The effect of platelet-rich plasma on chondrocyte healing in traumatic dislocation of the hip in a rat model

Year 2021, Volume: 5 Issue: 12, 1159 - 1163, 01.12.2021

Toktamış Savaş , Orhan Buyukbebeci , Erman Öğümsöğütlü Ahmet Sarper Bozkurt , Ömer Eronat

https://doi.org/10.28982/josam.1005052

Abstract

Background/Aim: Traumatic hip dislocations (THD) are orthopedic emergencies and significant complications such as cartilage degeneration can be reduced with early reduction. This study aimed to examine the effect of platelet-rich plasma (PRP) on cartilage cells in one-, two- or 8-hours prolonged hip dislocation.
Methods: We used 24 Sprague-Dawley rats in this study and divided them into three main groups based on whether their hips were in the protruding position for one, two, or eight hours. Each main group was further divided into two subgroups, with the right hips constituting the experimental group and the left hips, the control group. Traumatic hip dislocation modeling was performed surgically on both hips of the rats under anesthesia in the same session. After both dislocated joints were reduced and the hip capsules were sutured, platelet-rich plasma was administered to the right hips. After 1 week, all rats were sacrificed, their femoral heads were excised and subjected to histopathological examination. Terminal deoxynucleotidyl transferase‐mediated dUTP nick‐end labeling (TUNEL) testing was used to show chondrocyte apoptosis in the femoral head. The apoptotic index (AI) showing the ratio of cartilage cells to apoptosis was calculated histopathologically. A comparison of apoptotic indices was made between the groups.
Results: The AIs of the one-, two- and eight hours-long hip dislocation groups were 0.012 (0.005), 0.023 (0.011), 0.046 (0.012), respectively (P<0.001), while those of the control groups were 0.028 (0.010), 0.077 (0.015), 0.100 (0.016), respectively (P<0.001).
Conclusion: In traumatic hip dislocation known to cause chondrocyte apoptosis, PRP provides a significant reduction in the apoptotic index.

Keywords

Apoptosis, Cartilage, Traumatic joint dislocation, Apoptotic index, Platelet-rich plasma (PRP)

Project Number

TF.DT.19.47

References

• 1. Armstrong JR. Traumatic dislocation of the hip joint; review of 101 dislocations. The Journal of bone and joint surgery British volume. 1948;30b(3):430-45.
• 2. DeLee JC. Fractures and dislocations of the hip. In: Rockwood CA, Bucholz RW, Green DP, Court-Brown CM, Heckman JD, Tornetta P, editors. Rockwood and Green's Fractures in Adults. Philadelphia, PA: Lippincott-Raven; 1996. p. 1756-803.
• 3. Dreinhofer KE, Schwarzkopf SR, Haas NP, Tscherne H. Isolated traumatic dislocation of the hip. Long-term results in 50 patients. The Journal of bone and joint surgery British volume. 1994;76(1):6-12.
• 4. Yang RS, Tsuang YH, Hang YS, Liu TK. Traumatic dislocation of the hip. Clinical orthopedics and related research. 1991(265):218-27.
• 5. Middleton KK, Barro V, Muller B, Terada S, Fu FH. Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. The Iowa orthopaedic journal. 2012;32:150-63.
• 6. Sunitha RV, Munirathnam NE. Platelet-rich fibrin: Evolution of a second-generation platelet concentrate. Indian Journal of Dental Research. 2008;19(1):42-6.
• 7. Loeser RF. Growth factor regulation of chondrocyte integrins. Differential effects of insulin-like growth factor 1 and transforming growth factor beta on alpha 1 beta 1 integrin expression and chondrocyte adhesion to type VI collagen. Arthritis and rheumatism. 1997;40(2):270-6.
• 8. Chubinskaya S, Malfait AM, Wimmer MA. Form and function of articular cartilage. In: O’Keefe RJ, editor. Orthopaedic basic science: foundations of clinical practice American Academy of Orthopaedic Surgeons. 4th ed ed. Rosemont, IL2013. p. 183-97.
• 9. Nishida Y, Knudson CB, Eger W, Kuettner KE, Knudson W. Osteogenic protein 1 stimulates cells-associated matrix assembly by normal human articular chondrocytes: up-regulation of hyaluronan synthase, CD44, and aggrecan. Arthritis and rheumatism. 2000;43(1):206-14.
• 10. Dhurat R, Sukesh M. Principles and Methods of Preparation of Platelet-Rich Plasma: A Review and Author's Perspective. Journal of cutaneous and aesthetic surgery. 2014;7(4):189-97.
• 11. Papavasiliou VA. The fate of articular cartilage in traumatic dislocation of the hip. Clinical orthopaedics and related research. 1982(171):287-9.
• 12. Mehlman CT, Hubbard GW, Crawford AH, Roy DR, Wall EJ. Traumatic hip dislocation in children. Long-term followup of 42 patients. Clinical orthopaedics and related research. 2000(376):68-79.
• 13. Colwell CW, Jr., D'Lima DD, Hoenecke HR, Fronek J, Pulido P, Morris BA, et al. In vivo changes after mechanical injury. Clinical orthopaedics and related research. 2001(391 Suppl):S116-23.
• 14. Lotz M, Hashimoto S, Kühn K. Mechanisms of chondrocyte apoptosis. Osteoarthritis Cartilage. 1999;7(4):389-91.
• 15. Hashimoto S, Takahashi K, Amiel D, Coutts RD, Lotz M. Chondrocyte apoptosis and nitric oxide production during experimentally induced osteoarthritis. Arthritis and rheumatism. 1998;41(7):1266-74.
• 16. Kourí JB, Aguilera JM, Reyes J, Lozoya KA, González S. Apoptotic chondrocytes from osteoarthrotic human articular cartilage and abnormal calcification of subchondral bone. J Rheumatol. 2000;27(4):1005-19.
• 17. Hashimoto S, Ochs RL, Komiya S, Lotz M. Linkage of chondrocyte apoptosis and cartilage degradation in human osteoarthritis. Arthritis and rheumatism. 1998;41(9):1632-8.
• 18. Guner S, Buyukbebeci O. Analyzing the effects of platelet gel on knee osteoarthritis in the rat model. Clin Appl Thromb Hemost. 2013;19(5):494-8.
• 19. Brav EA. Traumatic dislocation of the hip: army experience and results over a twelve-year period. J Bone Joint Surg Am. 1962;44(6):1115-34.
• 20. Epstein HC. Posterior fracture-dislocations of the hip; long-term follow-up. The Journal of bone and joint surgery American volume. 1974;56(6):1103-27.
• 21. Pietrafesa CA, Hoffman JR. Traumatic dislocation of the hip. Jama. 1983;249(24):3342-6.
• 22. Stewart MJ, McCarroll HR, Jr., Mulhollan JS. Fracture-dislocation of the hip. Acta orthopaedica Scandinavica. 1975;46(3):507-25.
• 23. Hougaard K, Thomsen PB. Traumatic posterior dislocation of the hip--prognostic factors influencing the incidence of avascular necrosis of the femoral head. Arch Orthop Trauma Surg. 1986;106(1):32-5.
• 24. Jaskulka RA, Fischer G, Fenzl G. Dislocation and fracture-dislocation of the hip. The Journal of bone and joint surgery British volume. 1991;73(3):465-9.
• 25. Elliott J, Ng de J, Tham SK. Chondrocyte apoptosis in response to dislocation of the hip in the rat model. ANZ journal of surgery. 2006;76(5):398-402.
• 26. D'Lima DD, Hashimoto S, Chen PC, Colwell CW, Jr., Lotz MK. Impact of mechanical trauma on matrix and cells. Clinical orthopaedics and related research. 2001(391 Suppl):S90-9.
• 27. D'Lima DD, Hashimoto S, Chen PC, Lotz MK, Colwell CW, Jr. Cartilage injury induces chondrocyte apoptosis. The Journal of bone and joint surgery American volume. 2001;83-A Suppl 2(Pt 1):19-21.
• 28. D'Lima DD, Hashimoto S, Chen PC, Lotz MK, Colwell CW, Jr. In vitro and in vivo models of cartilage injury. The Journal of bone and joint surgery American volume. 2001;83-A Suppl 2(Pt 1):22-4.
• 29. Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, et al. Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. Arthroscopy. 2011;27(11):1490-501.
• 30. Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010;38(2):255-62.