Ak. Letson et Le. Dahners, THE EFFECT OF COMBINATIONS OF GROWTH-FACTORS ON LIGAMENT HEALING, Clinical orthopaedics and related research, (308), 1994, pp. 207-212
Platelet-derived growth factor, basic fibroblast growth factor, and in
sulin-like growth factor Type 1 have demonstrated chemotactic and mito
genic properties in vitro that could benefit healing ligaments. These
growth factors also have demonstrated in vivo effects when used in ski
n wound-healing models. In a previous study, bFGF and IGF-1, used alon
e, failed to improve healing. The authors wished to test the hypothesi
s that platelet-derived growth factor alone or combinations of platele
t-derived growth factor plus insulin-like growth factor Type 1, platel
et-derived growth factor plus basic fibroblast growth factor, or basic
fibroblast growth factor plus insulinlike growth factor Type 1 would
increase the healing efficiency of ligaments because of their effects
on different parts of the cell replication cycle and their abilities t
o induce chemotaxis. Ligaments receiving platelet-derived growth facto
r alone were 73% +/- 55% stronger than their contralateral internal co
ntrols (p < 0.0025). Stiffness increased 94% +/- 63% over controls (p
< 0.0025), and breaking energy was 101% +/- 104% > controls (p < 0.1).
Ligaments treated with a combination of platelet-derived growth facto
r plus insulin-like growth factor Type 1 and platelet-derived growth f
actor plus basic fibroblast growth factor also had increases in ruptur
e force, stiffness, and breaking energy over internal controls. Ligame
nts treated with a combination of basic fibroblast growth factor plus
insulin-like growth. factor Type 1 also appeared to have some improved
healing; the results, however) did not prove to be statistically sign
ificant. Synergistic effects of growth factor combinations were not ev
ident.