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  • PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies

    Abstract

    Objective: To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects.

    Results: The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs-one for knee and one for hip-did not report significant superiority of PRP compared to the control group (HA).

    Conclusions: Conclusions:Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.

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  • A New Technique for the Treatment of Lumbar Facet Joint Syndrome Using Intra-articular Injection with Autologous Platelet Rich Plasma

    Abstract

    Background and Objectives: Lumbar facet joint syndrome is currently suggested to be a main source of axial low back pain, and a large portion of axial low back pain is caused by disorders in lumbar facet joints. Intra-articular injection is one of the most common treatment methods in the early clinical application. Therefore, we attempt to seek a new injectable material, autologous platelet rich plasma (PRP), to treat lumbar facet syndrome, as well as to assess its therapeutic effectiveness and safety.

    Conclusions: In the short-term period of 3 months, the new technique of lumbar facet joint injection with autologous PRP is effective and safe for patients with lumbar facet joint syndrome. Key words: Low back pain, lumbar facet joint syndrome, autologous platelet rich plasma, intra-articular injection.

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  • Growth Factors Levels Determine Efficacy of Platelets Rich Plasma Injection in Knee Osteoarthritis: A Randomized Double Blind Noninferiority Trial Compared With Viscosupplementation

    Abstract

    Purpose: To assess the noninferiority of a single platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA), to alleviate pain and enhance functional capacity in knee osteoarthritis, and identify biological characteristics of PRP that may affect their efficacy.

    Conclusions: Current results indicated that a single injection of very pure PRP offers a significant clinical improvement in the management of knee osteoarthritis, equivalent to a single HA injection in this patient population. Moreover, a significant correlation between the doses of TGF-β1 and PDGF-AB and the worsening of WOMAC score 3 months after the procedure was found.

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  • Platelet‑rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

    Abstract

    Knee osteoarthritis is a degenerative disease that may develop due ageing, obesity, strain, congenital abnormal joints, joint deformity or trauma. It is caused by many factors, such as degradation of articular cartilage injury, joint edge and subchondral bone hyperplasia of reactivity.

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  • Platelet-rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors

    Abstract

    Knee osteoarthritis is a degenerative disease that may develop due ageing, obesity, strain, congenital abnormal joints, joint deformity or trauma. It is caused by many factors, such as degradation of articular cartilage injury, joint edge and subchondral bone hyperplasia of reactivity. Platelet-rich plasma (PRP) is an autologous blood sample that contains highly concentrated platelets and multiple cell growth factors. PRP promotes synovial cell proliferation and differentiation and may recover cartilage morphology. In the present study, the clinical efficacy of PRP was investigated in patients with knee osteoarthritis aged between 18 and 30 years in a phase-III clinical study. Following an 8-week baseline, patients with knee osteoarthritis were randomized into once-weekly, double-blind treatment with PRP (2-14 ml) or placebo groups. The results indicated that patients with osteoarthritis treated with PRP had modulated plasma concentrations of inflammatory factors and pro-angiogenic factors compared with the placebo group.

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  • Lateral Ankle sprain (LAS) is a common sports injury associated with recurrent ankle sprain

    Abstract

    Lateral a nkle sprain (LAS) is the most common musculoskeletal injury in the physically active population; it is also a common condition in the general population. Apart from the pain and temporary period of reduced functioning and disability, it is also associated with increased risk of recurrent ankle sprain, the development of chronic ankle stability (CAI) and post - traumatic ankle osteoarthritis (PTOA). While the direct costs for treatment of an isolated LAS are relatively low, compounding these are indirect costs from follow up care, loss of pro ductivity, time loss of activity and care of its long - term consequences. Therefore, it becomes apparent that the healthcare burden that emerges from so called "simple" LAS is substantial.

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  • The efficacy of using platelet rich plasma in treating chronic tendinopathies

    Abstract

    As a common source of long-term pain and physical disability, overuse injuries, such as chronic tendinopathies, severely impact a patient's quality of life. Caused by repetitive trauma, chronic tendinopathies affect hundreds of millions of people each year. The exact pathogenic mechanism in developing this musculoskeletal injury is still largely unknown, making clinical recommendations on the best course of treatment highly debatable. Nonetheless, advancements in biotechnology have made autologous blood products, specifically the use of platelet rich plasma injections, an increasingly popular method in the orthopedic field. Studies have shown that the concentrated platelet sample harbors a number of bioactive mediators. Once activated and injected at the site of injury, these growth factors and cytokines augment the natural healing process in tendinopathic cases. With limited reported complications, many clinicians believe that platelet rich plasma therapy is a safe and accessible treatment option for patients diagnosed with chronic tendinopathy. As such, the primary purpose of this paper is to determine the efficacy of platelet rich plasma injections in treating chronic tendinopathies.

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  • Osteochondral defects of the talus with a focus on platelet-rich plasma as a potential treatment option: a review

    Abstract

    Objective: To provide a review of osteochondral lesions of the talus, to discuss the evidence of the risks and benefits of platelet-rich plasma (PRP) as a viable treatment option, and to measure the efficacy of PRP using MRI evidence of cartilage regeneration, as well as scales that measure improvement in 'pain' and 'functionality'.

    Eligibility criteria: Studies that use PRP in either conservative or intraoperative settings to treat osteochondral defects of the talus.

    Results: There are seven studies that compare hyaluronic acid or standard surgical options against PRP in treating osteochondral lesions of the talus. Five studies use PRP as supplemental treatment in intraoperative settings, while two studies use PRP conservatively as intra-articular injections. There were minimal adverse effects. Pain and functionality scores consistently improved in those who underwent PRP treatments over the course of 4 years. MRI showed significant but inconsistent results in chondral regeneration.

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  • The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis

    Abstract

    Introduction: Osteoarthritis (OA) is a chronic joint disease that usually occurs in older people and leads to pain and disabilities. OA treatment ranges from drug therapy to surgery. Drug and rehabilitation therapy are preferred over surgery, and, especially, there is a tendency toward compounds causing regenerative changes in the knee joint. In the present study, the effects of platelet-rich plasma (PRP) injection and prolotherapy (PRL) were examined on the level of pain and function of the knee joint in patients with OA.

    Conclusion: Results of the present study suggested a significant decrease in the overall WOMAC score of patients who undergo either PRP therapy or PRL. This positive change in the overall WOMAC score led to an improvement in the quality of life of patients with knee OA shortly after the first injection. PRP injection is more effective than PRL in the treatment of knee OA.

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  • Comparison of Intralesional Platelet Rich Plasma and 10% Dextrose Effect towards Injured Muscle Healing

    Abstract

    Platelet Rich Plasma (PRP) and Dextrose 10% have prolife rant effect by promote growth factor so that it could be use to promote healing of soft tissue. By using PRP and dextrose 10% injection intralesion in muscle injury were hoped fasten muscle healing process and improve muscle quality. This is experimental comparative research, was done on 27 rats that divided into 3 groups. After All of subject got muscle injury grade II, The first group was administered with PRP, , the second group with dextrose 10%, the third group with NaCl 0,9% injection intralesion. After one week, the subjects were sacrificed, and their gastrocnemius muscles were examined to see the level of myoblast through immuno histochemical technique. The result show increase level of myoblast in PRP and dextrose 10% group than control, and the level of myoblast was better in PRP group than dextrose 10% group (PRP:Dextrose 10%:NaCl 0,9% = 12,33: 8,00: 5,67). In conclusion, usage PRP and dextrose 10% injection intralesion can increase level of myoblast in muscle injury grade 2, and usage PRP was better than dextrose 10%.

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  • Concentrations of Blood Components in Commercial Platelet-Rich Plasma Separation Systems: A Review of the Literature

    Abstract

    Background: Platelet-rich plasma (PRP) has proven to be a very safe therapeutic option in the treatment of tendon, muscle, bone, and cartilage injuries. Currently, several commercial separation systems are available for the preparation of PRP. The concentrations of blood components in PRP among these separation systems vary substantially.

    Methods: MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE were searched for studies that compared the concentrations of blood components and growth factors in PRP between various separation systems and studies that reported on the concentrations of blood components and growth factors of single separation systems. The primary outcomes were platelet count, leukocyte count, and concentration of growth factors (eg, platelet-derived growth factor-AB [PDGF-AB], transforming growth factor-β1 [TGF-β1], and vascular endothelial growth factor [VEGF]). Furthermore, the preparation protocols and prices of the systems were compared.

    Results: There were 1079 studies found, of which 19 studies were selected for inclusion in this review. The concentrations of platelets and leukocytes in PRP differed largely between, and to a lesser extent within, the studied PRP separation systems. Additionally, large differences both between and within the studied PRP separation systems were found for all the growth factors. Furthermore, preparation protocols and prices varied widely between systems.

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  • Autologous US-guided PRP injection versus US-guided focal extracorporeal shock wave therapy for chronic lateral epicondylitis: A minimum of 2-year follow-up retrospective comparative study

    Abstract

    Purpose: To compare the efficacy of two independent groups of patients treated with ultrasound (US)-guided extracorporeal shock wave (ESW) therapy and with US-guided injection of platelet-rich plasma (PRP) for chronic lateral epicondylitis (LE) with a minimum of 2-year follow-up.

    Results: Both US-guided autologous PRP injection and US-guided focal ESW administration proved effective in chronic LE with significant improvement in the QuickDASH, VAS, RM and PRTEE scores (p < 0.0001). No adverse effects or complications were recorded in any groups. No differences were found in recurrence rate and final results of the QuickDASH, VAS, RM and PRTEE scores between the two groups (p > 0.05). The mean time between treatment and symptom resolution was significantly shorter for the PRP treatment (p = 0.0212); furthermore, the mean time to return to the normal activities was quicker for PRP group (p = 0.0119).

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  • Platelet Rich Plasma Injection Used as Treatment of High- Grade Partial Pectoralis Muscle Tear in Division I Football Player

    Abstract

    This case report describes a collegiate football player diagnosed with a high-grade partial pectoralis major tear, patient outcome after non-operative management using platelet-rich plasma injections, and a detailed description of the rehabilitation program used in this case. The purpose of this article is to describe a newer option for the management of this injury and give context to clinical decision-making in this setting.

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  • Comparative effectiveness of intra-articular prolotherapy versus peri-articular prolotherapy on pain reduction and improving function in patients with knee osteoarthritis: A randomized clinical trial.

    Abstract

    Background: Osteoarthritis is a common degenerative disease. Prolotherapy is an alternative therapy used in multiple musculoskeletal disorders. Objective: To compare the effectiveness of intra-articular dextrose injection versus peri-articular prolotherapy in patients with knee osteoarthritis (KOA). Methods: Fifty-two adults with painful primary knee osteoarthritis for at least three months were randomized to intra- and peri-articular injection groups. Prolotherapy was done twice with two week intervals. The outcome measures included the Oxford Knee Scale (OKS), Western Ontario McMaster University Osteoarthritis Index (WOMAC), and Visual Analogue Scale (VAS), which were obtained from patients before the first injection at the base line and after the second injection at the fourth and eighth weeks. Results: There were no statistically significant differences between demographic characteristics; before the injection, pain intensity, OKS, and WOMAC scores were approximately equal between the two groups. After dextrose prolotherapy, VAS, OKS, and WOMAC scores improved from baseline through the fourth and eighth weeks in both groups without any superiority between the two methods of injections (p<0.001). Conclusion: Dextrose prolotherapy either intra- or peri-articular injection resulted in significant improvement, so it could be an inexpensive and effective management of knee osteoarthritis.

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  • Platelet-rich plasma inhibits Wnt/β-catenin signaling in rabbit cartilage cells activated by IL-1β

    Abstract

    Objective: Platelet-rich plasma (PRP) has been reported to alleviate degenerative pathological damage to joint cartilage. This study aimed to investigate the effect of PRP on Wnt/β-catenin signaling in rabbit chondrocytes.

    Methods: Using 3-month-old New Zealand white rabbits, PRP was prepared from venous blood, and chondrocytes were cultured from knee joint cartilage and identified by staining for type II collagen and proteoglycan. The effects of PRP on chondrocyte viability were measured. The chondrocytes were divided into 5 groups: control, IL-1β, PRP (100-fold dilution), Dkk-1 (100 ng/mL) and Dkk-1 + PRP. The IL-1β, PRP, Dkk-1 and Dkk-1 + PRP groups were treated with interleukin (IL)-1β (50 μL, 10 μg/mL) for24 h. Chondrocyte morphology was observed by electron microscopy. Levels of carboxy terminal peptide (CTX-II) and cartilage oligomeric matrix protein (COMP) in culture media were measured by ELISA. Wnt-1, β-catenin and GSK-3β mRNA and protein expression were determined by RT-PCR and western blot respectively.

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  • Platelet-rich plasma has beneficial effects in mice with osteonecrosis of the femoral head by promoting angiogenesis

    Abstract

    Platelet-rich plasma (PRP) is autologous and multifunctional. Platelet concentrate from blood contains highly concentrated platelets and various types of cells, including growth factors. PRP promotes the recovery of cell proliferation and differentiation. Osteonecrosis of the femoral head is a disease caused by femoral head damage or an insufficient blood supply, which leads to the death of bone cells and abnormal bone marrow composition. The subsequent repair of bone cells may result in changes to the structure of femoral head, femoral head collapse and joint dysfunction. PRP may promote the repair of injured articular cartilage in patients with joint diseases through the removal of harmful inflammatory factors. In the present study, the therapeutic effects and primary mechanism of PRP action were investigated using a glucocorticoid-induced femoral head osteonecrosis mouse model.

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  • Freeze-Dried Chitosan-PRP Injectable Surgical Implants for Meniscus Repair: Pilot Feasibility Studies in Ovine Models

    Abstract

    Clinical management of meniscus tears often involves partial meniscectomy, which can lead to Osteoarthritis (OA). Meniscus repair augmentation strategies are being developed to compensate for the tissue's limited healing response. The purpose of the study was to assess the feasibility of using implants composed of freeze-dried Chitosan (CS) solubilized in Platelet-Rich Plasma (PRP) to improve meniscus repair in ovine models. Lyophilized formulations containing 1% (w/v) chitosan (degree of deacetylation 82% and number average molar mass 38 kDa), 1% (w/v) trehalose and 42.2 mM calcium chloride were solubilized in autologous PRP and applied to surgically induced meniscus lacerations.

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  • Treating de querveins tensynovitis using the prp technique : a case series

    Abstract

    PRP is the acronym for platelet rich plasma, an autologous, biological blood derived product which is exogenously applied to tissue areas where regeneration or healing is desired. Together with the platelets, high concentration of essential growth factors is harvested, and these includes platelet-derived growth factors (PDGF), vascular endothelial growth factors (VEGF), interleukin-like factors (IGF), fibronectin to name but a few , which is thought to enhance repair. First described in 1987 with success in an open heart surgery in Italy, PRP has found its fame and is now widely used in many areas of specialty, including sports medicine for treatment of musculoskeletal injuries, orthopedics for enhancement of bone healing, osteoarthritis, aesthetics medicine where ladies and men alike inject PRP onto their faces to increase radiance and reduce wrinkles, and as recent as 2013 in the field of urology to treat organic erectile dysfunction. The potential of PRP treatment is limitless, with many upcoming large scale studies backing its success. Principles of its application include obtaining a platelet concentrate 3-5 times its normal physiological levels and injecting it into areas where healing is desired.

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  • Ultrasound-Guided Platelet-Rich Plasma Injection in a Patient with a Plantar Fascia Tear

    Abstract

    Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey.

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  • Injectable-platelet rich fibrin using the low speed centrifugation concept improves cartilage regeneration when compared to platelet-rich plasma

    Abstract

    The aim of the present study was to evaluate the effect of injectable platelet-rich fibrin (i-PRF) on cultivated chondrocytes and osteochondral regeneration in critical-sized osteochondral defect of the rabbit's knee in comparison to autologous platelet-rich plasma (PRP). Chondrocytes were first investigated for their ability to proliferate and differentiate in response to PRP and i-PRF. Thereafter, full-thickness critical-sized osteochondral defects 5 mm in diameter and 5 mm in depth were created in the knee joint of 12 adult female New Zealand White rabbits. Defects were regenerated with either PRP or i-PRF and compared to control. Animals were sacrificed at 4 and 12 weeks postoperatively and evaluated histologically by macroscopic and microscopic examination for cartilage regeneration. i-PRF significantly promoted chondrocyte proliferation and mRNA levels of Sox9, collagen type II, and aggrecan when compared to PRP and control.

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