| Objective:To observe the effect of platelet rich plasma on early postoperative healing of ruptured Achilles tendon in rats,local injection of platelet rich plasma was conducted every other week after the operation.To provide experimental basis for exploring a new treatment method of Achilles tendon rupture.Materials and methods:Fifty male SD rats with an average body weight of 350～400 grams were selected.Ten of the rats were used as blood donors to obtain platelet-rich plasma(PRP),and the other forty rats were randomly assigned to two groups:the experimental group(PRP group)n=20,and the control group(normal saline group)n=20.The Achilles tendons of both hind limbs of rats in each group were dissected with a scalpel about 5mm above the insertion point of the Achilles tendons of each group,and then sutured with Kessler method.After that,PRP was injected into the ruptured part of the Achilles tendons of the experimental group,and normal saline was injected into the control group,and the incision was sutured.PRP was injected locally with a syringe about 5mm above the insertion point of the Achilles tendon of both hind limbs in the experimental group every other week after surgery,while normal saline was injected in the control group.Respectively 1,2,3,4 weeks after surgery only executed from each group of randomly selected 5,remove the Achilles tendon tissue after healing,and the Achilles tendon after the general macro assessment,production organization pathological tissue cells of a microscope,using ELISA method to detect the Achilles tendon of Ⅰ,Ⅲ type collagen content,biomechanical testing of Achilles tendon to assess the comparison between groups Achilles tendon healing.SPSS 26 software was used to process the experimental data,and the results were expressed as mean±standard deviation.(x±s).Pair t-test was used within the group,and two-sample t-test was used between the groups.If the experimental data were not normally distributed,Mann-Whitney U test was used.P<0.05 was considered statistically significant.Results:1.The general situation:No death occurred before or after operation.Rats in each group had normal diet.In the first week after surgery,3 patients in the normal saline group and 1 patient in the PRP group showed skin redness and swelling around the incision,severe touch reaction,obvious pain,no abnormal secretions and obvious claudication.In the second week after operation,the rats in each group walked normally,the operative sutures basically fell off and the wound healed.Three and four weeks after surgery,rats in each group walked normally,no obvious claudication was observed,all surgical sutures fell off,the wound healed well,and there was no redness or abn ormal secretions;2.General and macro conditions of Achilles tendon:The PRP group was better than the normal saline group in each period from 1 to 3 weeks;3.Biomechanical test:The maximum tensile resistance value of Achilles tendon in PRP group was significantly higher than that of normal saline Group during 1-4 weeks after operation(P<0.05).The cross-sectional area of Achilles tendon in PRP group was greater than that in normal saline group at each time period 1-3 weeks after operation(P<0.05).At week 4,there was no significant difference in the cross-sectional area of Achilles tendon between PRP group and saline group(P>0.05).Elongation of Achilles tendon in PRP group and normal saline group showed no difference during 1-3 weeks after operation(P>0.05).At the fourth week,the elongation of PRP group was higher than that of normal saline group(P<0.05).The stiffness value of Achilles tendon in PRP group was significantly higher than that in normal saline group during 1-4 weeks after operation(P<0.05);4.Ⅰ,Ⅲ type collagen content:the PRP group Ⅰ type collagen content in each time period 1-4 weeks group were significantly higher than that of normal saline(P<0.05).The PRP group Ⅲ type collagen content in 1-3 weeks significantly higher than the normal saline group(P<0.05).At 4 weeks of PRP group Ⅲ type collagen content is lower than normal saline group(P<0.05).The PRP group Ⅰ type collagen and Ⅲ type the ratio of collagen content(Ⅰ/Ⅲ)in postoperative 1-3 weeks each time no obvious difference compared with normal saline group(P>0.05).At week 4,the ratio of PRP group was significantly higher than that of normal saline group(P<0.05);5.Pathological examination of Achilles tendon tissue:the pathological scores of PRP group were lower than those of the normal saline group at each time period 1-4 weeks after surgery(P<0.05),indicating a lower degree of tissue degeneration,faster and better healing speed.Conclusion:1.Local application of PRP can increase the maximum tensile resistance and stiffness of Achilles tendon after rupture in rats,promote Achilles tendon healing;2.Local application of PRP may enhance angiogenesis,local cell migration,proliferation and differentiation,and promote the generation and deposition of collagen and structural remodeling of Achilles tendon tissue through the action of high concentration of growth factors,so as to make Achilles tendon heal better and more quickly. |
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