Effects of plasma rich in growth factors (PRGF) on biomechanical properties of Achilles tendon repair

• DOI: 10.1007/s00167-015-3725-2
• Publication Date: 2015-08-13T14:27:07Z
• Authors: Diego López-Nájera; Mónica Rubio-Zara...; Joaquín J. Sopena...; Eduard Alentorn-Geli; Ramón Cugat-Bertomeu; J. Andrés Fernánd...; Juan M. Domínguez...; Montserrat García...; Víctor J. Primo-C...; José M. Carrillo-...
• Keywords: PRP; Achilles tendon repair; Injections, Intralesional; Biomechanical properties; Tendón de Aquiles - Propiedades mecánicas.; Achilles Tendon; Achilles tendon - Wounds and injuries - Treatment.; Plasma; Random Allocation; 03 medical and health sciences; 0302 clinical medicine; Tendon Injuries; Animals; Crecimiento - Factores - Uso terapéutico.; Orthopedic Procedures; PRGF; Growth factors - Therapeutic use.; Wound Healing; Sheep; Plasma-rich growth factors; Achilles tendon - Regeneration.; Biomechanical Phenomena; Intercellular Signaling Peptides and Proteins; Female; Plasma sanguíneo - Uso terapéutico.; Tendón de Aquiles - Heridas y lesiones - Tratamiento.; Blood plasma - Therapeutic use.; Achilles tendon - Biomechanics.; Tendón de Aquiles - Regeneración.

To assess the biomechanical effects of intra-tendinous injections of PRGF on the healing Achilles tendon after repair in a sheep model.Thirty sheep were randomly assigned into one of the six groups depending on the type of treatment received (PRGF or placebo) and survival time (2, 4 and 8 weeks). The Achilles tendon injury was repaired by suturing the tendinous edges employing a three-loop pulley pattern. A trans-articular external fixation system was then used for immobilization. The PRGF or placebo was administered on a weekly basis completing a maximum of three infiltrations. The force, section and tension values were compared between the operated and healthy Achilles tendons across all groups.The PRGF-treated tendons had higher force at 8 weeks compared with the placebo group (p = 0.007). Between 2 and 4 weeks, a significant increase in force in both the PRGF-treated tendon (p = 0.0027) and placebo group (p = 0.0095) occurred. No significant differences were found for section ratio between PRGF-treated tendons and the placebo group for any of the time periods evaluated. At 2 weeks, PRGF-treated tendons had higher tension ratio compared with placebo group tendons (p = 0.0143). Both PRGF and placebo treatments significantly improved the force (p < 0.001 and p = 0.0095, respectively) and tension (p = 0.009 and p = 0.0039, respectively) ratios at 8 weeks compared with 2 weeks.The application of PRGF increases Achilles tendon repair strength at 8 weeks compared with the use of placebo. The use of PRGF does not modify section and tension ratios compared with placebo at 8 weeks. The tension ratio progressively increases between 2 and 8 weeks compared with the placebo.