Men and Women Differ in the Biochemical Composition of Platelet-Rich Plasma

Abstract

Background: Autologous platelet-rich plasma (PRP) is widely used for a variety of clinical applications. However, clinical outcome studies have not consistently shown positive effects. The composition of PRP differs based on many factors. An improved understanding of factors influencing the composition of PRP is important for the optimization of PRP use.

Conclusion: This study in healthy patients shows differences in the composition of PRP between men and women, with sex being a greater factor than age. There was also proteomic variability within the groups. These data support a personalized approach to PRP treatment and highlight the need for a greater understanding of the relationships between proteomic factors in PRP and clinical outcomes.

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The use of lumbar epidural injection of platelet lysate for treatment of radicular pain

Abstract

Background: Epidural steroid injections (ESI) are the most common pain management procedure performed in the US, however evidence of efficacy is limited. In addition, there is early evidence that the high dose of corticosteroids used can have systemic side effects. We describe the results of a case series evaluating the use of platelet lysate (PL) epidural injections for the treatment of lumbar radicular pain as an alternative to corticosteroids.

Methods: Registry data was obtained for patients (N = 470) treated with PL epidural injections presenting with symptoms of lumbar radicular pain and MRI findings that were consistent with symptoms. Collected outcomes included numeric pain score (NPS), functional rating index (FRI), and a modified single assessment numeric evaluation (SANE) rating.

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Role of leukocyte free platelet rich plasma in planter fasciitis: a prospective study

Abstract

Background: Planter fasciitis, is by definition, inflammation of planter fascia. Most of the cases are well treated conservatively and a few responds to surgery only. Objectives of present study were evaluating the efficacy of a single injection of leukocyte free platelet rich plasma in plantar fasciitis and to derive a correlation between the clinical and radiological outcome.

Methods: The present study consisted of 120 patients of bilateral (PF), (240 feet). These patients were divided into two groups PRP group of 60 patients and Placebo group of 60 patients. The study was conducted on patients attending Orthopaedics outpatient department Post Graduate Institute of Medial Education and Research (PGIMER) from July 2011 to June 2012. A primary efficacy criterion was changes from baseline in pain using (VAS). Functional results, level of satisfaction and outcome were measured by – AOFAS Foot Scale. Correlation of clinical with radiological outcome were performed.

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Efficacy Of Platelet Rich Plasma Versus Teroid Injection In Planter Fasciitis

Abstract

Background: Plantar fasciitis is local inflammation and fibrosis of the plantar aponeuroses reducing the quality of life and productivity of affected individuals. Pain in the heel and bottom of the foot is the
ultimate outcome

Objectives: To compare the effect of platelet rich plasma and steroid injections among
patients having planter fasciitis.

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Platelet Rich Plasma Supports Proliferation and Re-differentiation of Chondrocytes during In Vitro Expansion

Abstract

Articular cartilage regeneration is insufficient to restore sports injuries or defects that can occur from trauma. Treatment options for cartilage repair include autologous chondrocyte implantation (ACI) by isolation, expansion, and reimplantation of healthy donor chondrocytes. Chondrocyte expansion onto 2D substrates leads to dedifferentiation and loss of the cellular phenotype. We aimed to overcome the state of dedifferentiation by biochemical stimuli with platelet derivatives such as platelet rich plasma (PRP) and hyper acute serum (HAS) to achieve sufficient cell numbers in combination with variable oxygen tension. Human articular chondrocytes from osteoarthritic (OA) cartilage chondrocytes were switched from 10% FCS supplementation to either 10% PRP or 10% HAS after initial passaging for further experiments under normoxic (20%O2) or hypoxic (1%O2) conditions.

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Dr Weglein with Dr Stan lam in Hong Kong

Dr weglein with Dr Stan Image

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Platelet-rich plasma versus hyaluronic acid to treat tendinopathies

Abstract

Introduction: The treatment of patellar tendinopathies could be difficult. This is the reason why new treatments have been developed, among which platelet rich plasma (PRP) injections. Some clinical series have previously evaluated the effect of PRP in the treatment of proximal patellar tendinopathies. Recent systematic review concluded that PRP could be recommend as a treatment in such indication (1). Recently, the viscoelastic properties of hyaluronic acid (HA) on liquid connective tissue have been proposed for the treatment of tendinopathies (2). Some fundamental studies show encouraging results on HA’s ability to promote tendon gliding and reduce adhesion as well as to improve tendon architectural organisation. Some observations also support its use in a clinical setting to improve pain and function.

Purpose: We aimed to compare the effect of PRP injection versus two injections of HA after three months on patients who have a proximal patellar tendinopathy.

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Efficacy of platelet-rich plasma injections for symptomatic tendinopathy: systematic review and meta-analysis of randomised injection-controlled trials

Abstract

Aim To determine the efficacy of platelet-rich plasma (PRP) injections for symptomatic tendinopathy.

Results: A total of 16 randomised controlled trials (18 groups) of PRP versus control were included. Median sample size was 35 patients, a study size that would require an effect size ≥1.0 to achieve statistical significance. PRP was more efficacious than control in reducing tendinopathy pain, with an effect size of 0.47 (95% CI 0.22 to 0.72, p<0.001), signifying a moderate treatment effect. Heterogeneity among studies was moderate (I2=67%, p<0.001). In subgroup analysis and meta-regression, studies with a higher proportion of female patients were associated with greater treatment benefits with PRP.

Conclusions: Injection of PRP is more efficacious than control injections in patients with symptomatic tendinopathy.

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Hydrodissection of an Achilles Tendinopathy on a Professional Athlete

Abstract

We report a case of Achilles tendinosis that was treated with a high volume, hydrodissection visualized by conventional B-mode ultrasound. Prior MRI revealed a thickened right Achilles tendon with a small defect. Ultrasound examination showed a thickened Achilles tendon with physical exam revealing a prominent Haglund’s deformity, mild fusiform swelling and pain along the posterior Achilles (Figure 1 & 2). The condition had been poorly responsive to standard management including protected ambulation in a cam walker boot, anti-inflammatory medication, modalities and therapeutic exercise, as well as a platelet rich plasma injection. We suggest using high volume ultrasound guided injection adjacent to (anterior to) the Achilles tendon as an adjunct to treat this difficult clinical syndrome.

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Platelet rich plasma – A new revolution in medicine

Abstract

In the recent years there has been a paradigm shift in consideration of platelets from being just hemostatic cells to actually performing a myrad of diverse functions. The recent use of Platelet Rich Plasma as therapeutic agent is based on its growth factor content and the matrix provided by the platelets themselves. An overview of PRP, its uses in the field of medicine is provided for correct understanding of PRP therapy. Standardization of preparation and administration also remains a challenge due to various variables present. How beneficial are these individually tailored protocols, still remains to be seen.

Blood is mainly liquid plasma containing small solid components such as RBC, WBC and platelets. Platelets contain different growth factors and cytokines contributing to haemostasis and capable of stimulating healing of both bone and soft tissue.

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