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

Research output: Contribution to journalArticlepeer-review

Authors

  • Marie Didembourg
  • Alexander Wood
  • Amarpreet Devi
  • Joseph Alsousou
  • David Keene
  • Philippa Hulley
  • Susan Wagland
  • Scott Parsons
  • Jacqueline Thompson
  • Christopher Byrne
  • Michael Maia Schlussel
  • Heather O'Connor
  • Susan Dutton
  • Sarah Lamb
  • Keith Willett

Colleges, School and Institutes

External organisations

  • University of Birmingham

Abstract

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 standardised commercial preparation method across 19 different UK centres. 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.

Bibliographic note

Funding Information: The PATH-2 trial was funded by the Efficacy and Mechanism Evaluation program, a Medical Research Council (MRC) and National Institute for Health Research (NIHR) partnership (reference 12/206/30). The trial was supported by the NIHR Biomedical Research Centre, Oxford, and the NIHR Fellowship program (DJK, PDF-2016-09-056). SEL receives funding from the NIHR Collaboration for Leadership in Applied Health Research and Care Oxford at Oxford Health NHS Foundation Trust. University of Birmingham staff were funded by the Scar Free Foundation (SFF) and the NIHR Surgical Reconstruction and Microbiology Research Centre (SRMRC). The views and opinions expressed herein are those of the authors and do not necessarily reflect those of the MRC, NHS, SFF, NIHR, or Department of Health and Social Care. The sponsor (University of Oxford) and funders monitored the study but were not involved in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Details

Original languageEnglish
JournalPlatelets
Early online date26 Nov 2020
Publication statusE-pub ahead of print - 26 Nov 2020

Keywords

  • Achilles, platelet-rich plasma, rupture, tendon

ASJC Scopus subject areas