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  • Comparative evaluation of MSCs from bone marrow and adipose tissue seeded in PRP-derived scaffold for cartilage regeneration

    Abstract

    The aims of this study were to (1) determine whether platelet-rich plasma (PRP) could be prepared as a bioactive scaffold capable of endogenous growth factor release for cartilage repair; (2) compare the chondrogenic differentiation ability of mesenchymal stem cells (MSCs) from bone marrow (BMSC) and from adipose (ADSC) seeded within the PRP scaffold; and (3) test the efficacy of ADSC-PRP construct in cartilage regeneration in

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  • Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis

    Abstract

    Background The effectiveness of platelet-rich plasma (PRP) injections for osteoarthritis (OA) is still controversial. We investigated the effect of PRP injections in patients with knee OA based on decreasing pain, improving function, global assessment and changes regarding joint imaging.

    Methods We performed a comprehensive, systematic literature search in computerised databases (MEDLINE, EMBASE, CINAHL, CENTRAL, Web of Science and PEDro) until June 2014 for randomised or non-randomised controlled trials. These were graded for risk of bias and a level of evidence was provided. If possible, meta-analysis was performed

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  • Role of platelet-rich plasma in articular cartilage lesions

    Articular cartilage has only a limited capacity of selfhealing. Once seriously damaged, articular cartilage lesions will not regenerate; and any joint surface damage,if left untreated, will invariably deteriorate and eventually spread to surrounding areas.1 The end result of such a process is often the development of osteoarthritis (OA),which often occurs in large load-bearing joints, such as knee and femoral joint. So much attention has been focused on how to eliminate symptoms, repair damaged cartilage,restore the integrity of the articular surface, prevent or halt joint degeneration, and improve joint function. But it still remains a challenging problem for orthopedic surgeons.In recent years, the role of growth factors (GFs) on tissue repair has become a hot research topic. The biological effect of GFs on cartilage repair has been well documentedin vivo and in vitro.2-4 At present, most GFs are obtained mainly through genetic engineering technology and extracted from the animals; the preparation process is cumbersome, expensive, and inconvenient.

    Articular cartilage has only a limited capacity of selfhealing. Once seriously damaged, articular cartilage lesions will not regenerate; and any joint surface damage, if left untreated, will invariably deteriorate and eventually spread to surrounding areas.1 The end result of such a process is often the development of osteoarthritis (OA), which often occurs in large load-bearing joints, such as knee and femoral joint. So much attention has been focused on how to eliminate symptoms, repair damaged cartilage, restore the integrity of the articular surface, prevent or halt joint degeneration, and improve joint function. But it still remains a challenging problem for orthopedic surgeons. In recent years, the role of growth factors (GFs) on tissue repair has become a hot research topic. The biological effect of GFs on cartilage repair has been well documented in vivo and in vitro.2-4 At present, most GFs are obtained mainly through genetic engineering technology and extracted from the animals; the preparation process is cumbersome, expensive, and inconvenient.

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  • Effect of two different preparations of platelet-rich plasma on synoviocytes

    Abstract

    Purpose: To analyse the modifications induced by two different platelet-rich plasma (PRP) preparations on osteoarthritis (OA) synoviocytes, by documenting changes in gene expression of factors involved in joint physiopathology.

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  • Platelet rich plasma enhances the immunohistochemical expression of platelet derived growth factor and vascular endothelial growth factor in the synovium of the meniscectomized rat models of osteoarthritis

    Abstract

    This study was carried out on a rat model of surgically-induced osteoarthritis (OA) to assess the histological and immunohistochemical changes in the synovial membrane and to evaluate the effects of intra-articular injection of platelet rich plasma (PRP) in such cases. Forty five male albino rats were divided into 3 equal groups; control, surgically-induced OA and surgically-induced OA followed by intra-articular injection of PRP. Knee joints were processed for histological and immunohistochemical staining with anti-platelet derived growth factor (PDGF-A) and anti-vascular endothelial growth factor (VEGF) and the area percentages of immunostaining were measured by digital image analysis. Serum levels of PDGF-A and VEGF were analyzed by ELISA. The osteoarthritis research society international (OARSI) score was significantly higher in OA (2433.8

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  • Effects of anti-aggregant, anti-inflammatory and anti-coagulant drug consumption on the preparation and therapeutic potential of plasma rich in growth factors (PRGF)

    Abstract

    The prevalence and incidence of trauma-related injuries, coronary heart disease and other chronic diseases increase dramatically with age. This population sector is therefore a regular consumer of different types of drugs that may affect platelet aggregation and the coagulation cascade. We have evaluated whether the consumption of acetylsalicylic acid, acenocoumarol, glucosamine sulfate and chondroitin sulfate, and therefore their presence in blood, could interfere with the preparation and biological outcomes of plasma rich in growth factors (PRGF). Clotting time, clot retraction and platelet activation of PRGF was evaluated. PRGF growth factor content and the release of different biomolecules by tendon fibroblasts were also quantified, as well as cell proliferation and cell migration. The preparation and biological potential of PRGF is not affected by the intake of the evaluated drugs, and solely its angiogenic potential and its capacity to induce HA and fibronectin synthesis, is reduced in patients taking anti-coagulants.

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  • USE OF PLATELET-RICH PLASMA INJECTION FOR THE TREATMENT OF CHRONIC PLANTAR FASCITIS

    Abstract

    Plantar fascitis is a common cause of heel pain and different treatment options exists. PRP (platelet rich plasma) derived from autologous blood containing high concentration of growth factors help in tissue healing. The use of PRP in the treatment of plantar fascitis is fairly recent an evolving concept. The purpose of our work was to study the effectiveness of PRP in the treatment of chronic plantar fascitis.

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  • Dwight Howard out indefinitely

    HOUSTON -- There is no timetable for Houston Rockets center Dwight Howard\'s return after he underwent platelet-rich plasma therapy to treat his strained right knee, coach Kevin McHale said before Saturday night\'s 95-92 win against the Dallas Mavericks.

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  • TGF-β1, GDF-5, and BMP-2 stimulation induces chondrogenesis in expanded human articular chondrocytes and marrow-derived stromal cells

    Replacement of degenerated cartilage with cell-based cartilage products may offer a long-term solution to halt arthritis\' degenerative progression. Chondrocytes are frequently employed in cell-based FDA-approved cartilage products, yet human marrow-derived stromal cells (hMSCs) show significant translational potential, reducing donor site morbidity and maintaining their undifferentiated phenotype with expansion. This study sought to investigate the effects of transforming growth factor β1 (TGF-β1), growth/differentiation factor 5 (GDF-5), and bone morphogenetic protein 2 (BMP-2) during post-expansion chondrogenesis in human articular chondrocytes (hACs) and to compare chondrogenesis in passaged hACs with that of passaged hMSCs. Through serial expansion, chondrocytes dedifferentiated, decreasing expression of chondrogenic genes while increasing expression of fibroblastic genes. However, following expansion, 10 ng/mL TGF-β1, 100 ng/mL GDF-5, or 100 ng/mL BMP-2 supplementation during three-dimensional aggregate culture each upregulated one or more markers of chondrogenic gene expression in both hACs and hMSCs. Additionally, in both cell types, the combination of TGF-β1, GDF-5, and BMP-2 induced the greatest upregulation of chondrogenic genes, i.e., Col2A1, Col2A1/Col1A1 ratio, SOX9, and ACAN, and synthesis of cartilage-specific matrix, i.e., glycosaminoglycans (GAGs) and ratio of collagen II/I. Finally, TGF-β1, GDF-5, and BMP-2 stimulation yielded mechanically robust cartilage rich in collagen II and GAGs in both cell types, following 4 wks maturation. The present study illustrates notable success in employing the self-assembling method to generate robust, scaffold-free neocartilage constructs using expanded human ACs and MSCs. Stem Cells 2014

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  • Cartilage Oligomeric Matrix Protein Gene Multilayers Inhibit Osteogenic Differentiation and Promote Chondrogenic Differentiation of Mesenchymal Stem Cells

    Abstract

    There are still many challenges to acquire the optimal integration of biomedical materials with the surrounding tissues. Gene coatings on the surface of biomaterials may offer an effective approach to solve the problem. In order to investigate the gene multilayers mediated differentiation of mesenchymal stem cells (MSCs), gene functionalized films of hyaluronic acid (HA) and lipid-DNA complex (LDc) encoding cartilage oligomeric matrix protein (COMP) were constructed in this study via the layer-by-layer self-assembly technique. Characterizations of the HA/DNA multilayered films indicated the successful build-up process. Cells could be directly transfected by gene films and a higher expression could be obtained with the increasing bilayer number. The multilayered films were stable for a long period and DNA could be easily released in an enzymatic condition. Real-time polymerase chain reaction (RT-PCR) assay presented significantly higher (p < 0.01) COMP expression of MSCs cultured with HA/COMP multilayered films. Compared with control groups, the osteogenic gene expression levels of MSCs with HA/COMP multilayered films were down-regulated while the chondrogenic gene expression levels were up-regulated. Similarly, the alkaline phosphatase (ALP) staining and Alizarin red S staining of MSCs with HA/COMP films were weakened while the alcian blue staining was enhanced. These results demonstrated that HA/COMP multilayered films could inhibit osteogenic differentiation and promote chondrogenic differentiation of MSCs, which might provide new insight for physiological ligament-bone healing.

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  • Simultaneous regeneration of full-thickness cartilage and subchondral bone defects in vivo using a three-dimensional scaffold-free autologous construct derived from high-density bone marrow-derived mesenchymal stem cells

    Abstract

    BackgroundIn recent years, several methods have been developed for repairing full-thickness cartilage defects by tissue engineering using mesenchymal stem cells. Most of these use scaffolds to achieve sufficient thickness. However, considering the potential influence of scaffolds on the surrounding microenvironment, as well as immunological issues, it is desirable to develop a scaffold-free technique. In this study, we developed a novel technique, a scaffold-free autologous construct derived from bone marrow-derived mesenchymal stem cells (BM-MSCs), and successfully use this technique to regenerate cartilage and subchondral bone to repair an osteochondral defect in rabbit knees.MethodsBM-MSCs were isolated from bone marrow liquid aspirated from the iliac crest of rabbits. After expansion in culture dishes and re-suspension in 96-well plates, the cells spontaneously aggregated into a spheroid-like structure. The spheroids were loaded into a tube-shaped Teflon mold with a 5-mm height and maintained under air-liquid interface conditions. These loaded spheroids fused with each other, resulting in a cylinder-shaped construct made of fused cells that conformed to the inner shape of the mold. The construct was implanted into an osteochondral defect in rabbit knees and histologically analyzed 24 and 52

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  • Platelet derived growth factor (PDGF) contained in Platelet Rich Plasma (PRP) stimulates migration of osteoblasts by reorganizing actin cytoskeleton

    Abstract

    Platelet-rich plasma (PRP) is a platelet concentrate in a small volume of plasma. It is highly enriched in growth factors able to stimulate the migration and growth of bone-forming cells. PRP is often used in clinical applications, as dental surgery and fracture healing. Platelet derived growth factor (PDGF), is highly concentrated in PRP and it was shown in our previous studies to provide the chemotactic stimulus to SaOS-2 osteoblasts to move in a microchemotaxis assay. Aim of the present studies is to analyze the effects of a PRP pretreatment (short time course: 30-150

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  • The Lipid Portion of Activated Platelet-Rich Plasma Significantly Contributes to Its Wound Healing Properties

    Abstract

    Objective: Platelet-rich plasma (PRP) is a popular choice for the treatment of chronic wounds. Current dogma attributes these healing properties to the peptide growth factors of PRP. However, PRP is also rich in bioactive lipids whose contribution to healing has not been characterized and warrants investigation due to the protease-rich environment of chronic wounds.

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  • The construction of PRP-containing nanofibrous scaffolds for controlled release and their application to cartilage regeneration

    Abstract

    Platelet-rich plasma (PRP) has been widely used for decades in the clinic, since an abundance of growth factors can be released when it is activated. However, its clinical use is limited because this release is temporal and PRP lacks mechanical strength. The aim of this study was to incorporate PRP-derived growth factors into PCL/gelatin nanofibers using the emulsion electrospinning method to determine how growth factors are released from the scaffolds and how the presence of these factors enhances the bioactivity of the scaffolds. Scaffolds with or without PRP were prepared and characterized. Release of proteins from scaffolds over time and rabbit BMSC chemotaxis, proliferation, and chondrogenic induction were quantified in vitro. The in vivo restoring effect of the scaffolds was also evaluated by transplanting the scaffolds into a cartilage defect in an animal model, and the outcomes were determined by histological assessment, micro-CT scanning, and IL-1 measurement. The results showed that the mechanical properties of the scaffolds were mildly compromised by the addition of PRP, and that sustained release of growth factors from PRP-containing scaffolds occurred up to ~ 30 days in culture. Scaffold bioactivity was enhanced, as BMSCs demonstrated increased proliferation and notable chemotaxis in the presence of PRP. The chondrogenesis of BMSCs was also promoted when the cells were cultured on the PRP scaffolds. Furthermore, the PRP scaffolds showed better restorative effects on cartilage defects, as well as anti-inflammatory effects in the joint cavity (the IL-1 level was decreased). In conclusion, the results of the current study indicate the potential for using a PRP-containing electrospun nanofibrous scaffold as a bioactive scaffold, which is beneficial for optimizing the clinical application of PRP.

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  • Mesenchymal stem cells as a potent cell source for articular cartilage regeneration

    Abstract

    Since articular cartilage possesses only a weak capacity for repair, its regeneration potential is considered one of the most important challenges for orthopedic surgeons. The treatment options, such as marrow stimulation techniques, fail to induce a repair tissue with the same functional and mechanical properties of native hyaline cartilage.

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  • Onlay Bone Graft Maintenance Using Guided Bone Regeneration, Platelet Rich Plasma, and Their Combination

    Abstract

    Onlay bone grafts have a bad reputation of resorption with loss of contour and volume. Rigid fixation reduces the incidence of resorption but does not prevent it. Literature shows reduction of resorption by applying guided bone regeneration (GBR) barriers and platelet-rich plasma (PRP). Investigating the effect of combining them together to reduce resorption was the aim of this study. This study included 4 groups: control group, GBR group, PRP group, and GBR + PRP group. Twenty rabbits were used (40 mandibular halves). Onlay bone grafts were fixed by titanium miniscrews in all groups. Computed tomography scans of harvested mandibles after euthanasia allowed calculations of bone graft volume and density. Onlay bone graft volumes in all experimental groups were significantly higher than in the control group. Volume maintenance in the GBR group was significantly higher than in the PRP group. There was no significant difference in the volume of onlay bone grafts between the group of combined GBR + PRP and GBR alone. It was concluded that, to maintain the volume of onlay bone grafts, either GBR or PRP can be added. Combining them did not add any advantage over the GBR alone.

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  • Gelatin hydrogel impregnated with platelet-rich plasma releasate promotes angiogenesis and wound healing in murine model

    Abstract

    Platelet-rich plasma (PRP) contains numerous growth factors to promote wound healing and angiogenesis. The objective of this study was to explore the efficacy of biodegradable gelatin hydrogel impregnated with PRP releasate (PRPr) in the wound healing process compared with the single application of PRPr prepared from mouse PRP centrifuged by a double-spin method. Gelatin hydrogel disks with an isoelectric point of 5.0 were used in this study. A total of 180 mice (n =

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  • Platelet-rich plasma: evidence for the treatment of patellar and Achilles tendinopathy-a systematic review

    Abstract

    Platelet-rich plasma (PRP) has been introduced in the clinical practice to treat a growing number of different musculoskeletal pathologies. It is currently applied in the treatment of Achilles and patellar tendinopathies, which are common sport-related injuries very challenging to manage. Aim of the present paper was to review systematically the available clinical evidence concerning the application of PRP in the treatment of patellar and Achilles tendinopathy. A systematic review of the literature was performed according to the following inclusion criteria for relevant articles: (1) clinical reports of any level of evidence, (2) written in the English language, (3) with no time limitation and (4) on the use of PRP to treat conservatively Achilles and patellar tendinopathy. Twenty-two studies were included and analyzed. Two studies on patellar tendinopathy were randomized controlled trials (RCTs), whereas just one RCT was published on Achilles tendon. All the papers concerning patellar tendon reported positive outcome for PRP, which proved to be superior to other traditional approaches such as shock-wave therapy and dry needling. In the case of Achilles tendon, despite the encouraging findings reported by case series, the only RCT available showed no significant clinical difference between PRP and saline solution. The main finding of this study was the paucity of high-level literature regarding the application of PRP in the management of patellar and Achilles tendinopathy. However, the clinical data currently available, although not univocal, suggest considering PRP as a therapeutic option for recalcitrant patellar and Achilles tendinopathies.

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  • Chronic neck pain: making the connection between capsular ligament laxity and cervical instability

    Abstract

    The use of conventional modalities for chronic neck pain remains debatable, primarily because most treatments have had limited success. We conducted a review of the literature published up to December 2013 on the diagnostic and treatment modalities of disorders related to chronic neck pain and concluded that, despite providing temporary relief of symptoms, these treatments do not address the specific problems of healing and are not likely to offer long-term cures. The objectives of this narrative review are to provide an overview of chronic neck pain as it relates to cervical instability, to describe the anatomical features of the cervical spine and the impact of capsular ligament laxity, to discuss the disorders causing chronic neck pain and their current treatments, and lastly, to present prolotherapy as a viable treatment option that heals injured ligaments, restores stability to the spine, and resolves chronic neck pain. The capsular ligaments are the main stabilizing structures of the facet joints in the cervical spine and have been implicated as a major source of chronic neck pain.

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  • Cartilage regeneration by chondrogenic induced adult stem cells in osteoarthritic sheep model

    Abstract

    OBJECTIVES: In this study, Adipose stem cells (ADSC) and bone marrow stem cells (BMSC), multipotent adult cells with the potentials for cartilage regenerations were induced to chondrogenic lineage and used for cartilage regenerations in surgically induced osteoarthritis in sheep model.

    METHODS: Osteoarthritis was induced at the right knee of sheep by complete resection of the anterior cruciate ligament and medial meniscus following a 3-weeks exercise regimen. Stem cells from experimental sheep were culture expanded and induced to chondrogenic lineage. Test sheep received a single dose of 2 ×— 10(7) autologous PKH26-labelled, chondrogenically induced ADSCs or BMSCs as 5 mls injection, while controls received 5 mls culture medium.

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