Kemik Tünel İçi Tendon-Kemik iyileşmesinde Trombositten Zengin Plazmanın Etkisi

Yıl 2025, Cilt: 6 Sayı: 1, 16 - 21, 15.03.2025

Mesut Uluöz , Sinan Karaoglu , Cevat Yazıcı , Özlem Canöz

Öz

Giriş: Çalışmamızda otolog kandan elde edilen trombositten zengin plazmanın (TZP) tavşan tünel içi tendon kemik iyileşmesine etkisini, biyomekanik ve histolojik parametreler kullanılarak değerlendirmeyi amaçladık.

Yöntemler: Çalışmada 31 adet Yeni Zelanda tipi albino tavşanın arka bacakları kullanıldı. Her iki arka bacağın ekstensör digitorum longus tendonu proksimal yapışma yerinden alındıktan sonra, aynı bacak tibiada açılan kemik tünel içine yerleştirildi. P “trombosit” grubunda tendonun tünelde kalacak kısmına üç ayrı yerden insülin enjektörü ile TZP enjekte edildi, K “Kontrol” grubuna tendonun tünelde kalacak kısmına boş insülin enjektörüyle üç defa girildi. Ayrıca her grup kendi içerisinde “altı ve oniki haftalık olarak” ikiye ayrıldı. Sakrifikasyon işleminden sonra tibia ve tendonla birlikte çıkartılan kemik-tendon bileşkesi çekme cihazında 5mm/saniye hızında çekildi. Çekme işlemi, tendon, kemik-tendon bileşkesinden ayrılıncaya veya tendon kopuncaya kadar sürdürüldü. İşlem sırasında maksimum dayanma kuvveti (ULF) ve kopana kadar geçen süredeki uzama miktarı, makine tarafından kaydedildi. Bu değerler kullanılarak stiffness (katılık) ve enerji absorbsiyonu hesaplandı. Altıncı ve onikinci gruplardan üçer adet denek histolojik olarak incelendi.

Bulgular: Altıncı ve onikinci haftalarda biyomekanik parametrelerin hepsi kontrol grubuna göre yüksek bulundu ve onikinci haftadaki üç parametrenin tamamında, altıncı haftadaki üç parametrenin ikisinde (ULF, katılık) yükseklik anlamlıydı. (p<0,05)

Sonuç: Çalışma sonucunda Yeni Zelanda tipi albino tavşanda oluşturulan tünel içi iyileşme modelinde TZP uygulamasının,iyileşmeyi olumlu şekilde arttırdığı biyomekanik ve histolojik incelemelerle belirlendi. TZP uygulaması, tendon-kemik iyileşmesini hızlandırmak için başarıyla kullanılabilir.

Anahtar Kelimeler

trombositten zengin plazma, ön çapraz bağ, tendon

Etik Beyan

12/11/08 No: 08/62 ERCİYES ÜNİVERSİTESİ ETİK KURULUNDAN ÜZÜN ALINMIŞTIR

Destekleyen Kurum

ERCİYES ÜNİVERSİTESİ REKTÖRLÜK VE BAP

The Effect of Platelet Rich Plasma In Bone Tunnel Tendon-Bone Healing

Öz

Introduction: In our study, we aimed to evaluate the effect of platelet-rich plasma (PRP) obtained from autologous blood on rabbit intra-tunnel tendon bone healing using biomechanical and histologic parameters.

Methods: The hind legs of 31 New Zealand albino rabbits were used in the study. After the extensor digitorum longus tendon of both hind legs was removed from the proximal attachment site, the same leg was placed in a bone tunnel opened in the tibia. In the P “platelet” group, PRP was injected into the tunneled part of the tendon, while in the K “control” group, the tunneled part of the tendon. In addition, each group was divided into two groups “six and twelve weeks old”. After sacrification, the bone-tendon junction, which was removed together with the tibia and tendon, was pulled in a pulling device at a speed of 5mm/second. The machine recorded the maximal endurance force (ULF). Using these values, stiffness and energy absorption were calculated. Three specimens each from the sixth and twelfth groups were examined histologically.

Results: At 6.-12. weeks, all biomechanical parameters were higher than in the control group and the increase was significant in all three parameters at twelfth week and in two of the parameters (ULF, stiffness) at sixth week (p<0.05)

Conclusions: As a conclusion of the study, it was determined by biomechanical and histological examinations that PRP application positively enhanced healing in the intra-tunnel healing model created in the New Zealand albino rabbit. PRP application can be successfully used to accelerate tendon-bone healing.

Anahtar Kelimeler

Platelet-rich plasma, Anterior cruciate ligament, Tendons

Kaynakça

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