The effect of platelet-rich plasma in bone-tendon integration

Adv Clin Exp Med. Mar-Apr 2017;26(2):193-199. doi: 10.17219/acem/61384.


Background: The operative reconstruction of a torn or insufficient anterior cruciate ligament has become a routine surgical procedure in orthopedics. The long-term success of an anterior cruciate ligament reconstruction depends on the ability of the graft to heal adequately in a bone tunnel. Investigators studying reconstructions described healing within a tunnel as osseous ingrowth and incorporation. In particular, helping the healing using autologous material for the best integration process was a new idea that helped us to set up this study.

Objectives: The purpose of this study is to show the effect of platelet-rich plasma on bone-tendon healing.

Material and methods: Ten New Zealand rabbits were used. The study had 2 groups: (1) a study group including the right extremities of rabbits in which tendon-bone integration was strengthened by plateletrich plasma and (2) a control group including the left extremities of rabbits in which tendon-bone integration was without platelet-rich plasma. On the 56th day postoperatively, the portion of the distal femur containing the tunnel was amputated following the euthanization process for histological evaluation.

Results: In the histological evaluation of the tendon-integrated bone segments with platelet-rich plasma, the integration of tendon in the bone was successful without any necrosis formation in most of the tissues. However, in the control group without platelet-rich plasma, the integration was distorted in many zones and some cystic morphologies were present.

Conclusions: The findings of this study showed that using platelet-rich plasma during tendon-to-bone implantation has positive effects histologically. In the literature, many studies are available that have investigated the effect of platelet-rich plasma on anterior cruciate surgery radiologically. However, the histological findings are more reliable than radiological findings because bone-tendon integration is a biological process.

Keywords: anterior cruciate ligament; integration; platelet-rich plasma; revision surgery; tendon.

MeSH terms

  • Animals
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries / therapy*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Combined Modality Therapy
  • Humans
  • Platelet-Rich Plasma*
  • Rabbits
  • Reproducibility of Results
  • Tendons / transplantation*
  • Transplantation, Autologous
  • Wound Healing