Platelets (Feb 2021)

Characteristics of L-PRP preparations for treating Achilles tendon rupture within the PATH-2 study

  • Paul Harrison,
  • Marie Didembourg,
  • Alexander Wood,
  • Amarpreet Devi,
  • Robert Dinsdale,
  • Jon Hazeldine,
  • Joseph Alsousou,
  • David J Keene,
  • Philippa Hulley,
  • Susan Wagland,
  • Scott Parsons,
  • Jacqueline Thompson,
  • Christopher Byrne,
  • Michael Maia Schlüssel,
  • Heather O’Connor,
  • Susan J Dutton,
  • Sarah E Lamb,
  • Keith Willett

DOI
https://doi.org/10.1080/09537104.2020.1849604
Journal volume & issue
Vol. 32, no. 2
pp. 273 – 279

Abstract

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Platelet-rich plasma (PRP) is an autologous preparation that has been claimed to improve healing and mechanobiological properties of tendons both in vitro and in vivo. In this sub-study from the PATH-2 (PRP in Achilles Tendon Healing-2) trial, we report the cellular and growth factor content and quality of the Leukocyte-rich PRP (L-PRP) (N = 103) prepared using a standardized commercial preparation method across 19 different UK centers. Baseline whole blood cell counts (red cells, leukocyte and platelets) demonstrated that the two groups were well-matched. L-PRP analysis gave a mean platelet count of 852.6 x 109/L (SD 438.96), a mean leukocyte cell count of 15.13 x 109/L (SD 10.28) and a mean red blood cell count of 0.91 x 1012/L (SD 1.49). The activation status of the L-PRP gave either low or high expression levels of the degranulation marker CD62p before and after ex-vivo platelet activation respectively. TGF-β, VEGF, PDGF, IGF and FGFb mean concentrations were 131.92 ng/ml, 0.98 ng/ml, 55.34 ng/ml, 78.2 ng/ml and 111.0 pg/ml respectively with expected correlations with both platelet and leukocyte counts. While PATH-2 results demonstrated that there was no evidence L-PRP is effective for improving clinical outcomes at 24 weeks after Achilles tendon rupture, our findings support that the majority of L-PRP properties were within the method specification and performance.

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