Ability Of Platelet-rich Plasma Research Articles

Navigating the Therapeutic Landscape: A Comprehensive Review of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate in Knee Osteoarthritis.

This comprehensive review provides an in-depth analysis of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) as potential treatments for knee osteoarthritis. It explores their mechanisms of action, clinical efficacy, safety considerations, and the importance of personalised treatment approaches. The review highlights promising findings regarding the ability of PRP and BMAC to alleviate symptoms, improve joint function, and potentially slow disease progression. It emphasises the need for further research into long-term outcomes, direct comparative studies, protocol standardisation, biomarker identification, and cost-effectiveness assessments to enhance clinical practice. While the review does not directly compare PRP and BMAC, it provides valuable insights into their respective roles in knee osteoarthritis management. The review aims to contribute to evidence-based advancements in regenerative therapies for knee osteoarthritis by addressing critical research priorities and refining treatment strategies.

The ability of platelet-rich plasma to regenerate a non-vital immature permanent teeth

Objectives: To test the ability of platelet-rich plasma clinically and radiologically for pulp regeneration of immature teeth with apical periodontitis. Material and Methods: An experimental study was conducted From (March/2018-July/2020) 12 upper central immature incisors with acute apical periodontitis and necrotic pulp from six patients receiving regenerative endodontic treatment using concentrated platelets rich plasma were performed by the same endodontist at Mediclinic Middle East Hospitals. Informed consent, including explanation of risks and alternative treatments or no treatment were prepared and filled by the patient parents. The therapeutic protocol was involved accessing the pulp chamber; irrigation copiously with sodium hypochlorite; applying calcium hydroxide as intracanal medicament and a provisionally sealing it after 4 weeks. The canal was cleaned, dried and injected with concentrated platelets rich plasma which serve as a scaffold for pulp regeneration. MTA was used to seal the chamber before final filling with composite. Evaluations: All teeth were monitored clinically (mobility, palpation, percussion, and sensitivity cold test) and radiographically. Results: Twenty months follow-up all teeth showed resolution of periapical radiolucencies, continued root development with positive response to sensitivity cold test and no discoloration. Conclusion: The results of this study confirmed the previous finding that pulp regeneration can be gained by using cPRP successfully Keywords Immature teeth; Necrosis; cPRP; Regeneration.

PLATELET FUNCTION ASSESSMENT AMONG CHILDREN WITH CONGENITAL CYANOTIC HEART DISEASE PRESENTING IN TERTIARY CARE HOSPITAL LAHORE

Objective: The objective of this study was to determine the frequency of platelet dysfunction in congenital cyanotic heart diseases patients presenting to a tertiary care hospital in Lahore. Methodology: A cross sectional survey was carried out from March 2018 to February 2019 in children hospital Lahore. Patients of congenital cyanotic heart disease who fulfilled the inclusion were selected after taking informed consent. Aggregation ability of platelet rich plasma was tested by collagen (1.25μg/ml), ristocetin (1.2mg), epinephrine (5μM) and ADP (2.5μM). Results: There were one hundred and eighty-seven patients of congenital cyanotic heart disease in our study. The minimum age was 1 year and maximum age was 15 years with a mean age 8.02 ± 4.31 years. Platelet dysfunction was diagnosed in 60.4% patients. Conclusion: Platelet dysfunction was found to be high among patients of congenital cyanotic heart diseases.

PLATELET RICH PLASMA (PRP) DARI LIMBAH DARAH SAPI SEBAGAI OBAT LUKA BAKAR PADA TIKUS PUTIH (Rattus norvegicus)

Luka bakar adalah kerusakan jaringan pada kulit akibat terpajan panas tinggi, bahan kimiawi maupun arus listrik. Salah satu hewan yang disembelih di Rumah Potong Hewan (RPH) adalah sapi. Seekor sapi dapat menghasilkan limbah darah kurang lebih sebanyak 28 liter. Komponen darah terdiri dari plasma, sel darah merah, sel darah putih dan platelet. Platelet mengandung growth factor. Platelet Rich Plasma (PRP) atau plasma yang kaya akan platelet terbukti dapat mempercepat penyembuhan tulang dan jaringan lunak. Pembuatan PRP dari darah sapi dilakukan dengan metode sentrifuge. Hewan coba yang dipakai pada penelitian ini adalah tikus putih sebanyak 10 ekor. Besi panas berbentuk bulat dipanaskan dengan api, lalu ditempelkan pada kulit. Kelompok perlakuan diberi PRP dengan konsentrasi 10%, 20% dan 30% dengan salep vaselin album, kelompok kontrol negatif yang tidak diberi perlakuan dan kelompok kontrol positif yang diberi obat yang terbuat dari ekstrak plasenta sapi 10%+neomycin sulfate 0,5%. Parameter yang dipakai untuk mengukur tingkat kesembuhan luka adalah waktu kesembuhan dan pemeriksaan histopatologi. Pada hasil pengukuran waktu kesembuhan dianalisis dengan metode statistik One-way Analsisis of variance (Anova) tingkat signifikansi 95% dengan Kruskal-wallis, kesembuhan luka terdapat perbedaan signifikan antara PRP konsentrasi 10%, 20%, 30%, dan kontrol positif dengan kontrol negatif. Konsentrasi PRP yang optimal adalah 20%. Analisa tipe jaringan yang terbentuk dilakukan dengan pembuatan preparat histopatologi, hasil menunjukkan bahwa luka pada kelompok perlakuan dan kontrol positif tampak sembuh, sedangkan kelompok kontrol negatif epitelisasi belum tertutup jelas. PRP merupakan obat penyembuh luka bakar yang efektif sebagai pengganti obat komersil yang sudah tersedia.

Single Injection of High Volume of Autologous Pure PRP Provides a Significant Improvement in Knee Osteoarthritis: A Prospective Routine Care Study.

Background: Evidence is growing regarding the ability of platelet-rich plasma (PRP) injections to enhance functional capacity and alleviate pain in knee osteoarthritis (OA). However, heterogeneity in common practice regarding PRP preparation and biological content makes the initiation of this activity in a hospital complex. The aim of this study was to document the efficacy of a single PRP injection to treat knee OA and validate a routine care procedure. Methods: Fifty-seven patients with symptomatic knee OA received a single injection of large volume of very pure PRP. They were assessed at baseline and after one, three and six months, by measuring Knee Injury and Osteoarthritis Score (KOOS), Observed Pain after a 50-foot walk test and Visual Analog Scale (VAS) assessments. Magnetic Resonance Imaging (MRI) analysis was performed at baseline and six months after the procedure. The objective was to recover 50% of responders three months after the procedure using OMERACT-OARSI criteria. Results: A single administration of high volume pure PRP provided significant clinical benefit for 84.2% of the responders, three months after the procedure. The KOOS total score significantly increased from 43.5 ± 14.3 to 66.4 ± 21.7 six months after the procedure (p < 0.001). Pain also significantly decreased from 37.5 ± 25.1 to 12.9 ± 20.9 (p < 0.001). No difference was observed on MRI parameters. Conclusion: A single injection of large volume of very pure PRP is associated with significant functional improvement and pain relief, allowing initiation of daily PRP injection within our hospital.

A double blind randomised control trial investigating the efficacy of platelet rich plasma versus placebo for the treatment of greater trochanteric pain syndrome (the HIPPO trial): a protocol for a randomised clinical trial

BackgroundGreater trochanteric pain syndrome (GTPS) is a painful condition characterised by pain around the greater trochanter usually affecting middle-aged women. The majority of patients will improve with conservative management such as physiotherapy and non-steroidal anti-inflammatory drugs (NSAIDs); however, if this fails then more invasive treatments including corticosteroid injections and surgery may be required. Platelet-rich plasma (PRP) is an autologous blood product, which has a higher concentration of growth factors postulated to provide enhanced healing and anti-inflammatory properties. There have been numerous studies on PRP’s efficacy in musculoskeletal soft tissue conditions with similar pathology to GTPS, with varying results, most promising being in plantar fasciopathy and patellar tendinopathy. Corticosteroids are the established second-line treatment, but do not always work long term. PRP may be a suitable alternative to corticosteroid in GTPS with longer-term effects; however, there are very limited reports. The Hip Injections PRP Vs Placebo (HIPPO) trial aims to assess the ability of PRP to improve symptoms and function in patients with GTPS.Methods/designHIPPO is a single-centre, double-blind randomized placebo-controlled study in patients with a radiologically confirmed diagnosis of gluteus medius or minimus tendinopathy with swelling within the tendon insertion with or without bursitis. We aim to randomise 102 patients with GTPS to either the PRP or placebo (normal saline injection) treatment arm. Participants will receive one ultrasound (US) guided PRP/placebo injection into the trochanteric bursa and surrounding gluteus medius/minimus tendons. The primary outcome measure is the International Hip Outcome Tool-12. Secondary outcome measures will include a visual analogue score for pain, the three-level version of the EuroQol five-dimensional questionnaire and the modified Harris Hip Score. Outcomes will be measured at baseline, 3, 6 and 12 months. Participants will have the option at 6 months to have a repeat blinded injection or cross over to PRP. Analyses of primary and secondary outcomes will be made according to the intention-to-treat principle. The trial reporting will comply with Consolidated Standards of Reporting Trials (CONSORT) guidelines.DiscussionThe HIPPO study has been designed to test the hypothesis that PRP is effective in treating GTPS in patients who have failed conservative management and to assess the duration of effect of PRP.Trial registrationClinicalTrials.gov, NCT03479190. Registered on 27 March 2018.

Leukocyte depletion does not affect the in vitro healing ability of platelet rich plasma.

The clinical use of platelet-rich plasma (PRP) containing or deprived of leukocytes remains a subject of debate and a controversial issue. It is not yet clear whether leukocyte content has a positive or negative effect on tissue healing processes. Several studies, conducted mainly in the orthopedic field, support the use of leukocyte-poor (LP) PRP, whereas other studies have not identified any significant differences between the use of LP and leukocyte-rich PRP. In the present study, the role of leukocytes contained in PRP was assessed to verify their in vitro effect on fibroblasts and endothelial cells, which have a leading role in the biological processes associated with wound healing (including angiogenesis and matrix remodeling). The original sample of PRP was divided into two aliquots, one of which remained unaltered, while the other was deprived of leukocytes. The two aliquots were used in in vitro tests in order to verify the effects of leukocytes on proliferation, wound healing and tube formation, and in molecular analyses of growth factor and enzyme content. The present results highlighted a substantial overlap between the two formulations. This may be explained by similar levels of growth factors (vascular endothelial growth factor, thrombospondin-1, interferon-γ, platelet-derived growth factor-BB, -AA and -B, tumor growth factor-β1, fibroblast growth factor 7 and tumor necrosis factor-α) and enzymes (gelatinases and plasminogen activators) in the two formulations. These results support the hypothesis that the ability of the PRP to affect the in vitro biological response of endothelial cells and fibroblasts does not rely on the presence of leukocytes.

What is the preclinical evidence on platelet rich plasma and intervertebral disc degeneration?

Intervertebral disc degeneration is a common disease that usually starts from the third decade of life and it represents a significant cause of socio-economic problems. The accepted surgical treatment for disc degeneration is disc removal and vertebral fusion or, in selected cases, intervertebral disc arthroplasty. Several studies have demonstrated the ability of platelet rich plasma (PRP) to stimulate cell proliferation and extracellular matrix regeneration. However, literature results are still limited and more studies are required to clarify the role of PRP in the prevention or in the treatment of degenerative disc disease. The aim of this review is to summarize and critically analyze the current preclinical evidence about the use of PRP in intervertebral disc degeneration. Literature search was performed through various combinations of the following keywords: Intervertebral Disc Degeneration, Platelet Rich Plasma, PRP, Intervertebral disc regeneration. Papers included in our review cover the period between 2006 and 2014. The PRISMA 2009 checklist was followed. At the end of the review process, 12 articles were included in our final manuscript, including 6 "in vitro" and 6 "in vivo" studies. All the included studies lead to positive preclinical results. No standardization of methodological analysis was observed. It is not possible to draw definitive evidence about the use of PRP in IVD regeneration. We advise a proper standardization of the methodological analysis in order to compare the available data and achieve definitive results. This should be the cornerstone for future clinical applications.

Sensitivity of Plantar Pressure and Talonavicular Alignment to Lateral Column Lengthening in Flatfoot Reconstruction

Lateral column lengthening (LCL) of the calcaneus is commonly performed as part of correction of the adult acquired flatfoot deformity. Increases in postoperative lateral plantar pressure associated with pain in the lateral aspect of the foot have been reported. The aim of this study was to investigate changes in pressures in the lateral aspect of the forefoot with increments of 6, 8, and 10 mm of LCL in a cadaveric flatfoot model. The hypothesis was that increasing the LCL incrementally by 2 mm will linearly increase the plantar pressures in the lateral aspect of the forefoot. Eight fresh-frozen cadaveric foot specimens were used. A robot compressively loaded the foot to 400 N with a 310-N tensile load applied to the Achilles tendon. A flatfoot model was created by resecting the medial and inferior soft tissues of the midfoot, followed by axial load of 800 N for 100 cycles. Kinematic and plantar pressure data were gathered after the different amounts of LCL (6, 8, and 10 mm) were achieved. The talonavicular joint demonstrated a median abduction angle of 4.4° in the axial plane and -2.6° in the sagittal plane in the flatfoot condition as compared with the intact condition. The 6, 8, and 10-mm LCLs showed axial correction of talonavicular alignment by -1.4°, -4.9°, and -9.2° beyond that of the intact foot, and sagittal correction of -0.1°, 1.3°, and 2.9°, respectively. LCL of 6, 8, and 10 mm showed consistently increasing lateral forefoot average mean pressure, peak pressure, and contact area. LCL in 2-mm increments consistently reduced talonavicular abduction and consistently increased plantar pressure in the lateral aspect of the forefoot. The lateral column should be lengthened judiciously, as a 2-mm difference leads to significant difference not only in angular correction of the talonavicular joint but also with regard to pressure in the lateral aspect of the forefoot.

Platelet rich plasma may enhance peripheral nerve regeneration after cyanoacrylate reanastomosis: a controlled blind study on rats

The aim of this study was to explore the ability of platelet rich plasma (PRP) to promote peripheral nerve regeneration after cyanoacrylate reanastomosis in rats. A total of 18 rats were used in this study. Bilateral sciatic neurotomies were performed in 15 rats, and then immediately reanastomosed with cyanoacrylate glue. On one side (G1), the anastomosed nerves were treated with prepared autologous PRP gel; on the contralateral side (G2) the nerves received no additional treatment. Sham surgery was undertaken on the remaining 3 rats (6 cases) where bilateral sciatic nerves were surgically approached but not cut (passive control group, (G3). Biopsies were harvested 12 weeks postoperatively and examined under the light microscope using osmic acid stain. The number of nerve fibers in the distal and proximal nerve segments of G1 and G2 as well as in G3 were counted and the results analyzed and compared. Animals in G1 and G2 showed some weakness and ulceration in their right and left feet for a few weeks postoperatively, which gradually improved during the follow-up period. The histomorphometric assessment showed a higher axon count in the distal segment of G1 (291.7 axons) compared with that of G2 (280.5 axons) ( P = 0.001). Similar results were noticed when the proximal segments of both groups were compared ( P = 0.040). These results were reflected in the values of the neurotization indices of G1 (91.9%) and G2 (89.5%) ( P = 0.008). The number of nerve fibers in G1 and G2 remained lower than in G3 ( P = 0.0001). The authors conclude that PRP may enhance the number of regenerating nerve fibers after cyanoacrylate neruoanastomosis.