Comparison of platelet rich plasma and hyaluronic acid on tendon healing in rats

Tendon injuries are a common condition and the most important complications are adhesion and tendon rupture. However, new treatment options are being tested. This study aimed to demonstrate and compare the effectiveness of Platelet Rich Plasma (PRP) and Hyaluronic Acid (HA) applications on tendon healing macroscopically, histopathologically and biomechanically. Thirty-six Spraque Dawley male rats aged 6 month-old were used in the study. Primary tendon repair was performed with modified Kessler suture after complete incision in the achilles tendons under general anesthesia. The rats were randomly divided into 3 groups of 10. It was called the control (K) group and no medical procedure was performed. After the PRP group was repaired, 0.5 ml of PRP was applied as a single dose. 0.5 ml of HA was applied as a single dose to the subjects in the HA group. The remaining 6 rats were used as donors to obtain PRP. They were euthanized 6th weeks postoperatively. The obtained data were evaluated macroscopically, histopathologically and biomechanically. As a result of the evaluations, there was a statistically significant difference between the degree of macroscopic adhesion of the K, PRP, and HA group (p<0.05). There was no difference between the PRP and HA groups (p>0.05). There was a significant difference in the adhesion property between all the groups (p<0.05). Histopathological examinations showed that there was a statistically significant difference in fibrosis in all three groups (p<0.05). It was determined that the inflammation in the PRP group was statistically significant between the groups compared to the K and HA groups (p<0.05). In biomechanical examination, the statistical difference was significant in that the maximum strength was higher in the HA and PRP groups compared to the K group (p>0.05). Maximum mobility was statistically significant in the K group compared to the PRP and HA groups (p<0.05). There was no statistically significant difference between the PRP and HA groups (p˃0.05). In this study, PRP and HA applications created a good barrier for tendon healing and preventing adhesions, both treatment methods were effective, but the data obtained in our study could not reveal their superiority to each other. Keywords: tendon, healing, adhesion, PRP, hyaluronic acid, rat