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. 2021 Mar 19;16(1):202.
doi: 10.1186/s13018-021-02320-w.

The effect of the platelet-rich plasma and ozone therapy on tendon-to-bone healing in the rabbit rotator cuff repair model

Murat Gurger  1 , Gokhan Once  2 , Erhan Yilmaz  1 , Sukru Demir  1 , Ilknur Calik  3 , Yakup Say  4 , Ahmet Kavakli  5 , Sefa Key  1 , Mustafa Umit Gurbuz  1 , Onur Bingollu  1
Affiliations

The effect of the platelet-rich plasma and ozone therapy on tendon-to-bone healing in the rabbit rotator cuff repair model

Murat Gurger et al. J Orthop Surg Res. .

Abstract

Background: The aim of this study is to histologically and biomechanically investigate the effects of local PRP and ozone therapy (O2O3) on tendon-to-bone healing in a rabbit model of the supraspinatus tendon tear.

Methods: Four groups were formed to have seven rabbits in each group: repair, R; repair + PRP, RP; repair + ozone, RO; and repair + PRP + ozone, RPO. The supraspinatus tendon was detached by sharp dissection from the footprint and an acute tear pattern was created. Thereafter, tendon repair was performed with the transosseous technique. In the RP group, PRP, and in the RPO group, PRP + O2O3 mixture was injected to the tendon repair site. In the RO group, O2O3 gas mixture was injected into subacromial space three times a week for a total of 4 weeks. The study was ended at postoperative 6th week.

Results: When compared with the R group, a statistically significant increase was observed in the biomechanical strength of the RP and RPO groups. The highest increase in biomechanical strength was detected in the RPO group. The histology of the RO and RPO groups showed better collagen fiber continuity and orientation than the R and RP groups.

Conclusions: The results obtained from this study show that the ozonized PRP can be used as biological support to increase tendon-to-bone healing. However, these results need to be supported by clinical studies.

Keywords: Ozone therapy; Platelet-rich plasma; Rotator cuff; Tendon-to-bone healing.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
a Supraspinatus tendon was isolated and sutured and then detached from the footprint. b Bone tunnels were created. c Suture tips were passed through bone tunnels. d Suture tips were tied over the lateral humeral cortex
Fig. 2
Fig. 2
a A sample of the repaired supraspinatus tendon (asterisk, scapular origo; arrow, humeral insertion). b Polyester molded sample. c Tensile test
Fig. 3
Fig. 3
Tendon-to-bone interface H&E staining shows that vascularity and cellularity were higher with granulation tissue formation in the ozone-treated groups (c, d) compared to the non-treated groups (a, b). The arrows indicate the vascular structure
Fig. 4
Fig. 4
MTC staining demonstrates collagen fiber continuity and arrangement at tendon-to-bone interface. There is an improved collagen fiber continuity and arrangement in the ozone-treated groups (c, d) compared to the non-treated groups (a, b) (arrows, collagen fibers)
Fig. 5
Fig. 5
Maximum force to failure and maximum elongation (%) values of sample groups (mean ± standard deviation)
See this image and copyright information in PMC

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References

    1. Bedi A, Kovacevic D, Hettrich C, Gulotta LV, Ehteshami JR, Warren RF, Rodeo SA. The effect of matrix metalloproteinase inhibition on tendon-to-bone healing in a rotator cuff repair model. J Shoulder Elbow Surg. 2010;19(3):384–391. doi: 10.1016/j.jse.2009.07.010. - DOI - PubMed
    1. Cheung EV, Silverio L, Sperling JW. Strategies in biologic augmentation of rotator cuff repair: a review. Clin Orthop Relat Res. 2010;468(6):1476–1484. doi: 10.1007/s11999-010-1323-7. - DOI - PMC - PubMed
    1. Aicale R, Bisaccia RD, Oliviero A, Oliva F, Maffulli N. Current pharmacological approaches to the treatment of tendinopathy. Expert Opin Pharmacother. 2020;21(12):1467–1477. doi: 10.1080/14656566.2020.1763306. - DOI - PubMed
    1. Andia I, Maffulli N. How far have biological therapies come in regenerative sports medicine? Expert Opin Biol Ther. 2018;18(7):785–793. doi: 10.1080/14712598.2018.1492541. - DOI - PubMed
    1. Oryan A, Moshiri A, Meimandi-Parizi A, Maffulli N. Role of xenogenous bovine platelet gel embedded within collagen implant on tendon healing: an in vitro and in vivo study. Exp Biol Med (Maywood) 2015;240(2):194–210. doi: 10.1177/1535370214554532. - DOI - PMC - PubMed

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