Abstract
Dear Editor, We would like to thank Dr. Sharma for his interest in our paper entitled, “Platelet-rich plasma injections for chronic plantar fasciitis” [1]. The system used to obtain PRP did not concentrate white blood cells; furthermore, the concentration level of inflammatory cells are reduced in comparison to whole blood samples. We agree with Dr. Sharma about the hypothetical superior healing capability of PRP preparations without leucocites. Leucocyte-reduced PRP have been shown to produce a lower expression of inflammatory cytokines in flexor digitorum superficialis tendon explants in an animal model [2]. Dragoo et al. found that, in healthy rabbit tendons, leucocyte-rich PRP injection caused a significantly greater acute inflammatory response five days after injection in comparison with leucocyte-reduced PRP [3]. However, despite these results, further clinical investigations are warranted to confirm the superior clinical efficacy of leucocyte-reduced PRP in treating chronic plantar fascitiis or tendinopathies.
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