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  • Autologous Platelet-Rich Plasma Versus Dextrose Prolotherapy for the Treatment of Chronic Recalcitrant Plantar Fasciitis.

    Abstract

    OBJECTIVE: To determine the efficacy of autologous platelet-rich plasma (PRP) compared with dextrose prolotherapy (DP) in patients with chronic recalcitrant plantar fasciitis (PF) DESIGN: A single-blinded, randomized, controlled study.

    SETTING: Department of Physical Medicine and Rehabilitation of a university hospital.

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  • HGF mediates the anti-inflammatory effects of PRP on injured tendons.

    Platelet-rich plasma (PRP) containing hepatocyte growth factor (HGF) and other growth factors are widely used in orthopaedic/sports medicine to repair injured tendons. While PRP treatment is reported to decrease pain in patients with tendon injury, the mechanism of this effect is not clear. Tendon pain is often associated with tendon inflammation, and HGF is known to protect tissues from inflammatory damages. Therefore, we hypothesized that HGF in PRP causes the anti-inflammatory effects. To test this hypothesis, we performed in vitro experiments on rabbit tendon cells and in vivo experiments on a mouse Achilles tendon injury model. We found that addition of PRP or HGF decreased gene expression of COX-1, COX-2, and mPGES-1, induced by the treatment of tendon cells in vitro with IL-1β. Further, the treatment of tendon cell cultures with HGF antibodies reduced the suppressive effects of PRP or HGF on IL-1β-induced COX-1, COX-2, and mPGES-1 gene expressions. Treatment with PRP or HGF almost completely blocked the cellular production of PGE2 and the expression of COX proteins. Finally, injection of PRP or HGF into wounded mouse Achilles tendons in vivo decreased PGE2 production in the tendinous tissues. Injection of platelet-poor plasma (PPP) however, did not reduce PGE2 levels in the wounded tendons, but the injection of HGF antibody inhibited the effects of PRP and HGF. Further, injection of PRP or HGF also decreased COX-1 and COX-2 proteins. These results indicate that PRP exerts anti-inflammatory effects on injured tendons through HGF. This study provides basic scientific evidence to support the use of PRP to treat injured tendons because PRP can reduce inflammation and thereby reduce the associated pain caused by high levels of PGE2.

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  • Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection

    Background. Platelet-rich plasma is being used more frequently to promote healing of muscle injuries. The growth factors contained in platelet-rich plasma accelerate physiological healing processes and the use of these factors is simple and minimally invasive. The aim of this study was to demonstrate the efficacy of ultrasound-guided injection of platelet-rich plasma in muscle strains and the absence of side effects.

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  • Stem Cell Research & Therapy

    Activated platelet-rich plasma improves adipose-derived stem cell transplantation efficiency in injured articular cartilage

    Abstract

    Introduction

    Adipose-derived stem cells (ADSCs) have been isolated, expanded, and applied in the treatment of many diseases. ADSCs have also been used to treat injured articular cartilage.

    However, there is controversy regarding the treatment efficiency. We considered that ADSC transplantation with activated platelet-rich plasma (PRP) may improve injured articular cartilage compared with that of ADSC transplantation alone. In this study, we determined the role of PRP in ADSC transplantation to improve the treatment efficiency.

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  • Use of platelet-rich plasma in the care of sports injuries: our experience with ultrasound-guided injection

    Platelet-rich plasma injected into the injury site is one of the most important factors rendering the treatment effective. To maximise its efficacy the preliminary ultrasound must be done accurately to localise the lesion and guide the needle into the corresponding lesion. According to the current results, which document full muscle recovery and no relapse except for one case, platelet-rich plasma ultrasound-guided injection represents a valid mini-invasive treatment for muscle injuries.

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  • The influence of platelet-rich plasma on myogenic differentiation

    The ability to expand and direct both precursor and stem cells towards a differential fate is considered extremely advantageous in tissue engineering. Platelet-rich plasma (PRP) possesses a milieu of growth factors and cytokines, which have the potential to have either a differentiative or proliferative influence on the cell type tested. Here, we investigated the effect of PRP on C2C12 myoblasts. A range of PRP concentrations in differentiation media was used to determine whether a concentration dependence existed, while PRP embedded in fibres of aligned electrospun polydioxanone and polycaprolactone was used to determine whether this presence of fibres would cause any differences in response.

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  • Autologous platelet-rich plasma versus dextrose prolotherapy for the treatment of chronic recalcitrant plantar fasciitis

    Objective

    To determine the efficacy of autologous platelet-rich plasma (PRP) compared with dextrose prolotherapy (DP) in patients with chronic recalcitrant plantar fasciitis (PF)

    Design

    A single-blinded, randomized, controlled study

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  • The effect of ketorolac tromethamine, methylprednisolone, and platelet-rich plasma on human chondrocyte and tenocyte viability.

    PURPOSE: The purpose of this study was to evaluate the effect on cell viability of the isolated and combined use of allogeneic platelet-rich plasma (PRP) and ketorolac tromethamine on human chondrocytes and tenocytes in a highly controlled in vitro environment.

    METHODS: PRP was produced from 8 subjects. Human chondrocytes (Lonza, Hopkinton, MA) and tenocytes isolated from samples of the long head of the biceps tendons were treated in culture with PRP, ketorolac tromethamine, and methylprednisolone, both alone and in combination. Control samples were treated in media containing 2% or 10% fetal bovine serum (FBS). Cells were exposed for 1 hour. Luminescence assays were obtained to examine cell viability after 24 hours and long-term effects on cell viability after 120 hours. Radioactive thymidine assay was used to measure proliferation after 120 hours.

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  • Can thrombin-activated platelet releasate compensate the age-induced decrease in cell proliferation of MSC?

    Mesenchymal progenitor cells (MSCs) are promising for cell-based regeneration therapies. In elderly patients a reduced proliferation of MSCs has been described. Platelet-rich plasma (PRP) contains important factors necessary for osteogenic regeneration. The aim of this study was to find out whether the age-induced decrease in cell proliferation can be compensated by the use of supernatant of centrifuged, activated PRP (tPR). MSCs of donors of three age groups (A: young, 14-16 years, B: middle age, 36-46 years, C: older, 74-83 years) were expanded with 20% FCS alone or supplemented with thrombin-activated platelet releasate (tPR) (1%, 2.5%, and 5%) or platelet-poor plasma (PPP 5%). Cell proliferation and differentiation was measured on days 0, 3, and 7. Proliferation increased significantly in groups A and B with tPR, and non-significantly in group C.

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  • Platelet-Rich Plasma and the Elimination of Neuropathic Pain

    Peripheral neuropathic pain typically results from trauma-induced nociceptive neuron hyperexcitability and their spontaneous ectopic activity. This pain persists until the trauma-induced cascade of events runs its full course, which results in complete tissue repair, including the nociceptive neurons recovering their normal biophysical properties, ceasing to be hyperexcitable, and stopping having spontaneous electrical activity. However, if a wound undergoes no, insufficient, or too much inflammation, or if a wound becomes stuck in an inflammatory state, chronic neuropathic pain persists. Although various drugs and techniques provide temporary relief from chronic neuropathic pain, many have serious side effects, are not effective, none promotes the completion of the wound healing process, and none provides permanent pain relief.

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  • Platelet-Rich Plasma Significantly Improves Clinical Outcomes in Patients With Chronic Tennis Elbow

    A Double-Blind, Prospective, Multicenter, Controlled Trial of 230 Patients

    Background: Elbow tenderness and pain with resisted wrist extension are common manifestations of lateral epicondylar tendinopathy, also known as tennis elbow. Previous studies have suggested platelet-rich plasma (PRP) to be a safe and effective therapy for tennis elbow.

    Purpose: To evaluate the clinical value of tendon needling with PRP in patients with chronic tennis elbow compared with an active control group.

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  • Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial.

    PURPOSE Knee osteoarthritis is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. We conducted a 3-arm, blinded (injector, assessor, injection group participants), randomized controlled trial to assess the efficacy of prolotherapy for knee osteoarthritis. METHODS Ninety adults with at least 3 months of painful knee osteoarthritis were randomized to blinded injection (dextrose prolotherapy or saline) or at-home exercise. Extra- and intra-articular injections were done at 1, 5, and 9 weeks with as-needed additional treatments at weeks 13 and 17. Exercise participants received an exercise manual and in-person instruction. Outcome measures included a composite score on the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 100 points); knee pain scale (KPS; individual knee), post-procedure opioid medication use, and participant satisfaction. Intention-to-treat analysis using analysis of variance was used. RESULTS No baseline differences existed between groups. All groups reported improved composite WOMAC scores compared with baseline status (P <.01) at 52 weeks. Adjusted for sex, age, and body mass index, WOMAC scores for patients receiving dextrose prolotherapy improved more (P <.05) at 52 weeks than did scores for patients receiving saline and exercise (score change: 15.3

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  • PLATELET-RICH PLASMA GEL PROMOTES REGENERATION OF ARTICULAR CARTILAGE IN KNEES OF SHEEPS

    Abstract

    Objective: To assess the regeneration of osteochondral defects in the joint cartilage of the knee induced by autologous platelet-rich plasma (PRP). Methods: Osteochondral defects produced in the trochlear groove of both knees of ten sheep; defects of the right knees were filled with autologous PRP and the left knees were left unfilled. Macroscopic and microscopic evaluation was carried out 12 week later. The results were evaluated by the total score of both macroscopic and microscopic evaluations com - paring the two sides through the Wilcoxon paired test.

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  • Bone marrow mesenchymal stem cells: fat on and blast off by FGF21.

    Wan Y.
    Journal

    Int J Biochem Cell Biol. 2013 Mar;45(3):546-9. doi: 10.1016/j.biocel.2012.12.014. Epub 2012 Dec 25.
    Affiliation

    Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA. yihong.wan@utsouthwestern.edu

    Abstract

    Bone marrow mesenchymal stem cells (BMMSCs) are multipotent marrow stromal cells with the ability to differentiate into a variety of cell types required for tissue regeneration including osteoblasts and chondrocytes. Thus, they hold tremendous potential as powerful therapeutic strategies for the prevention and treatment of degenerative disorders including osteoporosis and osteoarthritis. The differentiation of BMMSCs into competing lineages such as osteoblasts and marrow adipocytes is regulated by various environmental cues and intrinsic signaling pathways. Here I highlight recent advances in the understanding of BMMSC function and regulation, including the interaction between BMMSCs with the hematopoietic/immune system, and the identification of novel modulators of BMMSC differentiation such as the metabolic hormone fibroblast growth factor 21 (FGF21). These new findings will further elucidate the dynamic regulation of BMMSCs in the pathophysiological control of skeletal homeostasis, and facilitate the clinical applications of BMMSCs in regenerative medicine.

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  • Painkillers mobilize blood stem cells

    Aspirin-related drugs suggest a way towards more effective stem-cell transplants.

    Aspirin-like drugs could improve the success of stem-cell transplants for patients with blood or bone-marrow disorders, a study suggests. The compounds coax stem cells from bone marrow into the bloodstream where they can be harvested for use in transplantation — and they do so with fewer side effects than drugs now in use.

    For patients with blood disorders such as leukaemia, multiple myeloma or non-Hodgkin\'s lymphoma, transplantation of haematopoietic stem cells — precursor cells that reside in the bone marrow and give rise to all types of blood cell — can be an effective treatment.

    Previous work has shown that prostaglandin E2, or PGE2, a lipid known to regulate multiple bodily reactions including pain, fever and inflammation, also has a role in keeping stem cells in the bone marrow. In the latest study, researchers show that in mice, humans and baboons, inhibition of PGE2 with non-steroidal anti-inflammatory drugs (NSAIDs) causes stem cells to leave the bone marrow.

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  • PRP as a New Approach to Prevent Infection: Preparation and In vitro Antimicrobial Properties of PRP

    Implant-associated infection is becoming more and more challenging to the healthcare industry worldwide due to increasing antibiotic resistance, transmission of antibiotic resistant bacteria between animals and humans, and the high cost of treating infections.

    In this study, we disclose a new strategy that may be effective in preventing implant-associated infection based on the potential antimicrobial properties of platelet-rich plasma (PRP). Due to its well-studied properties for promoting healing, PRP (a biological product) has been increasingly used for clinical applications including orthopaedic surgeries, periodontal and oral surgeries, maxillofacial surgeries, plasticsurgeries, sports medicine, etc.

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  • Relief for millions as back pain is CURED by a single injection

    The injection of bone marrow into the spine offers hope to millions left in daily agony.

    And the breakthrough could also boost the economy by saving more than

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  • Partial Regeneration of the Human Hip Via Autologous Bone Marrow Nucleated Cell transfer: A Case Study

    History: This is a case report of a 64- year-old white male with a 20 year histo - ry of unilateral hip pain that had become debilitating over the last several years. On intake, Harris hip score was rated as: Pain subscale=10, Function subscale=32, Deformity subscale=4, Motions sub - scale=4.775 with a total score of 50.8 out of 100. MRI of the affected hip showed se - vere degeneration with spurring, decrease in joint space, and several large subchon - dral cysts. The patient had been evaluated by an orthopedic surgeon and told he was a candidate for bipolar hip replacement.

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  • Ultrasound-guided platelet-rich plasma injections for the treatment of common peroneal nerve palsy associated with multiple ligament injuries of the knee

    Abstract

    Peroneal nerve palsy in traumatic knee dislocations associated with multiple ligament injuries is common. Several surgical approaches are described for this lesion with less-than-optimal outcomes. The present case represents the application of plasma rich in growth factors (PRGF) technology for the treatment of peroneal nerve palsy with drop foot. This technology has already been proven its therapeutic potential for various musculoskeletal disorders. Based on these results, we hypothesized that PRGF could stimulate the healing process of traumatic peroneal nerve palsy with drop foot.

    Methods

    The patient was a healthy 28-year-old man. He suffered peroneal nerve palsy with drop foot after multiple ligament injuries of the knee. PRGF was prepared according to the manufactured instruction. Eleven months after the trauma with severe axonotmesis, serial intraneural infiltrations of PRGF were started using ultrasound guidance. The therapeutic effect was assessed by electromyography (EMG), echogenicity of the peroneal nerve under ultrasound (US) and manual muscle testing.

    Results

    Twenty-one months after the first injection, not complete but partial useful recovery is obtained. He is satisfied with walking and running without orthosis. Sensitivity demonstrates almost full recovery in the peroneal nerve distribution area. EMG controls show complete reinnervation for the peroneus longus and a better reinnervation for the tibialis anterior muscle, compared with previous examinations.

    Conclusion

    Plasma rich in growth factors (PRGF) infiltrations could enhance healing process of peroneal nerve palsy with drop foot. This case report demonstrates the therapeutic potential of this technology for traumatic peripheral nerve palsy and the usefulness of US-guided PRGF.

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  • The Use Of PRP In Degenerative Lesions Of The Knee: Results At 2-year Follow-Up

    Abstract

    The purpose of our study was to determine the efficacy of Platelet-Rich Plasma (PRP) treatment in symptomatic patients with early knee osteoarthritis.

    Material and Methods: We prospectively followed up 80 patients with knee OA (Kellgren-Lawrence classification grade 1-3) for a minimum follow up of 24 months. Mean age of patients was 47.7 years. All patients were treated with 2 intra-articular injections at monthly interval with autologous PRP. Twenty-two of the patients repeated the 2 infiltrations at 6 and 12 months and 25 of the patients repeated the 2 infiltrations at 12 and 18 months, while 33 patients had only the initial 2 infiltrations. Half of the patients included in this study had undergone a previous operative intervention for cartilage lesions; previous cartilage interventions included cartilage shaving and microfracture. KOOS, VAS, Tegner, IKDC and MARX scores were collected at pre-treatment evaluation and at 6, 12, 18 and 24-month follow-up.

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