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Successful Treatment of Athletic Pubalgia in a Lacrosse Player with Ultrasound-Guided Needle Tenotomy and Platelet Rich Plasma Injection: A Case Report
Posted in: General | Posted on: 31-Aug-2014
Abstract
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Athletic pubalgia is a syndrome of persistent groin pain due to chronic, repetitive trauma or stress involving the pelvic joints and many musculotendinous structures that cross the anterior pelvis. As a result, the differential diagnosis can be complex, but insertional tendinopathies are the most common. This case report describes a novel approach to the treatment of distal rectus abdominis tendinopathies with ultrasound-guided needle tenotomy and platelet rich plasma (PRP) injection. Following injection, the patient returned to pain-free play at his previous level of intensity. This suggests PRP may be a useful treatment for this diagnosis.
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Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: a double-blind randomized clinical trial
Posted in: General | Posted on: 28-Aug-2014
Abstract
PURPOSE: To compare the advantages of prolotherapy in the treatment of first carpometacarpal osteoarthritis (OA) with those of corticosteroid local injection in the short and long term.
METHODS: We performed a randomized controlled trial from March 2010 to March 2011 in an outpatient clinic at a university hospital. Sixty participants (60 hands) with OA of the first carpometacarpal joint were assigned equally to two groups. For the corticosteroid group, after 2 monthly saline placebo injections, a single dose of 40
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Using nitric oxide to treat tendinopathy
Posted in: General | Posted on: 21-Aug-2014
Abstract
Nitric oxide (NO) is a small free radical generated by a family of enzymes, the nitric oxide synthases (NOSs). Following injury to a tendon, NO is induced by all three isoforms of NOS and NOS activity is also upregulated in tendinopathy. In animal models when NOS activity is inhibited by competitive inhibitors of NOS, tendon healing is reduced. When additional NO is added, tendon healing is enhanced. In humans, in three randomised clinical trials, we have shown that NO delivered via a transdermal patch enhances the subjective and objective recovery of patients with tennis elbow, Achilles tendinosis and supraspinatus tendinosis.
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Comparison of Postinjection Protocols After Intratendinous Achilles Platelet-rich Plasma Injections: A Cadaveric Study
Posted in: General | Posted on: 17-Aug-2014
Abstract
The purpose of the present investigation was to evaluate the distribution of intratendinous injected platelet-rich plasma (PRP) after 15 minutes of prone resting versus immediate manipulation simulating weightbearing. Ten cadaveric lower limbs were injected under ultrasound guidance with PRP dyed with India blue ink. The dyed PRP was injected into the mid-portion of the Achilles tendon, after which 5 specimens were placed in the prone position for 15
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Comparison of mesenchymal stem cells from bone marrow and adipose tissue for bone regeneration in a critical size defect of the sheep tibia and the influence of platelet-rich plasma.
Posted in: General | Posted on: 17-Aug-2014
Abstract
Aim of the present study was to compare the osteogenic potential of bone marrow derived mesenchymal stem cells (BMSC) and adipose-tissue derived stem cells (ASC) and to evaluate the influence of platelet-rich plasma (PRP) on the osteogenic capacity of ASC in a large animal model. Ovine BMSC (BMSC-group) and ASC (ASC-group) were seeded on mineralized collagen sponges and implanted into a critical size defect of the sheep tibia (n=5 each). In an additional group, platelet-rich plasma (PRP) was used in combination with ASC (PRP-group). Unloaded mineralized collagen (EMPTY-group) served as control (n=5 each). Radiographic evaluation was performed every 2 weeks, after 26 weeks histological analysis was performed. Radiographic evaluation revealed a significantly higher amount of newly formed bone in the BMSC-group compared to the ASC-group at week 10 and compared to EMPTY-group from week 12 (all p<0.05). A superiority on radiographic level concerning bone formation of the PRP-group versus the empty control group was found (p<0.05), but not for the ASC-group. Histological analysis confirmed radiographic evaluation finding analogous significances. In conclusion, ASC seem to be inferior to BMSC in terms of their osteogenic potential but that can partially be compensated by the addition of PRP.
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Platelet-rich plasma affects bacterial growth in vitro
Posted in: General | Posted on: 12-Aug-2014
Abstract
Background aims
Platelet-rich plasma (PRP), a blood derivative rich in platelets, is a relatively new technique used in tissue regeneration and engineering. The increased quantity of platelets makes this formulation of considerable value for their role in tissue healing and microbicidal activity. This activity was investigated against five of the most important strains involved in nosocomial infections (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae and Streptococcus faecalis) to understand the prophylactic role of pure (P)-PRP. Microbicidal proteins released from activated P-PRP platelets were also determined.
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Increased growth factors play a role in wound healing promoted by noninvasive oxygen-ozone therapy in diabetic patients with foot ulcers
Posted in: General | Posted on: 10-Aug-2014
Abstract
Management of diabetic foot ulcers (DFUs) is a great challenge for clinicians. Although the oxygen-ozone treatment improves the diabetic outcome, there are few clinical trials to verify the efficacy and illuminate the underlying mechanisms of oxygen-ozone treatment on DFUs. In the present study, a total of 50 type 2 diabetic patients complicated with DFUs, Wagner stage 2~4, were randomized into control group treated by standard therapy only and ozone group treated by standard therapy plus oxygen-ozone treatment. The therapeutic effects were graded into 4 levels from grade 0 (no change) to grade 3 (wound healing). The wound sizes were measured at baseline and day 20, respectively. Tissue biopsies were performed at baseline and day 11. The expressions of vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), and platelet-derived growth factor (PDGF) proteins in the pathologic specimens were determined by immunohistochemical examinations. The effective rate of ozone group was significantly higher than that of control group (92% versus 64%, P < 0.05). The wound size reduction was significantly more in ozone group than in control group (P < 0.001). After treatment, the expressions of VEGF, TGF-β, and PDGF proteins at day 11 were significantly higher in ozone group than in control group. Ozone therapy promotes the wound healing of DFUs via potential induction of VEGF, TGF-β, and PDGF at early stage of the treatment. (Clinical trial registry number is ChiCTR-TRC-14004415).
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Bacteriostatic effect of equine pure platelet-rich plasma and other blood products against methicillin-sensitive Staphylococcus aureus
Posted in: General | Posted on: 10-Aug-2014
Summary
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Objectives: 1) To evaluate the bacteriostatic in vitro effect of pure platelet-rich plasma (P-PRP), pure platelet-rich gel (P-PRG), leukocyte-poor gel (LPG), platelet-poor plasma (PPP), and heat inactivated plasma (IP) against methicillin-sensitive Staphylococcus aureus (MSSA) over a period of 24 hours. 2) To determine the degradation of platelet factor-4 (PF-4), transforming growth factor beta 1 (TGF-β1), and platelet-derived growth factor isoform BB (PDGF-BB) in these equine blood components. 3) To establish correlations between platelet and leukocyte counts, PF-4 concentrations, and MSSA growth. Methods: Fourteen horses were used. Blood components were obtained by a manual protocol. Every blood component was mixed with MSSA and M×¼ller-Hinton Broth and cultured at 37 °C for 24 hours. Samples for the determination of bacterial growth (colony-forming units) and PF-4, TGF-β1 and PDGF-BB concentrations were taken at one, four, eight, 12 and 24 hours. Results: The bacterial growth was significantly (p = 0.01) inhibited for P-PRP, P-PRG, LPG and PPP in comparison with IP and, the positive control group during the first 12 hours. The P-PRG had higher and sustained TGF-β1 and PDGF-BB concentrations over time in comparison with the other blood components. Clinical significance: The plasma complement could be one of the most responsible components of the in vitro bacteriostatic effect of P-PRP, P-PRG, LPG and PPP against MSSA. Additionally, P-PRG was the better biomaterial because it had an acceptable bacteriostatic effect and the highest concentration of growth factors.
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Comparison of Platelet-Rich Plasma Formulations for Cartilage Healing
Posted in: General | Posted on: 05-Aug-2014
Platelet-rich plasma (PRP) has been advocated as one treatment for cartilage tissue regeneration. To date, several different platelet-rich formulations have been available, but a deep knowledge of their composition and mechanism of action in a specific clinical use is needed. The aim of this study was to investigate the effect of various PRP formulations on human chondrocytes in vitro.
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Three-Dimensional Culture Environment Increases the Efficacy of Platelet Rich Plasma Releasate in Prompting Skin Fibroblast Differentiation and Extracellular Matrix Formation
Posted in: General | Posted on: 04-Aug-2014
Abstract
Platelet rich plasma clot- releasate (PRCR) shows significant influence on tissue regeneration in clinical trials. Although, the mechanism of PRCR effect on fibroblast differentiation has been studied on 2D culture system, a detailed investigation is needed to establish the role of PRCR in cell seeded in 3D scaffolds. Therefore, a study was conducted to evaluate the influence of PRCR in fibroblasts (DFB) differentiation and extracellular matrix formation on both 3D and 2D culture systems. Cell viability was measured using MTT assay and DFB differentiation was evaluated by determining the expression levels of nucleostamin and alpha smooth muscle actin (α-SMA), using indirect immunostaining and Western blotting. The expression levels of extracellular matrix genes (collagen-I, collagen-III, fibronectin and laminin) and focal adhesion formation gene (integrin beta-1) were measured using Real-time PCR. The PRCR at 10% showed significant effect on cells viability compared with 5% and 20% in both culture environments. The decrease in the expression levels of nucleostamin and the increase in α-SMA signify the DFB differentiation to myofibroblast-like cells that was prominently greater in 3D compared to 2D culture. In 3D culture systems, the total collage production, expression levels of the extracellular matrix gene and the focal adhesion gene were increased significantly compared to 2D culture. In conclusion, 3D culture environments enhances the proliferative and differentiation effects of PRCR on DFB, thereby potentially increases the efficacy of DFB for future tissue engineering clinical application.
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Comparison of short-term results of intraarticular platelet-rich plasma (PRP) and hyaluronic acid treatments in early-stage gonarthrosis patients
Posted in: General | Posted on: 04-Aug-2014
Abstract
The present study aimed to compare short-term clinical outcomes between intraarticular platelet-rich plasma (PRP) and hyaluronic acid (HA) treatments in early-stage gonarthrosis patients. Data of gonarthrosis patients, who were stage 1 or stage 2 according to Kellgren-Lawrence classification and underwent intraarticular PRP or HA treatment, were obtained retrospectively. The patients received treatment for three times at one-week intervals (intraarticular PRP or HA). They were evaluated using the Knee Society's Knee Scoring System (KSS) and the visual analog scale (VAS) scoring system before treatment and at the second and sixth months of treatment. The study included 132 patients (mean age, 55.06
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Platelet-Rich Plasma Injections for the Treatment of Hamstring Injuries A Randomized Controlled Trial
Posted in: General | Posted on: 03-Aug-2014
Abstract
Background: A hamstring injury is one of the most common types of injury affecting athletes. Despite this, the optimal management of hamstring muscle injuries is not yet defined. The effect of autologous platelet-rich plasma (PRP) therapy on the recovery of hamstring injuries is unclear.
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Purpose: To investigate the effect of a single PRP injection in the treatment of grade 2 hamstring muscle injuries.
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Study Design: Randomized controlled trial; Level of evidence, 2.
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Whey protein could help diabetics
Posted in: General | Posted on: 28-Jul-2014
Consuming whey protein - a popular protein among sportsmen who want to build muscle - before a regular breakfast reduces the blood sugar "spikes" common after meals rich in carbohydrates.
It also is believed by Israeli and other researchers in an Israeli-Swedish study to improve the body's insulin response. The research was conducted by Prof. Daniela Jakubowicz and Dr. Julio Wainstein at Wolfson Medical Center in Holon, Prof. Oren Froy of the Hebrew University of Jerusalem, Prof. Bo Ahrשn of Lund University and colleagues.
It was recently published in Diabetologia, the journal of the European Association for the Study of Diabetes.
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Clinical Applications of Platelet-Rich Plasma in Patellar Tendinopathy
Posted in: General | Posted on: 27-Jul-2014
Introduction
Platelet-rich plasma (PRP) is prepared by centrifuging anticoagulated whole blood obtained by phlebotomy.Therefore,it contains a hyperphysiological concentration of autologous platelets, 3-8 times the concentration of platelets in whole blood [1]. However, the exact definition of PRP has not been determined in terms of the concentration of platelet, and most published reports differ on PRP concentrations [2].
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Does Platelet-Rich Plasma Freeze-Thawing Influence Growth Factor Release and Their Effects on Chondrocytes and Synoviocytes?
Posted in: General | Posted on: 21-Jul-2014
Introduction
The use of platelet concentrates is becoming very popular in the field ofmusculoskeletal tissue regeneration.Awidespread interest has been shown for platelet-rich plasma (PRP) as an injective treatment or as a surgical augmentation procedure of several tissues [7]. These molecules bind to the transmembrane receptors of their target cells regulating cell signaling pathways [1, 7, 8]. Alpha-granules also contain cytokines, chemokines, and many other bioactive proteins that stimulate chemotaxis, cell proliferation, and maturation, modulate inflammatory molecules, and attract leukocytes [8].
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The effect of platelet-rich plasma injections in the non-surgical treatment of a partial rotator cuff tear
Posted in: General | Posted on: 09-Jul-2014
Introduction: Rotator cuff tears are associated with significant morbidity and have a reported incidence of greater than 50% amongst the adult population. We present a case report of a partial rotator cuff tear treated with platelet-rich plasma injections.
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Case Report: A 60-year-old female was presented with a partial supraspinatus tear having failed to improve with physiotherapy. The patient underwent a course of three platelet-rich plasma injections to her tear. Patient outcome was measured using the numerical pain rating scale (NPRS), percentage perceived improvement (PPI) and also a handheld dynamometer assessment of rotator cuff strength. Repeat ultrasound examination was performed. The patient reported improvements in pain as measured by NPRS and PPI, though maximal improvement was not maintained through to final data collection at 52nd week. Dynamometer follow-up showed improvement in strength. Ultrasound at 52nd week showed evidence of ingrowth of tissue though this did not resemble normal tendon. The patient noted increased pain post her second platelet-rich plasma injection though this was self-limiting and managed with simple analgesia.
Conclusion: In this case report, platelet-rich plasma injections for the treatment of a partial rotator cuff tear resulted in improvement in all recorded outcome measures. This highlights the need for more formal controlled trials to determine the use of platelet-rich plasma in the treatment of rotator cuff pathology.
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Efficacy and Safety of Plasma Rich in Growth Factors Intra-Articular Infiltrations in the Treatment of Knee Osteoarthritis
Posted in: General | Posted on: 07-Jul-2014
Purpose
The goal of this study was to systematically review the efficacy and safety of plasma rich in growth factors (PRGF) as a treatment for reducing symptoms in patients with knee osteoarthritis.
Methods
A comprehensive and systematic literature search was conducted for PRGF treatment of knee osteoarthritis following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. All the studies had to include a PRGF group and a control group. Pre- and post-treatment measures of joint pain, reduced function, and stiffness were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index, Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee score, Lequesne index, or number of Outcome Measures for Rheumatology Committee and Osteoarthritis Research Society International Standing Committee for Clinical Trials Response Criteria Initiative (OMERACT-OARSI) responders, with a follow-up period of at least 4 weeks. An assessment of both the quality and risk of bias of the studies was conducted.
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Platelet-rich plasma injections for the treatment of refractory Achilles tendinopathy: results at 4 years
Posted in: General | Posted on: 29-Jun-2014
Abstract
BACKGROUND: Chronic Achilles tendinopathy is responsible for a severe reduction in physical performance and persistent pain. There is currently a number of therapeutic options and the local administration of growth factors is an emerging treatment strategy. In particular, platelet-rich plasma (PRP) is a widely used way to provide a local regenerative stimulus for tendon healing. The aim of this study was to document the mid-term results obtained after treating recalcitrant Achilles tendinopathy with injections of high concentrate, leucocyte-rich PRP.
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One injection of platelet-rich plasma associated to a submaximal eccentric protocol to treat chronic jumper's knee
Posted in: General | Posted on: 29-Jun-2014
Abstract
INTRODUCTION: Jumper's knee is a frequent chronic overuse syndrome of the upper part of the patellar tendon. Platelets contain lots of growth factors which could enhance the healing process of tendons.
METHODS: Twenty patients with chronic upper patellar tendinopathy were enrolled. Assessments were made before infiltration of PRP, and 6 weeks and 3 months after the infiltration, using a 10--point Visual Analogic Scale, clinical examinations with a pressure algometer, algofunctional scores (IKDC and VISA--P), functional assessments (isokinetic and optojump evaluations) and imagery (ultrasounds and MRI). The PRP was obtained with an apheresis system (COM.TEC, Fresenius). Six millilitres of PRP were injected without local anaesthetic. One week after infiltration, patients started a standardised sub--maximal eccentric reeducation.
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Role of platelet-released growth factors in detoxification of reactive oxygen species in osteoblasts
Posted in: General | Posted on: 29-Jun-2014
Abstract
INTRODUCTION: Oxidative stress can impair fracture healing. To protect against oxidative damage, a system of detoxifying and antioxidative enzymes works to reduce the cellular stress. The transcription of these enzymes is regulated by antioxidant response element (ARE). The nuclear factor (erythroid-derived 2)-like2 (Nrf2) plays a major role in transcriptional activation of ARE-driven genes. Recently it has been shown that vascular endothelial growth factor (VEGF) prevents oxidative damage via activation of the Nrf2 pathway in vitro. Platelet-released growth factor (PRGF) is a mixture of autologous proteins and growth factors, prepared from a determined volume of platelet-rich plasma (PRP). It has already used to enhance fracture healing in vitro. The aim of the present study was to elucidate if platelets can lead to upregulation of VEGF and if platelets can regulate the activity of Nrf2-ARE system in primary human osteoblast (hOB) and in osteoblast-like cell line (SAOS-2).
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Background aims

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Purpose

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