Abstract:
BACKGROUND:Platelet-rich concentrates are used as a source of growth factors to improve the healing process. The diverse preparation protocols and the gaps in knowledge of their biological properties complicate the interpretation of clinical results. QUESTIONS/PURPOSES:In this study we aimed to (1) analyze the concentration and kinetics of growth factors released from leukocyte- and platelet-rich fibrin (L-PRF), leukocyte- and platelet-rich plasma (L-PRP), and natural blood clot during in vitro culture; (2) investigate the migration of mesenchymal stem cells (MSCs) and human umbilical vein endothelial cells (HUVECs) as a functional response to the factors released; and (3) uncover correlations between individual growth factors with the initial platelet/leukocyte counts or the induced cell migration. METHODS:L-PRF, L-PRP, and natural blood clot prepared from 11 donors were cultured in vitro for 28 days and media supernatants collected after 8 hours and 1, 3, 7, 14, and 28 days. Released transforming growth factor β1 (TGF-β1), vascular endothelial growth factor (VEGF), insulin growth factor (IGF-1), platelet-derived growth factor AB (PDGF-AB), and interleukin-1β (IL-1β) were measured in the supernatants with enzyme-linked immunosorbent assay. Migration of MSC and HUVEC induced by the supernatants was evaluated in Boyden chambers. RESULTS:More TGF-ß1 was released (mean ± SD in pg/mL of blood) from L-PRF (37,796 ± 5492) compared with L-PRP (23,738 ± 6848; p < 0.001) and blood clot (3739 ± 4690; p < 0.001), whereas more VEGF and IL-1ß were released from blood clot (1933 ± 704 and 2053 ± 908, respectively) compared with both L-PRP (642 ± 208; p < 0.001 and 273 ± 386; p < 0.001, respectively) and L-PRF (852 ± 376; p < 0.001 and 65 ± 56, p < 0.001, respectively). No differences were observed in IGF-1 and PDGF-AB released from any of the concentrates. TGF-β1 release peaked at Day 7 in L-PRF and at 8 hours and Day 7 in L-PRP and 8 hours and Day 14 in blood clot. In all concentrates, main release of VEGF occurred between 3 and 7 days and of IL-1β between Days 1 and 7. IGF-1 and PDGF-AB were released until Day 1 in L-PRP and blood clot, in contrast to sustained release over the first 3 days in L-PRF. The strongest migration of MSC occurred in response to L-PRF, and more HUVEC migration was seen in L-PRF and blood clot compared with L-PRP. TGF-β1 correlated with initial platelet counts in L-PRF (Pearson r = 0.66, p = 0.0273) and initial leukocyte counts in L-PRP (Pearson r = 0.83, p = 0.0016). A positive correlation of IL-1β on migration of MSC and HUVEC was revealed (Pearson r = 0.16, p = 0.0208; Pearson r = 0.31, p < 0.001). CONCLUSIONS:In comparison to L-PRP, L-PRF had higher amounts of released TGF-β1, a long-term release of growth factors, and stronger induction of cell migration. Future preclinical studies should confirm these data in a defined injury model. CLINICAL RELEVANCE:By characterizing the biologic properties of different platelet concentrates in vitro, we may gain a better understanding of their clinical effects and develop guidelines for specific future applications.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Schär MO,Diaz-Romero J,Kohl S,Zumstein MA,Nesic Ddoi
10.1007/s11999-015-4192-2subject
Has Abstractpub_date
2015-05-01 00:00:00pages
1635-43issue
5eissn
0009-921Xissn
1528-1132journal_volume
473pub_type
杂志文章abstract::Following peripheral nerve repair, tension on the suture line is regarded as an important factor in producing scar tissue. In some cases, one or more microsurgical epiperineurium-fascial stitches (EPFS) along the proximal and distal stumps of a transected nerve permit their firm approximation, shifting tensile forces ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::The natural history of degenerative lumbar spinal stenosis is documented poorly. Little is known about the efficacy of nonoperative treatments. An aggressive nonoperative treatment consisting of therapeutic exercise, analgesics, and epidural steroid injections is proposed. The clinical evaluation of the patients is re...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200103000-00018
更新日期:2001-03-01 00:00:00
abstract::This is a review of 13 patients with chronic osteomyelitis treated at the author's institution using techniques similar to the management of giant cell tumors of bone. This included aggressive serial debridements and appropriate antibiotic coverage and subsequent bone-grafting or soft-tissue coverage procedures. The n...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Despite the lack of consensus guidelines and randomized control trials, the use of arthroscopy for the treatment of osteoarthritis of the knee has increased over the last decade. Techniques used for the arthroscopic treatment of osteoarthritis of the knee include joint lavage, joint débridement, meniscectomy, abrasion...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/BLO.0b013e31802fc18c
更新日期:2007-02-01 00:00:00
abstract::In experimental fractures in rabbits, a decrease in blood volume associated with anemia delays healing, but uncomplicated normovolemic anemia has no adverse effect. For the purpose of stimulating the repair process in normovolemic anemia individuals blood transfusions would be ineffectual. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1977-03-01 00:00:00
abstract::Theoretical and experimental studies before and after stem insertion demonstrated that stresses and strains were closer to normal for uncemented stems than for cemented stems. The values were affected by relative tightness of fit in the proximal and distal regions and by the presence or absence of a collar. For design...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract:UNLABELLED:Most previous studies of THA in sickle cell disease report high risks of medical and orthopaedic complications, including infections and a higher incidence of failure than observed after THA for osteonecrosis related to other conditions. Based on our experience (1245 orthopaedic procedures during the last 25...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-007-0069-3
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Despite the overall effectiveness of total hip arthroplasty (THA), a subset of patients remain dissatisfied with their results because of persistent pain or functional limitations. It is therefore important to develop predictive tools capable of identifying patients at risk for poor outcomes before surgery. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4350-6
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:When associated with a knee dislocation, management of the medial ligamentous injury is challenging, with little literature available to guide treatment. QUESTIONS/PURPOSES:We (1) compared MRI findings of medial ligament injuries between Schenck KDIIIM and KDIV injuries, (2) compared clinical outcomes and h...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3483-3
更新日期:2014-09-01 00:00:00
abstract::Surgical fusion may be indicated to stabilize deformed or painful hindfoot joints. Although more commonly performed in children or adolescents, it is the salvage procedure available for adults. Twenty-six patients (30 feet; 20 women, six men) followed for an average of 44.1 months after hindfoot arthrodesis were inves...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract:BACKGROUND:Recently, the authors of two prospective multicenter observational studies recommended surgery to improve head sphericity in older children, whereas large retrospective observational studies suggest that surgery does not improve head sphericity in older children. Thus, the treatment for Legg-Calvé-Perthes di...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11999-012-2326-3
更新日期:2012-09-01 00:00:00
abstract::Limb lengthening is not uncommon after total hip replacement and may cause subjective problems for patients. We have studied 150 total hip replacements to investigate the operative change in limb length. A radiologic evaluation is used and is shown to be accurate. One hundred forty-four limbs were lengthened an averag...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00
abstract::Synovial tissues taken from 13 cases of synovial chondromatosis (SC) were examined by light and electron microscopy. In three of the 13 cases, early cellular changes were observed by electron microscopy. Most of the foci were independently situated within an accumulation of fine, homogenous chondroid matrix in the sub...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract::Reconstruction of massive proximal tibial defects caused by failed cemented total knee arthroplasty (TKA) was evaluated using cancellous allograft and a rigidly fixed tibial component. Twenty patients with massive tibial defects requiring revision TKA were operated on using this technique from December 1984 to Decembe...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-11-01 00:00:00
abstract::Isolated capitellar fractures are rare, intraarticular fractures requiring an aggressive management regimen. Several treatment options have been described for the Type 1 fracture. A new technique of direct anatomic reduction and fixation of the fracture using a maxillofacial plate is reported. Advantages of this new t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract::In situ hybridization and ultrastructural immunohistochemistry were used to study the synthesis and distribution of 2 bone matrix proteins, bone sialoprotein and osteopontin, in the proximal tibial epiphysis in 21-, 32-, and 84-day-old rats. Bone sialoprotein messenger ribonucleic acid expression was restricted to cel...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199609000-00033
更新日期:1996-09-01 00:00:00
abstract::A series of 59 knees in 58 patients were surgically treated from 1977 to 1982 for chondromalacia patellae, and were followed for an average of 1.2 to 4.6 years after the operation. The operative procedure was open lateral retinacular release in all knees. In knees with recurrent patellar subluxation, the number of poo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::This report is a prospective review of 450 low-friction arthroplasties (LFAs) performed by a single surgeon from 1972 to 1983 in a community hospital. The clinical results show sustained quality of the result over a maximum follow-up period of 11 years. The radiologic review shows a slight increase in the number and s...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-10-01 00:00:00
abstract::This study was designed to evaluate the efficacy of the Holmium:YAG laser for performing lateral release and medial joint capsular tightening intracapsularly and to compare the efficacy of the laser versus a scalpel blade for performing a lateral release by performing arthroscopic surgery on 29 caprine patellofemoral ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1998-11-01 00:00:00
abstract::This study attempted to evaluate whether total hip arthroplasty for displaced femoral neck fractures had significantly different outcomes when compared with total hip arthroplasty for osteoarthritis. This is a retrospective study of 60 patients who had total hip arthroplasties between 1997 and 2001. Thirty patients (m...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000127114.67635.19
更新日期:2004-04-01 00:00:00
abstract::The aim of this study was to describe the course of untreated or conservatively treated arthrosis of the knee joint. Of 265 patients presenting with knee pain who had weightbearing radiographs taken between 1970 and 1973, 132 (33 men and 99 women) responded to and participated in a clinical followup 20 years later usi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199707000-00019
更新日期:1997-07-01 00:00:00
abstract::Subtalar dislocations are uncommon injuries. In an effort to obtain accurate information, eight recent major series (more than five patients) were summarized, including the experience at the authors' institution between 1975 and 1985 (12 patients). Medial dislocations predominated (79.5%), lateral injuries accounted f...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::Two hundred thirty-four consecutive alumina-on-alumina hip replacements using a press-fit metal-backed socket, performed on 214 patients (98 women, 116 men) have been reviewed. These included 201 primary procedures and 33 revision procedures. The median age of the patients at the time of surgery was 62 years (range, 2...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200010000-00016
更新日期:2000-10-01 00:00:00
abstract::Eleven patients with chronic pain on the ulnar side of the wrist and roentgenographic evidence of a hypertrophic ulnar styloid nonunion were treated with subperiosteal excision of the nonunion fragment. This procedure relieved the localized pain without changing either radiocarpal or distal radioulnar joint stability....
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
abstract:BACKGROUND:Readmissions after total joint arthroplasty have become a key quality measure in elective surgery in the United States. The Affordable Care Act includes the Hospital Readmission Reduction Program, which calls for reduced payments to hospitals with excessive readmissions. This policy uses a method to determin...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-5156-x
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Femoroacetabular impingement has been proposed as a cause of early osteoarthritis, but it is not known how this develops over time or whether the shape of the proximal femur influences this risk. QUESTIONS/PURPOSES:(1) Which areas of the acetabulum are worn more frequently by individuals with a cam deformit...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2720-x
更新日期:2013-02-01 00:00:00
abstract::Muscle transplantation in deltoid paralysis in poliomyelitis has been practiced only sporadically and considered ineffective. Trapezius transfer to humeral shaft with fascia lata extension was performed to restore abduction power of the shoulder in 24 patients between 4--10 years of age. It is recommended that the mus...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-09-01 00:00:00
abstract:BACKGROUND:Hip dysplasia is the most common cause of secondary osteoarthritis (OA). Periacetabular osteotomy (PAO) or rotational acetabular osteotomy (RAO) has been used as a joint-preserving procedure. However, the patient selection criteria are not clearly defined. QUESTIONS/PURPOSES:Based on a systematic review, we...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1007/s11999-012-2516-z
更新日期:2012-12-01 00:00:00
abstract::A technique of computed tomography with intravenous contrast has proven useful in the differentiation between osteoid osteoma and other similar appearing lucent lesions of bone in 6 cases. The clinical evaluation of benign appearing radiolucent lesions of long bones has been greatly improved by the use of modern imagi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199606000-00030
更新日期:1996-06-01 00:00:00
abstract::A technique for ipsilateral femoral neck and shaft fracture using the sliding compression hip screw with plate combined with trochanteric antegrade Ender nailing of the femur was applied in two cases. Ender nails can be passed without difficulty past a compression hip screw and the bicortical plating screws. The hip a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00