Effect of platelet-rich fibrin on epidural fibrosis and comparison to ADCON® Gel and hyaluronic acid

• Published in: Acta orthopaedica et traumatologica turcica Vol. 52; no. 6; pp. 469 - 474
• Main Authors: Demirel, Esra, Yildiz, Kadri, Çadirci, Kenan, Aygün, Hayati, Şenocak, Eyüp, Gündoğdu, Betül
• Format: Journal Article
• Language: English
• Published: Turkey Elsevier B.V 01.11.2018; Turkish Association of Orthopaedics and Traumatology; AVES
• Subjects: ADCON gel; Adjuvants, Immunologic - pharmacology; Animals; Disease Models, Animal; Drug Therapy, Combination - methods; Epidural fibrosis; Epidural Space - drug effects; Epidural Space - pathology; Fibrosis; Histological comparison; Hyaluronic Acid - pharmacology; Hyaluronic acid gel; Laminectomy - adverse effects; Laminectomy - methods; Lumbar Vertebrae - surgery; Organic Chemicals - pharmacology; Platelet-Rich Fibrin; Postoperative Complications - pathology; Postoperative Complications - prevention & control; PRF; Rats; Rats, Sprague-Dawley; Research Paper; Treatment Outcome; Hyaluronic acid gel; Histological comparison; PRF; Epidural fibrosis; ADCON gel
• ISSN: 1017-995X; 2589-1294
• DOI: 10.1016/j.aott.2018.07.005

In this experimental study, PRF (Platelet Rich Fibrin), HA (Hyaluronic Acid) gel and ADCON® Gel were compared in terms of preventing epidural fibrosis. Twenty-eight Sprague–Dawley rats (mean weight, 400–450 g) were divided into 4 groups. L3-L4 laminectomy was performed in each group. Following laminectomy, Adcon® Gel, HA gel and PRF were applied onto the surgery site locally in Group 1, 2 and 3, respectively. Group 4 was maintained as control without any local application. After five weeks, L3-L4 vertebrae were removed totally and taken to histopathological evaluation for epidural fibrosis, acute inflammatory cell density, chronic inflammatory cell density, hemorrhage, angiogenesis and new bone formation. Acute inflammation cell density, angiogenesis, and new bone formation levels were comparable among the study groups (p > 0.05). However, new bone formation was higher in the PRF group. Epidural fibrosis and chronic inflammatory cell density were significantly lower in the PRF group (p < 0.05). We concluded that PRF contributed to hemostasis and prevented epidural fibrosis.