Purpose
To evaluate the chondrogenic potential of platelet concentrates on human subchondral
mesenchymal progenitor cells (MPCs) as assessed by histomorphometric analysis of proteoglycans
and type II collagen. Furthermore, the migratory and proliferative effect of platelet
concentrates were assessed.
Methods
Platelet-rich plasma (PRP) was prepared using preparation kits (Autologous Conditioned
Plasma [ACP] Kit [Arthrex, Naples, FL]; Regen ACR-C Kit [Regen Lab, Le Mont-Sur-Lausanne,
Switzerland]; and Dr.PRP Kit [Rmedica, Seoul, Republic of Korea]) by apheresis (PRP-A)
and by centrifugation (PRP-C). In contrast to clinical application, freeze-and-thaw
cycles were subsequently performed to activate platelets and to prevent medium coagulation
by residual fibrinogen in vitro. MPCs were harvested from the cortico-spongious bone
of femoral heads. Chondrogenic differentiation of MPCs was induced in high-density
pellet cultures and evaluated by histochemical staining of typical cartilage matrix
components. Migration of MPCs was assessed using a chemotaxis assay, and proliferation
activity was measured by DNA content.
Results
MPCs cultured in the presence of 5% ACP, Regen, or Dr.PRP formed fibrous tissue, whereas
MPCs stimulated with 5% PRP-A or PRP-C developed compact and dense cartilaginous tissue
rich in type II collagen and proteoglycans. All platelet concentrates significantly
(ACP, P = .00041; Regen, P = .00029; Dr.PRP, P = .00051; PRP-A, P < .0001; and PRP-C, P < .0001) stimulated migration of MPCs. All platelet concentrates but one (Dr.PRP,
P = .63) showed a proliferative effect on MPCs, as shown by significant increases (ACP,
P = .027; Regen, P = .0029; PRP-A, P = .00021; and PRP-C, P = .00069) in DNA content.
Conclusions
Platelet concentrates obtained by different preparation methods exhibit different
potentials to stimulate chondrogenic differentiation, migration, and proliferation
of MPCs. Platelet concentrates obtained by commercially available preparation kits
failed to induce chondrogenic differentiation of MPCs, whereas highly standardized
PRP preparations did induce such differentiation. These findings suggest differing
outcomes with PRP treatment in stem cell–based cartilage repair.
Clinical Relevance
Our findings may help to explain the variability of results in studies examining the
use of PRP clinically.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Autologous platelet-rich plasma promotes proliferation and chondrogenic differentiation of adipose-derived stem cells.Mol Med Rep. 2015; 11: 1298-1303
- Human platelet-rich plasma stimulates migration and chondrogenic differentiation of human subchondral progenitor cells.J Orthop Res. 2012; 30: 845-852
- Platelet-rich plasma therapy: A systematic literature review and evidence for clinical use.Phys Sportsmed. 2011; 39: 42-51
- Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: From early degeneration to osteoarthritis.Arthroscopy. 2011; 27: 1490-1501
- Platelet-rich plasma in patients with tibiofemoral cartilage degeneration.Arch Orthop Trauma Surg. 2013; 133: 1295-1301
- Cartilage repair in the knee with subchondral drilling augmented with a platelet-rich plasma-immersed polymer-based implant.Knee Surg Sports Traumatol Arthrosc. 2014; 22: 1225-1234
- Autologous matrix-induced chondrogenesis combined with platelet-rich plasma gel: Technical description and a five pilot patients report.Knee Surg Sports Traumatol Arthrosc. 2011; 19: 536-542
- PRP for the treatment of cartilage pathology.Open Orthop J. 2013; 7: 120-128
- Platelet-rich plasma differs according to preparation method and human variability.J Bone Joint Surg Am. 2012; 94: 308-316
- Characterization and comparison of 5 platelet-rich plasma preparations in a single-donor model.Arthroscopy. 2014; 30: 629-638
- Platelet and growth factor concentrations in activated platelet-rich plasma: A comparison of seven commercial separation systems.J Artif Organs. 2014; 17: 186-192
- Arthroscopic double row cuff repair with suture-bridging and autologous conditioned plasma injection: Functional and structural results.Int J Shoulder Surg. 2014; 8: 101-106
- Comparison of intra-articular injections of plasma rich in growth factors (PRGF-Endoret) versus Durolane hyaluronic acid in the treatment of patients with symptomatic osteoarthritis: A randomized controlled trial.Arthroscopy. 2013; 29: 1635-1643
Kaux JF, Croisier JL, Bruyere O, et al. One injection of platelet-rich plasma associated to a submaximal eccentric protocol to treat chronic jumper’s knee. J Sports Med Phys Fitness in press, available online 19 June, 2014.
- Growth factor levels in platelet-rich plasma and correlations with donor age, sex, and platelet count.J Craniomaxillofac Surg. 2002; 30: 97-102
- In vitro chondrogenesis of bone marrow-derived mesenchymal progenitor cells.Exp Cell Res. 1998; 238: 265-272
- Chondrogenic differentiation of human subchondral progenitor cells is impaired by rheumatoid arthritis synovial fluid.J Orthop Res. 2010; 28: 819-827
- Bioactive factors in platelet-rich plasma obtained by apheresis.Transfus Med Hemother. 2013; 40: 432-440
- Why normal distribution is normal?.Br J Philos Sci. 2013; 65: 1-29
- Platelet-rich plasma in the pathologic processes of cartilage: Review of basic science evidence.Arthroscopy. 2013; 29: 1399-1409
- The effect of platelet lysate supplementation of a dextran-based hydrogel on cartilage formation.Biomaterials. 2012; 33: 3651-3661
- Adult and umbilical cord blood-derived platelet-rich plasma for mesenchymal stem cell proliferation, chemotaxis, and cryo-preservation.Biomaterials. 2012; 33: 5308-5316
- Differential effect of platelet-rich plasma and fetal calf serum on bone marrow-derived human mesenchymal stromal cells expanded in vitro.J Tissue Eng Regen Med. 2011; 5: 648-654
- Partnership between platelet-rich plasma and mesenchymal stem cells: In vitro experience.Muscles Ligaments Tendons J. 2014; 4: 52-62
- “Humanized” stem cell culture techniques: The animal serum controversy.Stem Cells Int. 2011; 2011: 504723
Laudy AB, Bakker EW, Rekers M, Moen MH. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: A systematic review and meta-analysis. Br J Sports Med in press, available online 21 November, 2014. doi:10.1136/bjsports-2014-094036.
- Platelet-rich plasma: A milieu of bioactive factors.Arthroscopy. 2012; 28: 429-439
- Variability of platelet-rich plasma preparations.Sports Med Arthrosc. 2013; 21: 186-190
- Comparison of platelet-rich plasma formulations for cartilage healing: An in vitro study.J Bone Joint Surg Am. 2014; 96: 423-429
Article info
Publication history
Published online: May 13, 2015
Accepted:
March 19,
2015
Received:
September 3,
2014
Footnotes
Peter Cornelius Kreuz and Jan Philipp Krüger contributed equally.
The authors report the following potential conflict of interest or source of funding: J.P.K. receives support from TransTissue Technologies. German Federal Ministry of Education and Research (BMBF grant FKZ 01QE1314). U.F. receives support from TransTissue Technologies. Supported by Eurostars Program (German Federal Ministry of Education and Research, BMBF grant FKZ 01QE1314). M.E. receives support from TransTissue Technologies. Supported by Eurostars Program (German Federal Ministry of Education and Research, BMBF grant FKZ 01QE1314). Employee of TransTissue Technologies. A.P. receives support from German Heart Center. Advisory contract regarding pharmaceutical licenses. German Red Cross–Blood Donation Service. Lectures for leading physicians in transfusion services (Berlin Chamber of Physicians). W.P. receives support from Clinical Excellence Circle, Otto Bock Health Care, Karl Storz Endoscopy, and AAP Implants. C.K. receives support from TransTissue Technologies. Supported by Eurostars Program (German Federal Ministry of Education and Research, BMBF grant FKZ 01QE1314). Consultant of BioTissue. Employee of TransTissue Technologies.
Identification
Copyright
© 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
