Basic And Clinical Study Of Platelet-rich Plasma On Acute And Chronic Achilles Tendon Injury

Achilles tendon is an important tissue structure that transmits the back of the calf to the foot.Its main function is to planter flexed the foot and ankle.Achilles tendon injuries mainly include Achilles tendinitis and acute Achilles tendon rupture.Because Achilles tendon is mainly composed of tendon cells,the recovery of Achilles tendon tissue is slow and the nutritional demand is high,which causes the recovery of Achilles tendon injury to be slow.Promoting the healing of Achilles tendon injury and reducing its complications has always been a hot and difficult point in research.Platelet-rich plasma(PRP)contains high concentrations of platelets that release a variety of high concentrations of growth factors.Growth factors can accelerate the repair of Achilles tendon damage by promoting angiogenesis,cell matrix and collagen synthesis.In this experiment,we will study the effect of PRP on the healing of Achilles tendinitis and acute Achilles tendon rupture through clinical trials.The relationship between the time of PRP injection and the use of PRP concentration and tissue healing will be studied through basic experiments.Part Ⅰ:Clinical study of platelet-rich plasma in the treatment of acute and chronic Achilles tendon injury1.PurposeTo study the effect of PRP on the healing of acute Achilles tendon rupture and chronic Achilles tendinitis.2.Method2.1 Acute Achilles tendon ruptureFrom January 1,2018 to January 1,2019,a total of 21 patients with acute Achilles tendon rupture were collected.Fifteen of the 21 patients underwent Kessler suture combined with PRP for acute Achilles tendon rupture,and six control patients underwent Kessler suture alone for acute Achilles tendon rupture.The patients underwent AOFAS,VISA-A and VAS scores in the third,sixth and sixth months after surgery.Determine the recovery of the patient.2.2 Achilles tendinitisFrom January 1,2018 to January 1,2019,a total of five patients with Achilles tendinitis were collected.A total of 5(7 feet)patients with chronic Achilles tendinitis received PRP injection.The patients underwent AOFAS,VISA-A and VAS scores of the hindfoot before surgery and 4 weeks,8 weeks and 12 weeks after surgery.Evaluate patient recovery.3.Results3.1 Acute Achilles tendon ruptureIn the 3rd,6th and 9th postoperative period,the AOFAS and VISA-A scores of the experimental group and the control group were statistically different(P<0.05).In the third month after surgery,the difference between the two scores was the largest.As time went on,the difference between the two scores was the smallest at the 9th month after surgery.The VAS scores were statistically different in the 3rd and 6th months after surgery(P<0.05).3.2 Achilles tendonitisPatients with Achilles tendinitis underwent AOFAS,VISA-A,and VAS scores before and 4 weeks,8 weeks,and 12 weeks after surgery.There were significant differences between the preoperative and postoperative scores(P<0.05).The AOFAS and VISA-A scores were highest in the 12th week,the 8th week followed,and the 4th week was the lowest.The difference between the preoperative score and the postoperative week 4 score was the largest,the difference between the 4th week and the 8th week was the second,and the difference between the 8th week and the 12th week was the smallest.4.ConclusionIn this experiment,PRP can be found to promote the recovery of acute Achilles tendon rupture and Achilles tendinitis.And early has a significant effect.Part Ⅱ:Experimental study on the effect of PRP on the repair of acute Achillestendon rupture in rats1.PurposeTo study the relationship between the time of PRP injection and the PRP concentration after injury to the Achilles tendon injury,and to explore the optimal PRP concentration to promote the recovery of acute Achilles tendon rupture.2.MethodTen rats were subjected to cardiac puncture and blood was taken for preparation of PRP.80 rats were anesthetized and the Achilles tendon defect model was prepared under aseptic conditions.Rats were divided into 16 subgroups according to different time points after injection and different concentrations of PRP.Rats were sacrificed 4 weeks after surgery and Achilles tendon specimens were removed.By assessing the degree of adhesion,mechanical analysis,and histological staining of Achilles tendon and periorbital tissue.The effects of different concentrations of PRP on the healing of acute Achilles tendon rupture were evaluated at different time points after injury.3.ResultsEighty rats were sacrificed 4 weeks after surgery.In the tensile test,the PRP group was injected immediately after injury and the PRP group was the best with 4.5 times PRP.There was significant difference(P<0.05).In the PRP group on the 1st day after injury and the PRP group on the 2nd day after injury,9 times PRP was the best,with statistical difference(P<0.05).HE staining of the Achilles tendon in rats showed that the PRP group was injected immediately after injury and the PRP group was injected at the 6th hour after injury.The best recovery was achieved with 4.5 times PRP,and the collagen fiber arrangement and cell morphology were the best.In the PRP group on the 1st day after injury and the PRP group on the 2nd day after injury,it was observed that the injection of 9 times PRP recovered best,and the collagen fiber arrangement and cell morphology were better than other groups.4.ConclusionIn this experiment,it was found that the concentration of PRP and the time of PRP injection are also factors to be considered,and the high concentration of PRP can not achieve the best therapeutic effect.Damage to the local area within a short period of time following the Achilles tendon injury can release a higher concentration of growth factors,thereby eliminating the need for high concentrations of exogenous PRP.However,as time goes by,the growth factor released by the body itself is gradually consumed,and exogenous high-concentration PRP is needed to promote the repair of Achilles tendon injury.