ORIGINAL ARTICLE

The Effects of Platelet-Rich-Plasma (PRP) Injection on Ligament Injury

Yudhistira Pradnyan Kloping , Andre Triadi Desnantyo, Nancy Margaritha Rehatta

Yudhistira Pradnyan Kloping
Faculty of Medicine, Airlangga University, Surabaya. Email: distrayyss@gmail.com

Andre Triadi Desnantyo
Faculty of Medicine, Airlangga University, Surabaya

Nancy Margaritha Rehatta
Faculty of Medicine, Airlangga University, Surabaya
Online First: April 26, 2016 | Cite this Article
Kloping, Y., Desnantyo, A., Rehatta, N. 2016. The Effects of Platelet-Rich-Plasma (PRP) Injection on Ligament Injury. Bali Medical Journal 5(1): 31-37. DOI:10.15562/bmj.v5i1.174


Background: Soft tissue injuries are becoming a problem especially among active people and athletes, thus doctors are focusing on PRP injection however variety of study results are making the beneficial effects of PRP towards soft tissue healing unclear. The purpose of this study is to clarify the effects of PRP injection on the healing aspect of a ligament injury. Methods: The experimental study used European rabbit (Oryctolagus cuniculus), which was divided into the control and treated group. The 22 samples, ankle ligaments were injured. The treated group was injected with 4 ml PRP taken autologously. On the 2nd day the samples were examined for hematoma. 4 samples from each group were also examined histopathologically. On the 2nd week, the ligament thickness of the remaining samples from each group was examined ultrasonographically. Results: The clinical result showed lower presence of hematoma on the group injected with PRP compared to the control group. The Capillary dilation was less on the treated group compared to the control group. The Inflammatory cells were less on the treated group compared to the control group. The Fibroblasts Cells was less on the treated group compared to the control group. The fibrocytes was more abundant on the treated group compared to the control group. The average of Ligament Thickness was thicker on the treated group compared to the control group. Conclusion: The Injection of PRP is beneficial to a ligament injury based on its effect on enhancing healing on the inflammation, regeneration, and remodeling phases.

References

Mishra A, Pavelko T. Treatment of Chronic Elbow Tendinosis With Buffered Platelet-Rich Plasma. American Journal of Sports Medicine. 2006;34(11):1774-1778.

Bendinelli P, Matteucci E, Dogliotti G, Corsi M, Banfi G, Maroni P et al. Molecular basis of anti-inflammatory action of platelet-rich plasma on human chondrocytes: Mechanisms of NF-κB inhibition via HGF. J Cell Physiol. 2010;225(3):757-766.

El-Sharkawy H, Kantarci A, Deady J, Hasturk H, Liu H, Alshahat M et al. Platelet-Rich Plasma: Growth Factors and Pro- and Anti-Inflammatory Properties. Journal of Periodontology. 2007;78(4):661-669.

Xian L, Roy Chowdhury S, Bin Saim A, Bt Hj Idrus R. Concentration-dependent effect of platelet-rich plasma on keratinocyte and fibroblast wound healing. Cytotherapy. 2015;17(3):293-300.

Browning S, Weiser A, Woolf N, Golish S, SanGiovanni T, Scuderi G et al. Platelet-Rich Plasma Increases Matrix Metalloproteinases in Cultures of Human Synovial Fibroblasts. The Journal of Bone and Joint Surgery (American). 2012;94(23):e172 1.

Paoloni J, De Vos R, Hamilton B, Murrell G, Orchard J. Platelet-Rich Plasma Treatment for Ligament and Tendon Injuries. Clinical Journal of Sport Medicine. 2011;21(1):37-45.

Lo I. K., Marchuk L., Majima T., Frank C. B., Hart D. A. Medial collateral ligament and partial anterior cruciate ligament transection: mRNA changes in uninjured ligaments of the sheep knee. J Orthop Sci. 2003;8:707–713.

Wellington, K., Allan, M., Scott, R., Freddie, F., Michael, A., Pietro, RS., Terry, C., Frank, B., Kelly. 'Platelet-rich Plasma in Orthopaedic Applications: Evidence-based Recommendations for Treatment'. 2013:21:739-48.

Doherty C, Delahunt E, Caulfield B, Hertel J, Ryan J, Bleakley C. The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies. Sports Med. 2013;44(1):123-140.

Clayton R, Court-Brown C. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury. 2008;39(12):1338-1344.

Lee J., Harwood F. L., Akeson W. H., Amiel D. Growth factor expression in healing rabbit medial collateral and anterior cruciate ligaments.Iowa Orthop J. 1998;18:19–25

Hardy, MA., 1989. 'The Biology of Scar Formation', vol. 69, pp. 1014-24.

Modi W, Dean M, Seuanez H, Mukaida N, Matsushima K, O'Brien S. Monocyte-derived neutrophil chemotactic factor (MDNCF/IL-8) resides in a gene cluster along with several other members of the platelet factor 4 gene superfamily. Hum Genet. 1990;84(2).

Chin, GC., Diegelmann, RF., Schultz, GS., 2005. 'Cellular and molecular regulation of wound healing' In: Falabella AF, Kirsner RS, editors. Wound Healing. Boca Raton: Taylor & Francis Group, pp 17-37.

Schultz G, Wysocki A. Interactions between extracellular matrix and growth factors in wound healing. Wound Repair and Regeneration. 2009;17(2):153-162.

Borrione P, Gianfrancesco A, Pereira M, Pigozzi F. Platelet-Rich Plasma in Muscle Healing. American Journal of Physical Medicine & Rehabilitation. 2010;89(10):854-861.

Zhang J, Wang J. Platelet-Rich Plasma Releasate Promotes Differentiation of Tendon Stem Cells Into Active Tenocytes. The American Journal of Sports Medicine. 2010;38(12):2477-2486.

Chen L, Dong S, Liu J, Tao X, Tang K, Xu J. Synergy of tendon stem cells and platelet-rich plasma in tendon healing. Journal of Orthopaedic Research. 2011;30(6):991-997.

Rozman P, Bolta Z. Use of platelet growth factors in treating wounds and soft-tissue injuries. Acta Dermatovenerol Alp Pannonica Adriat. 2007;16(4):156-65.

Amento EP, Beck LS. TGF-beta and wound healing. Ciba Found Symp. 1991;157:115-23.

Knighton DR, Hunt TK, Scheuenstuhl H, Halliday BJ, Werb Z, Banda MJ. Oxygen tension regulates the expression of angiogenesis factor by macrophages. Science. 1983;221(4617):1283-5.

Hardwicke J, Schmaljohann D, Boyce D, Thomas D. Epidermal growth factor therapy and wound healing--past, present and future perspectives. Surgeon. 2008;6(3):172-7.

Hedges JC, Singer CA, Gerthoffer WT. Mitogen-activated protein kinases regulate cytokine gene expression in human airway myocytes. Am J Respir Cell Mol Biol. 2000;23(1):86-94.

Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489-96.


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