Diego López-Nájera1,2,3, Mónica Rubio-Zaragoza4,5,6, Joaquín J Sopena-Juncosa4,5,6, Eduard Alentorn-Geli7, Ramón Cugat-Bertomeu4,6,8, J Andrés Fernández-Sarmiento4,9, Juan M Domínguez-Pérez4,9, Montserrat García-Balletbó4,6,8, Víctor J Primo-Capella10,11, José M Carrillo-Poveda4,5,6. 1. García-Cugat Foundation, Barcelona, Spain. cvgramenet@gmail.com. 2. Instituto Veterinario de Ortopedia y Traumatología (IVOT), Barcelona, Spain. cvgramenet@gmail.com. 3. Clínica Veterinaria Gramenet, Hospital Veterinari Montigalà , Av dels Banús 1, Santa Coloma de Gramenet, Barcelona, Spain. cvgramenet@gmail.com. 4. García-Cugat Foundation, Barcelona, Spain. 5. Departamento de Medicina y Cirugía Animal, Universidad CEU Cardenal Herrera, Valencia, Spain. 6. CEU-UCH Chair of Medicine and Regenerative Medicine, García-Cugat Foundation, Valencia, Spain. 7. Duke Sports Sciences Institute, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA. 8. Artroscopia GC, Hospital Quirón, Barcelona, Spain. 9. Departamento de Medicina y Cirugía Animal, Universidad de Córdoba, Córdoba, Spain. 10. Health Care Technology Group, Biomedical Research Networking Center Bioengineering, Biomaterials, Nanomedicine (CIBER-BBN), Valencia, Spain. 11. Biomechanics Institute of Valencia (IBV), Universidad Politecnica de Valencia, Valencia, Spain.
Abstract
PURPOSE: To assess the biomechanical effects of intra-tendinous injections of PRGF on the healing Achilles tendon after repair in a sheep model. METHODS: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. RESULTS: 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. CONCLUSION: 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.
RCT Entities:
PURPOSE: To assess the biomechanical effects of intra-tendinous injections of PRGF on the healing Achilles tendon after repair in a sheep model. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Luis A Solchaga; Alison Bendele; Vivek Shah; Leo B Snel; Hans K Kestler; Joshua S Dines; Christopher K Hee Journal: J Orthop Res Date: 2013-09-09 Impact factor: 3.494
Authors: Sabino Padilla; Mikel Sánchez; Victor Vaquerizo; Gerard A Malanga; Nicolás Fiz; Juan Azofra; Christopher J Rogers; Gonzalo Samitier; Steven Sampson; Roberto Seijas; Ricardo Elorriaga; Jack Taunton; Frank Boehm; Roberto Prado; Ramón Cugat; Eduardo Anitua Journal: Int J Mol Sci Date: 2021-01-15 Impact factor: 5.923