combined with advanced ACL primary repair technology also achieved satisfactory clinical outcomes in ACL injured patients [ 12 ].…”