The effects of plasma rich in growth factors (PRGF-Endoret) on healing of medial collateral ligament of the knee

Knee Surg Sports Traumatol Arthrosc. 2013 Aug;21(8):1763-9. doi: 10.1007/s00167-012-2002-x. Epub 2012 Apr 13.


Purpose: Platelet-rich plasma (PRP) has been increasingly used in sports-related injuries for therapeutic applications. However, there are numerous manufacturing procedures and treatment protocols of PRP use, which make difficult to assess its real efficacy for tissue healing. This study addressed to evaluate the therapeutic effects of locally delivered plasma rich in growth factors (PRGF-Endoret) on the early healing of medial collateral ligament (MCL) in rabbit knees.

Methods: Thirty-one Japanese white rabbits were subjected to a mop-end tear in the MCL of the left knee. PRGF-Endoret was prepared using Anitua's technique. Two groups were set up. In 17 knees, prepared 1.0 ml of PRGF-Endoret after clotting was applied on the tear site, while in 14 knees the tear site was untreated serving as a control. Quantitative aspects of PRGF-Endoret, the concentration of platelets, leukocytes and erythrocytes and therapeutic growth factors such as PDGF-BB and TGF-β1 were measured. Rabbits were sacrificed at 3 and 6 weeks after the operation and histological and biomechanical evaluation were performed.

Results: No leukocytes were measured and certain amount of growth factors such as PDGF-BB and TGF-β1 were confirmed in the PRGF-Endoret. PRGF-Endoret stimulated proliferation of fibroblasts and neovascularization, and induced statistically better structural properties in repaired MCL.

Conclusions: Our findings provide evidence that local administration of PRGF-Endoret promotes early steps in ligament healing and the repair of structural properties in a rabbit model. PRGF-Endoret would be a useful product in clinical treatment of ligament injuries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Becaplermin
  • Biomechanical Phenomena
  • Cell Proliferation
  • Fibroblasts / metabolism
  • Intercellular Signaling Peptides and Proteins / administration & dosage*
  • Medial Collateral Ligament, Knee / blood supply
  • Medial Collateral Ligament, Knee / injuries*
  • Neovascularization, Physiologic
  • Plasma / chemistry*
  • Proto-Oncogene Proteins c-sis / analysis
  • Rabbits
  • Rupture
  • Stifle / injuries
  • Transforming Growth Factor beta1 / analysis
  • Wound Healing*


  • Intercellular Signaling Peptides and Proteins
  • Proto-Oncogene Proteins c-sis
  • Transforming Growth Factor beta1
  • Becaplermin