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  • Platelet-rich plasma in regenerative medicine

    Abstract

    Platelet-rich plasma (PRP) contains at least seven growth factors including epidermal growth factor, platelet-derived growth factor, transforming growth factor-beta, vascular endothelial growth factor, fibroblast growth factor, insulin-like growth factor, and keratinocyte growth factor. The therapeutic effect of PRP occurs because of the high concentration of these growth factors compared with that in normal plasma. In recent years, has been widely used across many clinical fields, especially regenerative medicine. This review will present an overview of applications of PRP in regenerative medicine. The mechanisms of PRP effects on healing also are mentioned in this review.

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  • Comparison of Platelet-Rich Plasma Formulations for Cartilage Healing: An in Vitro Study

    Background:

    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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  • Can the combination of localized \

    Summary

    Regenerative injection therapy (RIT), also known as proliferative therapy, has been used for over 30 years in the USA in patients with spinal and peripheral joint and ligamentous pathologies. It involves the injection of mildly irritating medications onto ligaments and tendons, most commonly at origins and insertions. These injections cause a mild inflammatory response which \"turns on\" the normal healing process and results in the regeneration of these structures. At the same time they strengthen and become less sensitive to pain through a combination of neurolysis of small nerve fibers (C-fibers) and increased stability of the underlying structures.

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  • Intraarticular injection of platelet-rich plasma reduces inflammation in a pig model of rheumatoid arthritis of the knee joint

    Abstract

    OBJECTIVE: Treatment options for rheumatoid arthritis range from symptomatic approaches to modern molecular interventions such as inhibition of inflammatory mediators. Inhibition of inflammation by platelet-rich plasma (PRP) has been proposed as a treatment for tendinitis and osteoarthritis. The present study was undertaken to investigate the effect of PRP on antigen-induced arthritis (AIA) of the knee joint in a large animal model.

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  • Stem cell knee injection shown to regenerate meniscus, reduce pain

    Results of a randomized, double-blind controlled study in the Journal of Bone and Joint Surgery supported the use of human mesenchymal stem cell for meniscal regeneration and the control of knee pain.

    \"There was evidence of meniscus regeneration and improvement in knee pain following treatment with allogeneic human mesenchymal stem cells,\" C. Thomas Vangsness Jr., MD, and colleagues wrote in the study. \"These results support the study of human mesenchymal stem cells for the apparent knee-tissue regeneration and protective effects. € The study followed 55 patients at seven institutions who underwent partial medial meniscectomy and received the study treatment 7 days to 10 days after meniscectomy via a superolateral knee injection.

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  • Human fibroblast-like cultures in the presence of platelet-rich plasma as a single growth factor source: clinical implications

    OBJECTIVE: The purpose of this study was to compare the proliferation, morphology, and antigenic expression of human fibroblast-like cells between primary cultures treated with platelet-rich plasma (PRP) or fetal bovine serum (FBS) as the growth factor source.

    DESIGN: Cells from human gingival tissue samples obtained from healthy volunteers during oral surgery were studied. Isolated cells were cultured in media supplemented with 10% PRP or FBS. Platelet-rich plasma was prepared from the venous blood of each patient. The authors studied short- and long-term cell cultures in the presence of PRP or FBS as the sole growth factor source in order to determine (a) cell growth rate, by MTT (3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) assay; (b) cell morphology, by electronic microscopy; and (c) antigenic expression, by flow cytometry and confocal microscopy.

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  • Knee osteoarthritis: hyaluronic acid, platelet-rich plasma or both in association?

    Introduction: Bidirectional interactions between cells and fluidic surroundings regulate cellular functions and maintain tissue or organ architecture. Accordingly, the synovial fluid is the primary source of environmental signals and determines to a great extent the molecular interactions within the joint capsule, both in homeostasis and pathology.

    Areas covered: We provided an update on hyaluronic acid (HA) and platelet-rich plasma (PRP) concepts necessary to build the rationale for creating a combined treatment. The information is based on a PubMed search using the terms \'platelet-rich plasma\', \'hyaluronic acid\', \'knee pathology\', \'knee osteoarthritis\' (OA).

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  • Orthobiologics and platelet rich plasma

    Abstract

    Orthobiologics have evolved to the extent that they significantly influence modern orthopedic surgical practice. A better understanding of the role of various growth factors and cells in the process of tendon healing, ligament repair, cartilage regeneration and bone formation has stimulated focused research in many chronic musculoskeletal ailments. Investigators have published results of laboratory as well as clinical studies, using orthobiologics like platelet rich plasma, stem cells, autologous conditioned serum etc., with variable results. However, a clear consensus over the best orthobiologic substance and the method of preparation and usage of these substances is lacking. Much of the confusion is due to the fact that studies ranging from RCTs to case reports present variable results, and the interpretations are wide-ranging. We have reviewed the available orthobiologics related data with a focus on platelet rich plasma in orthopedic conditions.

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  • Are Multiple Platelet-Rich Plasma Injections Useful for Treatment of Chronic Patellar Tendinopathy in Athletes?

    Abstract

    Background: Chronic patellar tendinopathy (PT) is one of the most common overuse knee disorders. Platelet-rich plasma (PRP) appears to be a reliable nonoperative therapy for chronic PT.

    Purpose: To evaluate clinical and radiological outcomes of 3 consecutive ultrasound (US)-guided PRP injections for the treatment of chronic PT in athletes.

    Study Design: Case series; Level of evidence, 4.

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  • Platelet-Rich Plasma (PRP) Promotes Fetal Mesenchymal Stem/Stromal Cell Migration and Wound Healing Process

    Abstract

    Numerous studies have shown the presence of high levels of growth factors during the process of healing. Growth factors act by binding to the cell surface receptors and contribute to the subsequent activation of signal transduction mechanisms. Wound healing requires a complex of biological and molecular events that includes attraction and proliferation of different type of cells to the wound site, differentiation and angiogenesis. More specifically, migration of various cell types, such as endothelial cells and their precursors, mesenchymal stem/stromal cells (MSCs) or skin fibroblasts (DFs) plays an important role in the healing process. In recent years, the application of platelet rich plasma (PRP) to surgical wounds and skin ulcerations is becoming more frequent, as it is believed to accelerate the healing process. The local enrichment of growth factors at the wound after PRP application causes a stimulation of tissue regeneration. Herein, we studied: (i) the effect of autologous PRP in skin ulcers of patients of different aetiology, (ii) the proteomic profile of PRP, (iii) the migration potential of amniotic fluid MSCs and DFs in the presence of PRP extract in vitro, (iv) the use of the PRP extract as a substitute for serum in cultivating AF-MSCs. Considering its easy access, PRP may provide a valuable tool in multiple therapeutic approaches.

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  • Inhibition of Chondrocyte and Synovial Cell Death After Exposure to Commonly Used Anesthetics: Chondrocyte Apoptosis After Anesthetics

    Background:

    An intra-articular injection of local anesthetics is a common procedure for diagnostic and therapeutic purposes. It has been shown that these agents are toxic to articular cartilage and synovial tissue in a dose- and time-dependent fashion, and in some cases, they may lead to postarthroscopic glenohumeral chondrolysis (PAGCL). However, the role of apoptosis in cell death is still unclear, and the potential role of apoptosis inhibition in minimizing chondrocyte and synovial cell death has not been reported.

    Purpose: (1) To quantify the degree of apoptotic cell death in chondrocytes and synovial cells exposed to local anesthetics, and(2) to determine whether caspase inhibition could reduce cell death.

    Study Design: Controlled laboratory study.

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  • Platelet rich fibrin and alloplast in the treatment of intrabony defect: A case report

    Abstract

    Periodontal regeneration is defined as the reproduction or reconstitution of a lost or injured part to restore the architecture and function of the periodontium. The ultimate goal of periodontal therapy is to regenerate the lost periodontal tissues caused by periodontitis. The most positive outcome of periodontal regenerative procedures in intra bony defect has been achieved with bone grafts. For complete regeneration, delivery of growth factors in a local environment holds a great deal in adjunct to bone grafts. Platelet rich fibrin (PRF) is considered as second generation platelet concentrate, consisting of viable platelets, releasing various growth factors. Hence, this case report aims to investigate the clinical and radiological (bone fill) effectiveness of autologous PRF along with the use of alloplastic bone mineral in the treatment of intra bony defects.

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  • Effect of Diet-Induced Vitamin D Deficiency on Rotator Cuff Healing in a Rat Model

    Abstract

    Background: Few studies have considered hormonal influences, particularly vitamin D, on healing.

    Hypothesis: Vitamin D deficiency would have a negative effect on the structure of the healing tendon-bone interface in a rat model and would result in decreased tendon attachment strength.

    Study Design: Controlled laboratory study.

    Methods: Vitamin D deficiency was induced in 28 male Sprague-Dawley rats using a specialized vitamin D-deficient diet and ultraviolet light restriction. Serum levels of vitamin D were measured after 6 weeks. These vitamin D-deficient animals (experimental group) plus 32 rats with normal vitamin D levels (controls) underwent unilateral detachment of the right supraspinatus tendon from the greater tuberosity of the humerus, followed by immediate repair using bone tunnel suture fixation. The animals were sacrificed at 2- and 4-week intervals after surgery for biomechanical analysis. A paired t test was used to compare serum vitamin D levels at day 0 and at 6 weeks. A nonparametric Mann-Whitney U test was used to compare load-to-failure and stiffness values between the experimental group and controls. Bone density and new bone formation at the tendon insertion site on the greater tuberosity were assessed with micro-computed tomography (CT). The organization of collagen tissue, new bone formation, vascularity at the tendon-bone interface, fibrocartilage at the tendon-bone interface, and collagen fiber continuity between the tendon and bone tissue were evaluated with safranin O and picrosirius red staining.

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  • Effect of Diet-Induced Vitamin D Deficiency on Rotator Cuff Healing in a Rat Model

    Abstract

    Background: Few studies have considered hormonal influences, particularly vitamin D, on healing.

    Hypothesis: Vitamin D deficiency would have a negative effect on the structure of the healing tendon-bone interface in a rat model and would result in decreased tendon attachment strength.

    Study Design: Controlled laboratory study.

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  • Platelet-Rich Plasma Efficacy Versus Corticosteroid Injection Treatment for Chronic Severe Plantar Fasciitis

    Abstract

    Background: Chronic plantar fasciitis is a common orthopedic condition that can prove difficult to successfully treat. In this study, autologous platelet-rich plasma (PRP), a concentrated bioactive blood component rich in cytokines and growth factors, was compared to traditional cortisone injection in the treatment of chronic cases of plantar fasciitis resistant to traditional nonoperative management.

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  • The effect of platelet-rich plasma on osteochondral defects treated with mosaicplasty

    Abstract

    Purpose

    This study investigated the efficacy of platelet-rich plasma (PRP) on articular surfaces on which the mosaicplasty technique was performed. Our hypothesis was that PRP can accelerate the osseointegration process and enhance the quality of articular integrity after the mosaicplasty procedure.

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  • Effect of platelet-rich plasma-incorporated gelatin hydrogel microspheres and subchondral drilling on equine cartilage defects

    Abstract

    We evaluated the effect of platelet-rich plasma-incorporated gelatin hydrogel microsphere (PRP/GM) together with subchondral drilling for cartilage regeneration in horses. Cartilage defects (diameter, 4.5 mm; depth, 3.0 mm) were created in both third carpal bones of six thoroughbred horses. A subchondral hole was drilled at the center of this cartilage defect (diameter, 2.0 mm; depth, 35 mm) in one randomly selected carpal joint (test joint), whereas no subchondral hole was made in the contralateral joint (control joint). Thereafter, the test joint was injected with PRP/GM and the control joint with saline-infused GM. Additional injections of PRP/GM were given 14 and 28 days after surgery. After 16 weeks, histological analysis was conducted. The macroscopic and histological scores of the test group were significantly higher than those of the control group (P < 0.05). These data indicated that the application of PRP/GM together with subchondral drilling accelerated cartilage regeneration in horses.

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  • Dextrose prolotherapy for recalcitrant coccygodynia

    Abstract

    PURPOSE: To present the results of dextrose prolotherapy undertaken for chronic non-responding coccygodynia in 37 patients.

    METHODS: 14 men and 23 women (mean age, 36 years) with chronic coccygodynia not responding to conservative treatment for more than 6 months were included. 27 of them had received local steroid injections. A visual analogue score (VAS) was recorded for all patients before and after injection of 8 ml of 25% dextrose and 2 ml of 2% lignocaine into the coccyx. In 8 patients with a VAS of more than 4 after the second injection, a third injection was given 4 weeks later.

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  • Hyaluronic Acid and Platelet Rich Plasma in Hip Osteoarthritis: Work in Progress

    Introduction

    In the last decade Hyaluronic Acid (HA) and, more recently, Platelet Rich Plasma (PRP) have been used in the treatment of hip osteoarthritis (OA) [1]. Sound basic research supports their therapeutic potential.

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  • Effect of Platelet Lysate on Human Cells Involved in Different Phases of Wound Healing

    Abstract

    Background

    Platelets are rich in mediators able to positively affect cell activity in wound healing. Aim of this study was to characterize the effect of different concentrations of human pooled allogeneic platelet lysate on human cells involved in the different phases of wound healing (inflammatory phase, angiogenesis, extracellular matrix secretion and epithelialization).

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