The Effect of Autogenous Peritoneal Graft Augmented with Platelets- Plasma Rich Protein on the Healing of Induced Achilles Tendon Rupture, in Dogs

BACKGROUND: In dogs, Achilles tendon rupture is an important clinical issue. Treatment of the ruptured tendon remains a controversial problem. However, surgical intervention, by the using of different biological scaffolds, has been recognized as the most effective approach for the repair of such cases. OBJECTIVES: The current study aimed to evaluate the efficiency of platelets-plasma rich protein (PRP) and autogenous peritoneal scaffold to improve the healing process of ruptured Achilles tendon in dogs. METHODS: Eighteen healthy dogs of the local breed were randomly allocated into three equal groups. Achilles tendon of the hind limbs were prepared aseptically and transected transversely. In the control group, the tendon was reconstructed with the traditional suture using modified Kessler techniques. In the peritoneal scaffold group, a combination of traditional suture and the autogenous peritoneal scaffold was used to augment the defected tendon. In the peritoneal scaffold with the PRP group, the induced rupture was treated as similar to the peritoneal scaffold group and supported by a topical application of PRP. In addition to the gross observation, the healing process was evaluated with histopathological and sonographic investigations at 15, 30, and 60 days post-operative. RESULTS: By comparison with control, the utilizing of autologous peritoneum scaffold augmented with PRP revealed a valuable impact on Achilles tendon healing. This impact was manifested by improved fibroblastic proliferation, reduced adhesion, and improved mechanical function of the tendon. Also, the sonographic examination of the fibrosis site demonstrated the presence of hyperechoic spots. CONCLUSIONS: We concluded that utilizing both the peritoneal scaffold augmented and PRP along with the traditional suture revealed remarkable optimistic effects on healing of the ruptured Achilles tendon in dogs.