The effects of a combination treatment with mesenchymal stem cell and platelet-rich plasma on tendon healing: an experimental study

Authors: İLKER UYAR, ZEYNEP ALTUNTAŞ, SIDDIKA FINDIK, MEHMET EMİN CEM YILDIRIM, SERHAT YARAR, MURAT AKTAN, AHMET AVCI

Abstract: Background/Aim: The objective of this study was to investigate the effects that the application of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) following tendon repair have on the strength and healing of the tendon and also to examine the possible mechanisms of action that take place. Materials and methods: The Achilles tendons of 80 rats were repaired and divided into eight groups. Following the repairs, MSCs obtained from humans were injected into the rat tendons in groups 1 and 2, a combination of MSCs from humans and PRP from rats was injected into the tendons in groups 3 and 4, and PRP from rats was injected into the tendons in groups 5 and 6. These procedures all took place simultaneously. Groups 7 and 8 did not receive any injections following the repairs. The rats were sacrificed at the end of the first and second months following the procedures, and biomechanical and histopathological analyses were performed. Results: Inflammatory cell density increased most significantly in the combined group when compared to the first and second months. The fibroblast density on the tendon repair region was significantly lower in the second-months groups of each intervention compared to their first-month groups (p = 0.001). For the analysis of the maximum tensile breaking force, the behaviors of the groups over time were significant when compared to the control groups (p = 0.0015). Also, the mean maximum breaking force in the combined group was statistically significantly higher at the end of the second month than at the end of the first month (p = 0.0008). Conclusion: The combination therapy increased tendon strength force. This combination therapy can make a positive contribution to the healing of tendons after surgery.

Keywords: Experimental study, mesenchymal stem cell, platelet-rich plasma, tendon healing

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