Tendon iyileşmesinde plateletten zengin plazma ve düşükyoğunluklu pulse ultrason tedavilerinin etkinliği: Deneysel çalışma
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: PRP ve LIPUS tedavilerinin tendon iyileşmesi üzerinde etkili olduğu bilinmektedir.
Bu çalışmada birlikte kullanıldığında tendon iyileşmesi üzerinde sinerjik bir etki
oluşturabileceği düşünülen PRP ve LIPUS tedavilerinin onarılmış sıçan aşil tendonları
üzerinde etkinliğinin değerlendirilmesi amaçlandı.
Yöntem: Otuz iki adet Wistar Albino sıçan randomize olarak 4 eş gruba ayrıldı (kontrol
grubu, PRP grubu, LIPUS grubu, PRP + LIPUS grubu). Tüm gruplarda sıçanların her iki aşil
tendonları kesilip aynı seansta tekrar onarıldı. Onarım sonrası (0. gün) PRP tedavi gruplarına
(PRP ve PRP + LIPUS grupları) kan merkezinde hazırlanan havuzlanmış trombositlerden
elde edilen 0.1 cc PRP operasyon bölgesine enjekte edildi. PRP enjeksiyonu 14. ve 28.
günlerde PRP tedavi gruplarında tekrarlandı. LIPUS tedavi gruplarına (LIPUS ve PRP +
LIPUS grupları) onarım sonrası 7. günde başlamak üzere haftada 5 seans, toplam 10 seans,
1 Mhz frekansta, günlük 5 dakika süreyle, %50 pulse modda, 0.5 w/cm² yoğunlukta ultrason
tedavisi etkin ışınım alanı 1 cm olan prob ile uygulandı. 8. haftada her sıçanın randomize
edilen bir bacağında biyomekanik, diğer bacağında histopatolojik inceleme yapılmak üzere
örnekler alındıktan sonra tüm hayvanlar sakrifiye edildi. Örnekler alınmadan önce Tang ve
ark. tanımladığı makroskopik adezyon kriterlerine göre adezyon değerlendirildi. Tendon
örnekleri biyomekanik olarak maksimum kopma kuvveti (N) ve maksimum gerilme miktarı
(mm) açısından, histopatolojik olarak ise enflamasyon şiddeti, vaskülarizasyon, tenosit
sınıflaması ve müsin birikimi açısından değerlendirildi.
Bulgular: Makroskopik adezyonun derecesi değerlendirildiğinde kontrol grubunda orta ve
ileri derecede adezyonun olduğu görülürken, PRP + LIPUS grubunun tamamında adezyonun
hafif derecede olduğu, PRP ve LIPUS gruplarında ise adezyonun hafif ve orta derecede
olduğu görüldü. Adezyon derecesi açısından kontrol grubunun diğer gruplarla
Objective: PRP and LIPUS treatments are known to be effective on tendon healing. In this study, it was aimed to evaluate the effectiveness of PRP and LIPUS treatments, which are thought to have a synergistic effect on tendon healing when used together, on repaired rat achilles tendons. Methods: Thirty two Wistar albino rats were equally and randomly divided into four groups (control group, PRP group, LIPUS group, PRP + LIPUS group). In all groups, both achilles tendons of the rats were cut and repaired in the same session. After the repair (day 0), 0.1 cc PRP obtained from pooled platelets prepared in the blood center was injected into the operation area to the PRP treatment groups (PRP and PRP + LIPUS groups). PRP injection was repeated in PRP treatment groups on the 14th and 28th days. Ultrasound treatment for LIPUS treatment groups (LIPUS and PRP + LIPUS groups), starting on the 7th day after the repair, 5 sessions per week, 10 sessions in total, at a frequency of 1 Mhz, for 5 minutes daily, in 50% pulse mode, at 0.5 w / cm² intensity, was applied with a probe with an effective radiation area of 1 cm. At 8 weeks, all animals were sacrificed after samples were taken randomly for biomechanical examination in one leg and histopathological examination in other leg of each rat. Before the samples were taken, adhesion was evaluated according to the macroscopic adhesion criteria defined by Tang et al. Tendon specimens were evaluated biomechanically in terms of maximum tensile strength (N) and maximum stretching amount (mm), and histopathologically in terms of inflammation severity, vascularization, tenocyte classification and mucin deposition. Results: When the degree of macroscopic adhesion was evaluated, while it was seen that there was moderate and severe adhesion in the control group, there was mild adhesion in the entire PRP + LIPUS group, and there was mild and moderate adhesion in the PRP and LIPUS vii groups. The difference was found to be statistically significant when comparing the control group with other groups in terms of adhesion degree (Control x PRP p = 0.014, Control x LIPUS p <0.0001, Control x PRP + LIPUS p <0.0001). Biomechanical analysis showed that the mean of maximum tensile strength and maximum stretching amount was significantly higher in LIPUS (69,42 N-17,53 mm) and PRP + LIPUS (69,24 N-17,48 mm) groups compared to the control (50,61 N-12,02 mm) and PRP (54,38 N-13,73 mm) groups, but the difference between the groups was not statistically significant. In histopathological examinations; there was no statistically significant difference between the groups in terms of inflammation severity, tenocyte classification and vascularization. No mucin deposition was seen in any sample. Conclusion: As a result of our study, it was observed that only LIPUS or PRP + LIPUS applications had positive effects in terms of adhesion formation on tendon healing in rats, but a positive effect was not shown in terms of biomechanics and histopathology.
Objective: PRP and LIPUS treatments are known to be effective on tendon healing. In this study, it was aimed to evaluate the effectiveness of PRP and LIPUS treatments, which are thought to have a synergistic effect on tendon healing when used together, on repaired rat achilles tendons. Methods: Thirty two Wistar albino rats were equally and randomly divided into four groups (control group, PRP group, LIPUS group, PRP + LIPUS group). In all groups, both achilles tendons of the rats were cut and repaired in the same session. After the repair (day 0), 0.1 cc PRP obtained from pooled platelets prepared in the blood center was injected into the operation area to the PRP treatment groups (PRP and PRP + LIPUS groups). PRP injection was repeated in PRP treatment groups on the 14th and 28th days. Ultrasound treatment for LIPUS treatment groups (LIPUS and PRP + LIPUS groups), starting on the 7th day after the repair, 5 sessions per week, 10 sessions in total, at a frequency of 1 Mhz, for 5 minutes daily, in 50% pulse mode, at 0.5 w / cm² intensity, was applied with a probe with an effective radiation area of 1 cm. At 8 weeks, all animals were sacrificed after samples were taken randomly for biomechanical examination in one leg and histopathological examination in other leg of each rat. Before the samples were taken, adhesion was evaluated according to the macroscopic adhesion criteria defined by Tang et al. Tendon specimens were evaluated biomechanically in terms of maximum tensile strength (N) and maximum stretching amount (mm), and histopathologically in terms of inflammation severity, vascularization, tenocyte classification and mucin deposition. Results: When the degree of macroscopic adhesion was evaluated, while it was seen that there was moderate and severe adhesion in the control group, there was mild adhesion in the entire PRP + LIPUS group, and there was mild and moderate adhesion in the PRP and LIPUS vii groups. The difference was found to be statistically significant when comparing the control group with other groups in terms of adhesion degree (Control x PRP p = 0.014, Control x LIPUS p <0.0001, Control x PRP + LIPUS p <0.0001). Biomechanical analysis showed that the mean of maximum tensile strength and maximum stretching amount was significantly higher in LIPUS (69,42 N-17,53 mm) and PRP + LIPUS (69,24 N-17,48 mm) groups compared to the control (50,61 N-12,02 mm) and PRP (54,38 N-13,73 mm) groups, but the difference between the groups was not statistically significant. In histopathological examinations; there was no statistically significant difference between the groups in terms of inflammation severity, tenocyte classification and vascularization. No mucin deposition was seen in any sample. Conclusion: As a result of our study, it was observed that only LIPUS or PRP + LIPUS applications had positive effects in terms of adhesion formation on tendon healing in rats, but a positive effect was not shown in terms of biomechanics and histopathology.
Açıklama
Anahtar Kelimeler
Tendon, Düşük yoğunluklu pulse ultrason, Plateletten zengin plazma, Tendon, Low intensity pulsed ultrasound, Platelet rich plasma
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Yarar, B. K. (2021). Tendon iyileşmesinde plateletten zengin plazma ve düşükyoğunluklu pulse ultrason tedavilerinin etkinliği: Deneysel çalışma. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Fizik Tedavi ve Rehabilitasyon Anabilim Dalı, Konya.
