The Influence of Locally Applied Platelet-Derived Growth Factor-BB on Free Tendon Graft Remodeling after Anterior Cruciate Ligament Reconstruction

Weiler, Andreas; Förster, Cornelius; Hunt, Patrick; Falk, R.; Jung, Tobias; Unterhauser, Frank N.; Bergmann, V; Schmidmaier, Gerhard; Haas, Norbert

doi:10.1177/0363546503261711

Cited by 121 publications

(109 citation statements)

References 55 publications

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“…In contrast, in a rabbit model of partial anterior cruciate ligament (ACL) laceration treated with 20 lg of PDGF in fibrin sealant applied to the injured ligament at the time of surgery, there was significantly decreased maximum load and stiffness of the femur-ACL-tibia complex, by 56% and 41%, respectively, compared with no treatment to the injured ACL [20]. After ACL reconstruction with flexor tendon autograft in sheep, 60 lg of PDGF mixed with poly(D, L-lactide), coated on sutures at the time of surgery, increased failure load at early time points compared with the control group [31]. At 12 and 24 weeks postsurgery, no difference in failure load was seen between groups.…”

Section: Discussionmentioning

confidence: 95%

rhPDGF-BB Promotes Early Healing in a Rat Rotator Cuff Repair Model

Kovacevic

Gulotta

Liang

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Tendon-bone healing after rotator cuff repair occurs by fibrovascular scar tissue formation, which is weaker than a normal tendon-bone insertion site. Growth factors play a role in tissue formation and have the potential to augment soft tissue healing in the perioperative period. Questions/purposes Our study aim was to determine if rhPDGF-BB delivery on a collagen scaffold can improve tendon-to-bone healing after supraspinatus tendon repair compared with no growth factor in rats as measured by (1) gross observations; (2) histologic analysis; and (3) biomechanical testing. Methods Ninety-five male Sprague-Dawley rats underwent acute repair of the supraspinatus tendon. Rats were randomized into one of five groups: control (ie, repair only), scaffold only, and three different platelet-derived growth factor (PDGF) doses on the collagen scaffold. Animals were euthanized 5 days after surgery to assess cellular proliferation and angiogenesis. The remaining animals were analyzed at 4 weeks to assess repair site integrity by gross visualization, fibrocartilage formation with safranin-O staining, and collagen fiber organization with picrosirius red staining, and to determine the biomechanical properties (ie, load-to-failure testing) of the supraspinatus tendon-bone construct. Results The repaired supraspinatus tendon was in continuity with the bone in all animals. At 5 days, rhPDGF-BB delivery on a scaffold demonstrated a dose-dependent response in cellular proliferation and angiogenesis compared with the control and scaffold groups. At 28 days, with the numbers available, rhPDGF-BB had no effect on increasing fibrocartilage formation or improving collagen fiber maturity at the tendon-bone insertion site compared with controls. The control group had higher tensile loads to failure and stiffness (35.5 ± 8.8 N and 20.3 ± 4.5 N/mm) than all the groups receiving the scaffold, including the PDGF groups (scaffold: 27 ± 6.4 N, p = 0.021 and 13 ± 5.7 N/mm, p = 0.01; 30 lg/mL PDGF: 26.5 ± 7.5 N, p = 0.014 and 13.3 ± 3.2 N/mm, p = 0.01; 100 lg/mL PDGF: 25.7 ± 6

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Section: Discussionmentioning

confidence: 95%

rhPDGF-BB Promotes Early Healing in a Rat Rotator Cuff Repair Model

Kovacevic

Gulotta

Liang

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…[5][6][7][8] Approaches to promote tendon and ligament repair by adding exogenous growth factors have been validated in various animal models. 1,[9][10][11][12] Recent in vitro studies using gene therapy approaches also hold promise for the treatment of tendon injury. [13][14][15] Growth factors that have been shown to influence cell metabolism in vitro 1,6 include insulin-like growth factor (IGF-I) [16][17][18][19][20] and fibroblast growth factor (b-FGF), 21,22 platelet-derived growth factor (PDGF) isoform B, 19,[21][22][23] and transforming growth factor-b (TGF-b).…”

Section: Introductionmentioning

confidence: 99%

Effect of osteogenic protein‐1 on the matrix metabolism of bovine tendon cells

Yamada

Akeda

Asanuma

et al. 2007

Journal Orthopaedic Research

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Tendon rupture is a common sports injury in adults. However, the mechanical properties of repair tissue are inferior to those of normal tissue. To accelerate tendon healing, an in vivo approach using growth factors has been applied and has shown evidence for the efficacy of biological stimulation of the repair process. Recombinant human osteogenic protein-1 (rhOP-1) has been shown to be effective in stimulating matrix production by various connective tissues. To test the effect of rhOP-1 on the matrix metabolism of tendon cells in vitro, bovine tendon cells were cultured in monolayer with various doses of rhOP-1 for 7 days. The addition of rhOP-1 to cell culture media resulted in significant increases in cell proliferation, DNA content, and the synthesis of proteoglycans (PGs) and collagen, compared to control cultures. The relative percentage of large PGs in the OP-1 culture was higher than that in the control culture. In conclusion, we show for the first time that rhOP-1 stimulates the proliferation of tendon cells and their ability to synthesize and accumulate PGs and collagen in their extracellular matrix. These biological properties may be used in the tissue-engineering of tendon tissues. ß

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“…1 ) and applied to the area of interest ( fig. 2 ), where the platelets were activated and an autologous PG was formed in 2 min, as reported earlier [21,22] .…”

Section: Platelet Gel Preparationmentioning

confidence: 78%

“…The role of PDGFs after ACL reconstruction has been analyzed in previous studies in animal models, and results were evaluated with biomechanical tests and histological findings [21,22] . In humans, results of early graft healing and revascularization were assessed by magnetic resonance imaging (MRI) [23][24][25][26] .…”

Section: Introductionmentioning

confidence: 99%

Effects of a Platelet Gel on Early Graft Revascularization after Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized, Double-Blind, Clinical Trial

Vogrin¹,

Rupreht²,

et al. 2010

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Background: Slow graft healing in bone tunnels and a slow graft ligamentization process after anterior cruciate ligament (ACL) reconstruction are some of the reasons for prolonged rehabilitation. Aims: The purpose of this study was to determine if the use of platelet gel (PG) accelerates early graft revascularization after ACL reconstruction. Methods: PG was produced from autologous platelet-rich plasma and applied locally. We quantitatively evaluated the revascularization process in the osteoligamentous interface zone in the bone tunnels and in the intra-articular part of the graft by means of contrast-enhanced magnetic resonance imaging (MRI). Results: After 4–6 weeks, the PG-treated group demonstrated a significantly higher level of vascularization in the osteoligamentous interface (0.33 ± 0.09) than the control group (0.16 ± 0.09, p < 0.001). In the intra-articular part of the graft, we found no evidence of revascularization in either group. Conclusion: Locally applied PG enhanced early revascularization of the graft in the osteoligamentous interface zone after ACL reconstruction.

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The Influence of Locally Applied Platelet-Derived Growth Factor-BB on Free Tendon Graft Remodeling after Anterior Cruciate Ligament Reconstruction

Cited by 121 publications

References 55 publications

rhPDGF-BB Promotes Early Healing in a Rat Rotator Cuff Repair Model

rhPDGF-BB Promotes Early Healing in a Rat Rotator Cuff Repair Model

Effect of osteogenic protein‐1 on the matrix metabolism of bovine tendon cells

Effects of a Platelet Gel on Early Graft Revascularization after Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized, Double-Blind, Clinical Trial

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