Trombositten zengin plazma kronik fokal kondral defektlerin mikrofraktür ile tedavisini daha etkin kılar mı? Sıçan modelli in vivo çalışma

Abstract

Amaç: Mevcut çalışmanın amacı trombositten zengin plazma (platelet-rich plasma, PRP) + mikrofraktür ile mikrofraktür tedavilerinin kronik fokal kondral defekt iyileşmesine etkisini karşılaştırmaktı. Çalışma planı: Bu çalışmada 57 adet erişkin erkek Sprague-Dawley sıçanı kullanıldı. Kırk iki sıçan kondral defekt oluşturulduktan sonra 14’erlikten 3 gruba (kontrol, sadece mikrofraktür, PRP+mikrofraktür) ayrıldı. Kalan 15 sıçan PRP hazırlanmasında kullanıldı. Tedaviden 3 ve 6 hafta sonra sıçanlara ötenazi uygulandı ve incelemeleri yapıldı. Uyarlanmış Pineda skorlama sistemi ile histolojik analiz ve Tip 2 kollajen için immünohistokimyasal boyama yapıldı. Bulgular: Her iki zaman aralığında da, kontrol grubu histolojik skorları (3. hafta: 8.8±1.2, 6. hafta: 8.5±0.7) mikrofraktür (3. hafta: 6.8±1.0, 6. hafta: 7.1±0.6) ve PRP+mikrofraktür (3. hafta: 6.4±1.3, 6. hafta: 5.7±1.2) gruplarından daha yüksekti (p<0.05). Altıncı hafta mikrofraktür grup skoru, 6. hafta PRP+mikrofraktür grubundan daha yüksekti (p<0.05). Tip 2 kollajen boyanma derecesi 6. haftada PRP+mikrofraktür grubunda daha yüksekti ve hücre membranında membranöz boyama gözlendiğinden benzersizdi. Çıkarımlar: Kronik fokal kondral defekt tedavisi için mikrofraktürlerle birlikte PRP uygulamasının kıkırdak iyileşmesini daha etkin kıldığı gözükmektedir.

Keywords

• Kıkırdak onarımı; mikrofraktür; trombositten zengin plazma.

Does platelet-rich plasma enhance microfracture treatment for chronic focal chondral defects? An in-vivo study performed in a rat model

Abstract

Objective: The purpose of the present study was to compare the effectiveness of platelet-rich plasma (PRP) + microfracture and microfracture treatments in the healing of chronic focal chondral defects.
Methods: The study included 57 adult male Sprague-Dawley rats. Forty-two rats were divided into three groups of 14 rats with a chondral defect (control, microfracture only, PRP+microfracture). The remaining 15 rats were used to produce the PRP preparation. The rats were then euthanatized at 3 and 6 weeks after treatment and examined. Histological analysis using the modified Pineda scoring system and immunohistochemical staining for Type 2 collagen were performed.
Results: At both time intervals, control group histological scores (Week 3: 8.8±1.2, Week 6: 8.5±0.7) were higher than microfracture (Week 3: 6.8±1.0, Week 6: 7.1±0.6) and PRP+microfracture (Week 3: 6.4±1.3, Week 6: 5.7±1.2) scores (p<0.05). The microfracture group score was higher at Week 6 than the PRP+microfracture group (p<0.05). The degree of Type 2 collagen staining was higher at Week 6 in the PRP+microfracture group and was unique in showing staining at the cell membrane.
Conclusion: The addition of PRP application to microfracture treatment appears to enhance cartilage healing in chronic focal chondral defects.

Keywords

• Cartilage repair
• microfracture
• platelet-rich plasma

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