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Chiu CH, Lei KF, Yeh WL. Development of a co-culture device for the study of human tenocytes in response to the combined stimulation of electric field and platelet rich plasma (PRP). Biomed Microdevices 2018; 19:69. [PMID: 28779376 DOI: 10.1007/s10544-017-0214-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
One of the objectives of rotator cuff repairs is to achieve biological healing and recovery in the tendon-bone zone. Some clinical evaluations reported the feasibility of tendon healing based on the stimulations of electric field and platelet-rich plasma (PRP). However, because of lack of appropriate tool for in vitro primary culture under complicated conditions, the efficacy and standard protocol of these healing approaches are still controversial among clinical experts. In this study, a novel co-culture device was developed for the study of tenocytes proliferation under single and combined stimulations of electric field and PRP. The device was a culture well divided into three sub-chambers separated by a barrier and embedded with a pair of parallel plate electrodes. Tenocytes and PRP gel could be respectively loaded into the sub-chambers and cultured with interlinked medium. Hence, tenocytes could concurrently receive a uniform electric field and platelet-derived growth factors by diffusion. Results revealed that the proliferation of tenocytes could be significantly enhanced by these stimulations. The device provides a precise and practical approach for the in vitro study of tendon healing, especially for PRP study. Moreover, optimization of the conditions of electric field and PRP could be determined by in vitro screening procedure before surgery to provide a personalized therapy.
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Affiliation(s)
- Chih-Hao Chiu
- Bone and Joint Research Center, Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Orthopedic Surgery, Taoyuan Chang Gung Memorial Hospital, Taoyuan, Taiwan.,PhD Program in Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Kin Fong Lei
- Graduate Institute of Medical Mechatronics, Chang Gung University, Taoyuan, Taiwan. .,Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
| | - Wen-Ling Yeh
- Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. .,Musculoskeletal Research Center, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Zhou Y, Zhang J, Yang J, Narava M, Zhao G, Yuan T, Wu H, Zheng N, Hogan MV, Wang JHC. Kartogenin with PRP promotes the formation of fibrocartilage zone in the tendon-bone interface. J Tissue Eng Regen Med 2017; 11:3445-3456. [DOI: 10.1002/term.2258] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 04/11/2016] [Accepted: 07/03/2016] [Indexed: 01/06/2023]
Affiliation(s)
- Yiqin Zhou
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
- Joint Surgery and Sports Medicine Department; Shanghai Changzheng Hospital, Second Military Medical University; 415 Fengyang Road, Huangpu Shanghai 200003 China
| | - Jianying Zhang
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
| | - Jinsong Yang
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
| | - Manoj Narava
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
| | - Guangyi Zhao
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
| | - Ting Yuan
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
| | - Haishan Wu
- Joint Surgery and Sports Medicine Department; Shanghai Changzheng Hospital, Second Military Medical University; 415 Fengyang Road, Huangpu Shanghai 200003 China
| | - Nigel Zheng
- Department of Mechanical Engineering and Engineering Science, Center for Biomedical Engineering and Science; University of North Carolina at Charlotte; Charlotte NC USA
| | - MaCalus V. Hogan
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
| | - James H.-C. Wang
- MechanoBiology Laboratory, Department of Orthopaedic Surgery; University of Pittsburgh School of Medicine; Pittsburgh PA USA
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Nourissat G, Ornetti P, Berenbaum F, Sellam J, Richette P, Chevalier X. Does platelet-rich plasma deserve a role in the treatment of tendinopathy? Joint Bone Spine 2015; 82:230-4. [DOI: 10.1016/j.jbspin.2015.02.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2014] [Indexed: 01/08/2023]
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New and emerging strategies in platelet-rich plasma application in musculoskeletal regenerative procedures: general overview on still open questions and outlook. BIOMED RESEARCH INTERNATIONAL 2015; 2015:846045. [PMID: 26075269 PMCID: PMC4436449 DOI: 10.1155/2015/846045] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 01/09/2015] [Accepted: 01/13/2015] [Indexed: 02/07/2023]
Abstract
Despite its pervasive use, the clinical efficacy of platelet-rich plasma (PRP) therapy and the different mechanisms of action have yet to be established. This overview of the literature is focused on the role of PRP in bone, tendon, cartilage, and ligament tissue regeneration considering basic science literature deriving from in vitro and in vivo studies. Although this work provides evidence that numerous preclinical studies published within the last 10 years showed promising results concerning the application of PRP, many key questions remain unanswered and controversial results have arisen. Additional preclinical studies are needed to define the dosing, timing, and frequency of PRP injections, different techniques for delivery and location of delivery, optimal physiologic conditions for injections, and the concomitant use of recombinant proteins, cytokines, additional growth factors, biological scaffolds, and stems cells to develop optimal treatment protocols that can effectively treat various musculoskeletal conditions.
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Hogan MV, Kawakami Y, Murawski CD, Fu FH. Tissue engineering of ligaments for reconstructive surgery. Arthroscopy 2015; 31:971-9. [PMID: 25618491 DOI: 10.1016/j.arthro.2014.11.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Revised: 10/30/2014] [Accepted: 11/13/2014] [Indexed: 02/02/2023]
Abstract
PURPOSE The use of musculoskeletal bioengineering and regenerative medicine applications in orthopaedic surgery has continued to evolve. The aim of this systematic review was to address tissue-engineering strategies for knee ligament reconstruction. METHODS A systematic review of PubMed/Medline using the terms "knee AND ligament" AND "tissue engineering" OR "regenerative medicine" was performed. Two authors performed the search, independently assessed the studies for inclusion, and extracted the data for inclusion in the review. Both preclinical and clinical studies were reviewed, and the articles deemed most relevant were included in this article to provide relevant basic science and recent clinical translational knowledge concerning "tissue-engineering" strategies currently used in knee ligament reconstruction. RESULTS A total of 224 articles were reviewed in our initial PubMed search. Non-English-language studies were excluded. Clinical and preclinical studies were identified, and those with a focus on knee ligament tissue-engineering strategies including stem cell-based therapies, growth factor administration, hybrid biomaterial, and scaffold development, as well as mechanical stimulation modalities, were reviewed. CONCLUSIONS The body of knowledge surrounding tissue-engineering strategies for ligament reconstruction continues to expand. Presently, various tissue-engineering techniques have some potential advantages, including faster recovery, better ligamentization, and possibly, a reduction of recurrence. Preclinical research of these novel therapies continues to provide promising results. There remains a need for well-designed, high-powered comparative clinical studies to serve as a foundation for successful translation into the clinical setting going forward. LEVEL OF EVIDENCE Level IV, systematic review of Level IV studies.
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Affiliation(s)
- MaCalus V Hogan
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Yohei Kawakami
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Christopher D Murawski
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A
| | - Freddie H Fu
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A..
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Brossi PM, Moreira JJ, Machado TSL, Baccarin RYA. Platelet-rich plasma in orthopedic therapy: a comparative systematic review of clinical and experimental data in equine and human musculoskeletal lesions. BMC Vet Res 2015; 11:98. [PMID: 25896610 PMCID: PMC4449579 DOI: 10.1186/s12917-015-0403-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/20/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This systematic review aimed to present and critically appraise the available information on the efficacy of platelet rich plasma (PRP) in equine and human orthopedic therapeutics and to verify the influence of study design and methodology on the assumption of PRP's efficacy. We searched Medline, PubMed, Embase, Bireme and Google Scholar without restrictions until July 2013. Randomized trials, human cohort clinical studies or case series with a control group on the use of PRP in tendons, ligaments or articular lesions were included. Equine clinical studies on the same topics were included independently of their design. Experimental studies relevant to the clarification of PRP's effects and mechanisms of action in tissues of interest, conducted in any animal species, were selected. RESULTS This review included 123 studies. PRP's beneficial effects were observed in 46.7% of the clinical studies, while the absence of positive effects was observed in 43.3%. Among experimental studies, 73% yielded positive results, and 7.9% yielded negative results. The most frequent flaws in the clinical trials' designs were the lack of a true placebo group, poor product characterization, insufficient blinding, small sampling, short follow-up periods, and adoption of poor outcome measures. The methods employed for PRP preparation and administration and the selected outcome measures varied greatly. Poor study design was a common feature of equine clinical trials. From studies in which PRP had beneficial effects, 67.8% had an overall high risk of bias. From the studies in which PRP failed to exhibit beneficial effects, 67.8% had an overall low risk of bias. CONCLUSIONS Most experimental studies revealed positive effects of PRP. Although the majority of equine clinical studies yielded positive results, the human clinical trials' results failed to corroborate these findings. In both species, beneficial results were more frequently observed in studies with a high risk of bias. The use of PRP in musculoskeletal lesions, although safe and promising, has still not shown strong evidence in clinical scenarios.
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Affiliation(s)
- Patrícia M Brossi
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Juliana J Moreira
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Thaís S L Machado
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Raquel Y A Baccarin
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
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Kabiri A, Esfandiari E, Esmaeili A, Hashemibeni B, Pourazar A, Mardani M. Platelet-rich plasma application in chondrogenesis. Adv Biomed Res 2014; 3:138. [PMID: 25161985 PMCID: PMC4139981 DOI: 10.4103/2277-9175.135156] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Accepted: 03/10/2013] [Indexed: 01/15/2023] Open
Abstract
Platelet-rich plasma (PRP), an autologous derivative of whole blood, has been recently used in surgical treatment. PRP contains growth factors including transforming growth factor-β (TGF-β), insulin-like growth factor (IGF), platelet-derived growth factor (PDGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) and also bioactive proteins that influence the healing of tendon, ligament, muscle, and bone. This article describes the current clinical applications of PRP in chondrogenesis. This study reviews and evaluates the studies that have been published in the field of chondrogenesis. All aspects of using PRP in chondrogenesis are reviewed.
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Affiliation(s)
- Azadeh Kabiri
- Department of Anatomical Sciences, Paramedical School, Guilan University of Medical Sciences, Langeroud, Iran
| | - Ebrahim Esfandiari
- Department of Anatomical Sciences and Molecular Biology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abolghasem Esmaeili
- Department of Biology, Molecular and Developmental Division, Faculty of Sciences, University of Isfahan, Isfahan, Iran
| | - Batool Hashemibeni
- Department of Anatomical Sciences and Molecular Biology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Pourazar
- Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Mardani
- Department of Anatomical Sciences and Molecular Biology, Isfahan University of Medical Sciences, Isfahan, Iran
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Atesok K, Fu FH, Wolf MR, Ochi M, Jazrawi LM, Doral MN, Lubowitz JH, Rodeo SA. Augmentation of tendon-to-bone healing. J Bone Joint Surg Am 2014; 96:513-21. [PMID: 24647509 DOI: 10.2106/jbjs.m.00009] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Tendon-to-bone healing is vital to the ultimate success of the various surgical procedures performed to repair injured tendons. Achieving tendon-to-bone healing that is functionally and biologically similar to native anatomy can be challenging because of the limited regeneration capacity of the tendon-bone interface. Orthopaedic basic-science research strategies aiming to augment tendon-to-bone healing include the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influence the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches, such as the use of coated sutures and interference screws, aim to deliver biological factors while achieving mechanical stability by means of various fixators. Controlled Level-I human trials are required to confirm the promising results from in vitro or animal research studies elucidating the mechanisms underlying tendon-to-bone healing and to translate these results into clinical practice.
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Affiliation(s)
- Kivanc Atesok
- Center for Musculoskeletal Care, NYU Hospital for Joint Diseases, 333 East 38th Street, New York, NY 10016
| | - Freddie H Fu
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA 15213
| | - Megan R Wolf
- Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 1011, Pittsburgh, PA 15213
| | - Mitsuo Ochi
- Department of Orthopaedic Surgery, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minamimi-ku, Hiroshima 734-8551, Japan
| | - Laith M Jazrawi
- Center for Musculoskeletal Care, NYU Hospital for Joint Diseases, 333 East 38th Street, New York, NY 10016
| | - M Nedim Doral
- Departments of Orthopaedics and Traumatology, and Sports Medicine, Hacettepe University School of Medicine, 06100 Sihhiye, Ankara, Turkey
| | | | - Scott A Rodeo
- Sports Medicine and Shoulder Service, Hospital for Special Surgery, 525 East 71st Street, New York, NY 10021. E-mail address for S. A. Rodeo:
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Baksh N, Hannon CP, Murawski CD, Smyth NA, Kennedy JG. Platelet-rich plasma in tendon models: a systematic review of basic science literature. Arthroscopy 2013; 29:596-607. [PMID: 23352397 DOI: 10.1016/j.arthro.2012.10.025] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Revised: 09/30/2012] [Accepted: 10/17/2012] [Indexed: 02/02/2023]
Abstract
PURPOSE To perform a systematic review of the basic science literature on the use of platelet-rich plasma (PRP) in tendon models. METHODS We searched the PubMed/Medline and Embase databases in June 2012 using the following parameters: ((tenocytes OR tendon OR tendinitis OR tendinosis OR tendinopathy) AND (platelet rich plasma OR PRP OR autologous conditioned plasma OR ACP)). The inclusion criteria for full-text review were in vivo and in vitro studies examining the effects of PRP on tendons and/or tenocytes. Clinical studies were excluded. Only studies published in peer-reviewed journals that compared PRP directly with a control were included. Data were extracted based on a predefined data sheet, which included information on PRP preparation, study methods, and results. Studies were analyzed for trends, comparing and contrasting the reported effects of PRP. RESULTS The search yielded 31 articles for inclusion in our review. Of the studies, 22 (71%) reported platelet concentrations in the PRP; 6 (19%) reported cytology. Eight in vivo studies found decreased tendon repair time, increased fiber organization, or both with PRP treatment. Eight in vitro studies reported that PRP treatment increased cell proliferation; 7 reported an increase in growth factor expression. Three in vivo studies found increased vascularity, and 4 found increased tensile strength with PRP treatment. CONCLUSIONS In the basic science studies evaluated, it appears that PRP confers several potential effects on tendon models compared with a control. However, the literature is inconsistent with regard to reporting the methods of preparation of PRP and in reporting platelet concentrations and cytology. CLINICAL RELEVANCE Establishing proof of concept for PRP may lead to further high-quality clinical studies in which the appropriate indications can be defined.
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Affiliation(s)
- Nikolas Baksh
- Hospital for Special Surgery, New York, New York, USA
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