Abstract
BackgroundThe 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.MethodsFour 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.ResultsWhen 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.ConclusionsThe 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.
Highlights
Rotator cuff tears are among the most common causes of shoulder pain and function loss in adults
In the repair + ozone (RO) and repair + PRP + ozone (RPO) groups, the number of collagen fibers was greatly increased, and there was a visible improvement in collagen organization
While none of the groups could fully reach the level of the healthy rabbits in terms of the regularity of the newly formed collagen fibers and continuity to the bone, the RPO group showed the closest similarity
Summary
Rotator cuff tears are among the most common causes of shoulder pain and function loss in adults. There is considerable improvement in surgical techniques, significant healing problems are observed after surgical repair [1]. There has been an increasing interest in biological augmentations used for tendon healing. In some in vitro studies, PRP has been shown to increase mesenchymal stem cells [8]. The use of PRP has become attractive to prevent healing problems, especially after rotator cuff repair. 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. 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.
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