Abstract
Autologous platelet-rich plasma (PRP) injection is an alternative but widely accepted method for the treatment of degenerative changes in tendon attachments known as enthesopathies. The PRP is considered a safe source for high concentrations of the growth factors involved in the healing process. Despite initial promising outcomes, many recent studies report conflicting results for this treatment. This may be due to differences in the concentrations of platelets and growth factors in PRPs obtained using different methods. The aim of this study was to compare PRP preparation systems in terms of morphotic components and selected growth factors to find the most appropriate procedure for the treatment of enthesopathies. Whole blood samples from 6 healthy male volunteers were collected. Using different commercial kits (Mini GPS III System, Arthrex ACP, and Xerthra, Dr. PRP), 4 PRPs were prepared from the blood of each participant. All samples were analyzed for the content of morphotic components and the following growth factors: transforming growth factor-β1 (TGF-β1), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), and platelet-derived growth factor AA (PDGF-AA). The Mini GPS III produced PRP with the highest concentration of platelets and white blood cells (WBC) compared to the other systems included in the study. Significant differences in the levels of EGF and PDGF-AA were found only between the Mini GPS III and Arthrex ACP. There was positive correlation between the content of platelets and the levels of PDGF-AA and EGF. The red blood cells (RBC) concentration positively correlated with PDGF-AA, EGF and VEGF. This study showed differences between the morphotic components and levels of selected growth factors in PRP obtained with the different preparation methods. Due to insufficient data, we cannot argue for or against any of the studied protocols for the treatment of enthesopathy. Further studies on a larger population are required to validate our results.
Highlights
Autologous platelet-rich plasma (PRP) injection is an alternative but widely accepted method for the treatment of degenerative changes in tendon attachments known as enthesopathies
All samples were analyzed for the content of morphotic components and the following growth factors: transforming growth factor-β1 (TGF-β1), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), and platelet-derived growth factor AA (PDGF-AA)
The red blood cells (RBC) concentration positively correlated with PDGF-AA, EGF and VEGF
Summary
Autologous platelet-rich plasma (PRP) injection is an alternative but widely accepted method for the treatment of degenerative changes in tendon attachments known as enthesopathies. Many recent studies report conflicting results for this treatment. This may be due to differences in the concentrations of platelets and growth factors in PRPs obtained using different methods. Enthesopathies are degenerative changes in the site of tendon attachment to the bone This disease can affect many different sites in the human body. The change in the dogma of the inflammatory nature of this disease was the result of numerous histopathological studies that found disorganized tissue and neovessels within the involved tendon, but only few inflammatory cells. Symptoms resolve spontaneously and properly selected exercises help prevent them in the future. some cases turn into a chronic condition that is very difficult to treat, and sometimes only surgical excision of the affected tissue can lead to improvement
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