Platelet-Rich Plasma Applications for Achilles Tendon Repair: A Bridge between Biology and Surgery

Achilles tendon ruptures are very common tendon ruptures and their incidence is increasing in modern society, resulting in work incapacity and months off sport, which generate a need for accelerated and successful therapeutic repair strategy. Platelet-rich plasma (PRP) is emerging as adjuvant human...

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Published inInternational journal of molecular sciences Vol. 22; no. 2; p. 824
Main Authors Padilla, Sabino, Sánchez, Mikel, Vaquerizo, Victor, Malanga, Gerard A, Fiz, Nicolás, Azofra, Juan, Rogers, Christopher J, Samitier, Gonzalo, Sampson, Steven, Seijas, Roberto, Elorriaga, Ricardo, Taunton, Jack, Boehm, Frank, Prado, Roberto, Cugat, Ramón, Anitua, Eduardo
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 15.01.2021
MDPI
Subjects
Achilles
Achilles tendon
Achilles Tendon - injuries
Achilles Tendon - surgery
Biology
Biomechanics
Blood platelets
Cell Cycle
Cell Movement
Cell Proliferation
Collagen - chemistry
Cytokines
ErbB Receptors - metabolism
Erythrocytes
Fibroblasts
Gene expression
Growth factors
Humans
Integrin beta1 - metabolism
Keratinocytes - cytology
Keratinocytes - metabolism
Leukocytes
Ligands
NF-kappa B - metabolism
Plasma
platelet-rich plasma
Platelet-Rich Plasma - metabolism
PRGF
Receptor, IGF Type 1 - metabolism
Review
Rupture - surgery
Signal Transduction
Standardization
tendon
Tendon Injuries - surgery
Tendons
Tissue engineering
Ultrasonic imaging
Wound Healing
tendon
PRGF
platelet-rich plasma
Achilles
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Abstract Achilles tendon ruptures are very common tendon ruptures and their incidence is increasing in modern society, resulting in work incapacity and months off sport, which generate a need for accelerated and successful therapeutic repair strategy. Platelet-rich plasma (PRP) is emerging as adjuvant human blood-derived constructs to assist Achilles tendon rupture treatment. However, myriad PRP preparation methods in conjunction with poor standardization in the modalities of their applications impinge on the consistent effectiveness of clinical and structural outcomes regarding their therapeutic efficacy. The purpose of this review is to provide some light on the application of PRP for Achilles tendon ruptures. PRP has many characteristics that make it an attractive treatment. Elements such as the inclusion of leukocytes and erythrocytes within PRP, the absence of activation and activation ex vivo or in vivo, the modality of application, and the adjustment of PRP pH can influence the biology of the applied product and result in misleading therapeutic conclusions. The weakest points in demonstrating their consistent effectiveness are primarily the result of myriad PRP preparation methods and the poor standardization of modalities for their application. Selecting the right biological scaffold and applying it correctly to restitutio ad integrum of ruptured Achilles tendons remains a daunting and complex task.
AbstractList Achilles tendon ruptures are very common tendon ruptures and their incidence is increasing in modern society, resulting in work incapacity and months off sport, which generate a need for accelerated and successful therapeutic repair strategy. Platelet-rich plasma (PRP) is emerging as adjuvant human blood-derived constructs to assist Achilles tendon rupture treatment. However, myriad PRP preparation methods in conjunction with poor standardization in the modalities of their applications impinge on the consistent effectiveness of clinical and structural outcomes regarding their therapeutic efficacy. The purpose of this review is to provide some light on the application of PRP for Achilles tendon ruptures. PRP has many characteristics that make it an attractive treatment. Elements such as the inclusion of leukocytes and erythrocytes within PRP, the absence of activation and activation ex vivo or in vivo, the modality of application, and the adjustment of PRP pH can influence the biology of the applied product and result in misleading therapeutic conclusions. The weakest points in demonstrating their consistent effectiveness are primarily the result of myriad PRP preparation methods and the poor standardization of modalities for their application. Selecting the right biological scaffold and applying it correctly to restitutio ad integrum of ruptured Achilles tendons remains a daunting and complex task.
Author Prado, Roberto
Anitua, Eduardo
Samitier, Gonzalo
Sampson, Steven
Fiz, Nicolás
Seijas, Roberto
Taunton, Jack
Sánchez, Mikel
Elorriaga, Ricardo
Padilla, Sabino
Vaquerizo, Victor
Boehm, Frank
Cugat, Ramón
Azofra, Juan
Malanga, Gerard A
Rogers, Christopher J
AuthorAffiliation 6 Department of Orthopaedic Surgery, Príncipe de Asturias University Hospital, 28805 Alcalá de Henares, Spain; vaquerizovictor@yahoo.es
1 Eduardo Anitua Foundation for Biomedical Research, Jacinto Quincoces, 39, 01007 Vitoria, Spain; roberto.prado@bti-implant.es
11 Instituto Cugat, Plaza Alfonso Comín 5-7, Planta (-1), 08023 Barcelona, Spain; samitier@sportrauma.com (G.S.); seijastraumatologia@gmail.com (R.S.); ramon.cugat@sportrauma.com (R.C.)
10 San Diego Orthobiologics Medical Group, Inc., Carlsbad, CA 92011, USA; rogers@sdomg.com
13 Hospital Quirónsalud Barcelona, Plaza Alfonso Comín 5, 08023 Barcelona, Spain
3 University Institute for Regenerative Medicine & Oral Implantology-UIRMI (UPV/EHU-Fundación Eduardo Anitua), Jacinto Quincoces, 39, 01007 Vitoria, Spain
9 Rutgers University and New Jersey Regenerative Medicine Institute, Cedar Knolls, NJ 07927, USA
16 Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Basurto, Montevideo Etorb, 18, 48013 Bilbao, Spain; rielo
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Copyright 2021. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
2021 by the authors. 2021
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Keywords tendon
PRGF
platelet-rich plasma
Achilles
Language English
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PublicationTitle International journal of molecular sciences
PublicationTitleAlternate Int J Mol Sci
PublicationYear 2021
Publisher MDPI AG
MDPI
Publisher_xml – name: MDPI AG
– name: MDPI
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Snippet Achilles tendon ruptures are very common tendon ruptures and their incidence is increasing in modern society, resulting in work incapacity and months off...
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SubjectTerms Achilles
Achilles tendon
Achilles Tendon - injuries
Achilles Tendon - surgery
Biology
Biomechanics
Blood platelets
Cell Cycle
Cell Movement
Cell Proliferation
Collagen - chemistry
Cytokines
ErbB Receptors - metabolism
Erythrocytes
Fibroblasts
Gene expression
Growth factors
Humans
Integrin beta1 - metabolism
Keratinocytes - cytology
Keratinocytes - metabolism
Leukocytes
Ligands
NF-kappa B - metabolism
Plasma
platelet-rich plasma
Platelet-Rich Plasma - metabolism
PRGF
Receptor, IGF Type 1 - metabolism
Review
Rupture - surgery
Signal Transduction
Standardization
tendon
Tendon Injuries - surgery
Tendons
Tissue engineering
Ultrasonic imaging
Wound Healing
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Title Platelet-Rich Plasma Applications for Achilles Tendon Repair: A Bridge between Biology and Surgery
URI https://www.ncbi.nlm.nih.gov/pubmed/33467646
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Volume 22
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