Clin Orthop Surg.  2011 Dec;3(4):325-331. 10.4055/cios.2011.3.4.325.

The Effect of Platelet Rich Plasma from Bone Marrow Aspirate with Added Bone Morphogenetic Protein-2 on the Achilles Tendon-Bone Junction in Rabbits

• Kim HJ
• Nam HW
• Hur CY
• Park M
• Yang HS
• Kim BS
• Park JH

• KMID: 1097171
• DOI: http://doi.org/10.4055/cios.2011.3.4.325

Abstract

BACKGROUND
To determine if exogenously injected bone marrow derived platelet-rich plasma (PRP) plus bone morphogenetic protein (BMP)-2 could accelerate the healing of bone-tendon junction injuries and increase the junction holding strength during the early regeneration period.
METHODS
A direct injury model of the bone-tendon junction was made using an Achilles tendon-calcaneus bone junction in a rabbit. In the PRP/BMP-2/fibrin group, 0.05 mL of bone marrow derived PRP and 100 ng/mL of BMP-2 both incorporated into 0.1 mL of fibrin glue were injected into Achilles tendon-calcaneus bone junctions. The effect of the intervention was tested by comparing the results of an intervention group to a control group. The results of biomechanical testing, and histological and gross analyses were compared between the 2 groups at the following time points after surgery: 2 weeks, 4 weeks, and 8 weeks.
RESULTS
Histologic examinations showed that woven bone developed in tendon-bone junctions at 2 weeks after surgery in the PRP/BMP-2/fibrin group. Mechanical test results showed no significant difference between the PRP/BMP-2/fibrin and control groups at 2 and 4 weeks after surgery, but the mean maximal load in the PRP/BMP-2/fibrin group was significantly higher than in the control group (p < 0.05) at 8 weeks after surgery.
CONCLUSIONS
Bone marrow derived PRP and BMP-2 in fibrin glue accelerated healing in a rabbit model of tendon-bone junction injury.

Keyword

Bone-tendon junction; Achilles tendon; Bone marrow derived platelet rich plasma; Bone morphogenetic protein

MeSH Terms

Achilles Tendon/*injuries
Animals
Bone Marrow
Bone Morphogenetic Protein 2/*therapeutic use
Calcaneus/*injuries
Male
*Platelet-Rich Plasma
Rabbits

Figure

• 

  Fig. 1 Operative procedure. (A) Arrow point device (towel clip) made a hole at calcaneus. (B) The tendon was sutured with 2-0 steel wire in the rectangular manner and the fibrin glue mixed with bone marrow derived platelet-rich plasma and bone morphogenetic protein-2 was injected into the tendon to bone junction.

• 

  Fig. 2 Gross findings at 2 weeks. No differences were found between the 3 groups. (A) The control group. (B) The platelet-rich plasma/fibrin group. (C) The platelet-rich plasma/bone morphogenetic protein 2/fibrin group.

• 

  Fig. 3 Histological photographs at 2 weeks (H&E, × 50). (A) Cartilage was visible at the tendon-bone junctions in the control group. (B) Fibrocartilage was visible in the platelet-rich plasma/fibrin group. (C) Fibrocartilage and woven bone were visible in platelet-rich plasma/bone morphogenetic protein 2/fibrin group. C: calcaneus bone, J: junction, T: tendon.

• 

  Fig. 4 Histological photographs taken at 8 weeks (H&E, × 50). (A) Fibrocartilage was visible at tendon-bone junctions in the control group. (B) Tendons were connected to bone via fibrocartilage in the platelet-rich plasma/fibrin group. (C) Tendons were connected to bone via new bone in the platelet-rich plasma/bone morphogenetic protein 2/fibrin group. C: calcaneus bone, J: junction, T: tendon.

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