Administration Of Platelet-rich Plasma Research Articles

Evaluating the efficacy of platelet rich plasma injection for the treatment of chronic plantar fasciitis

Background: Plantar fasciitis is a common and recurring cause of heel pain in adults. Platelet-rich plasma (PRP) derived from autologous blood contains a high concentration of growth factors necessary for tissue healing and offer potential treatment for plantar fasciitis. Materials and Methods: The study was conducted in Coimbatore medical college hospital as a day care procedure. Between May and September 2017, 100 patients with chronic plantar fasciitis with a mean age of 40 years were included in this prospective study and were treated with single autologous PRP injection. All patients were assessed for the pain on the visual analog scale (VAS) and the American orthopedic foot and ankle score (AOFAS) both preinjection and postsingle injection of PRP. Results: The average pain perception before injection as assessed using VAS was observed to be 9.1. Before PRP injection, 72% of patients had severe limitation of activities and 28% of patients had moderate limitation of activities. Following the administration of PRP, VAS decreased to 1.6. Eighty-eight patients were completely satisfied; eight patients were satisfied with reservation, whereas four patients were unsatisfied with the treatment outcome. AOFAS improved from 52 to 90, thus establishing its therapeutic efficacy both at 8 weeks and 3 months posttreatment. Conclusion: The results of this study support that injection of autologous PRP is safe, does not affect the biomechanical function of the foot and is efficacious in improving plantar fasciitis.

Intrauterine administration of platelet-rich plasma improves embryo implantation by increasing the endometrial thickness in women with repeated implantation failure: A single-arm self-controlled trial.

PurposeThe purpose of this study was to investigate the effectiveness of intrauterine administration of platelet‐rich plasma (PRP) in frozen embryo transfer (FET) cycle in Japanese patients with a thin endometrium.MethodA prospective single‐arm self‐controlled trial was conducted in Japan. PRP administration was performed in 36 of the 39 eligible patients with a thin endometrium (≤7 mm). Hormone replacement therapy (HRT) with estrogen was performed for 2 menstrual cycles, and PRP was administrated on the 10th and 12th days of the second HRT cycle. The endometrial thickness was evaluated on transvaginal ultrasonography by two physicians at every visit, one an attending physician and the other a specialist physician blinded to the date and timing of the sonography. FET was performed during the second HRT cycle after PRP administration.ResultsAfter PRP administration, the mean (SD) endometrial thickness on the 14th day was significantly increased by 1.27 mm (P < .001) and 0.72 mm (P = .001) on the basis of the unblinded and blinded measurements, respectively. Of the 36 patients, 32 (88.9%) underwent FET. The clinical pregnancy rate was 15.6%. No adverse events occurred.ConclusionsPRP therapy was safe and effective in increasing endometrial thickness improving possibly pregnancy rate.

Cystocele Repair with Platelet-Rich Plasma

Cystocele is the most common vaginal wall prolapse with high incidence of recurrence after operation. Our aim in this study was to show the effectiveness of using platelet-rich plasma with cystocele repair. Patients were assigned to 2 groups: (1) cystocele repair only and (2) cystocele repair with platelet-rich plasma injection. Each group consisted of 28 patients. There were no significant differences between the groups in terms of demographics features. They were re-assessed 4 weeks later, 6 months later and annually with the standard Pelvic Organ Prolapse Quantification system to detect anatomic recurrence, the Pelvic Floor Distress Inventory for assessment of symptomatic recurrence and Patient Impression of Global Improvement questionnaire for assessment of subjective success. At the end of the 48-month follow-up period, the results were compared between the groups. The main outcome was low recurrence rate with platelet-rich plasma administration and secondary outcome was lower Pelvic Floor Distress Inventory scale score and higher Patient Impression of Global Improvement questionnaire results. The decrease in prolapse symptoms ascertained with the Pelvic Floor Distress Inventory scale was more significant in group 2 (6 vs. 2, p = 0.002), reoperation rate for symptomatic cystocele recurrence was significantly lower in group 2 (5 (17.8%) vs. 1 (3.5%), p = 0.001) and also subjective success evaluated with Patient Impression of Global Improvement scale was significantly higher in group 2 (21 vs. 25, p = 0.012). Considering mesh complications, platelet-rich plasma administration may be a good alternative to prevent cystocele recurrence. However, further research is needed to evaluate the safety and efficacy of this treatment.

The effect of perioperative platelet-rich plasma injections on postoperative failure rates following rotator cuff repair: a systematic review with meta-analysis

Platelet-rich plasma (PRP) has gained significant interest in recent years to potentially add biological augmentation of healing to surgical repairs of soft-tissue injuries. We sought to determine whether perioperative PRP injection influences the risk of failure following rotator cuff repair. A systematic search was performed in the Embase and PubMed databases and identified 16 randomized controlled trials or prospective cohort studies (1045 participants) reporting rates of failure, defined as a subsequent tear on postoperative imaging, after rotator cuff repair with or without perioperative PRP administration. A random-effects meta-analysis of the included studies was performed to determine the pooled effect of PRP administration on the postoperative failure risk. Among the 16 studies investigating rotator cuff repairs, PRP augmentation resulted in a 25% reduction in the risk of repair failure, with low heterogeneity among the included studies. A significant protective effect was seen for studies of only small to medium tears (7 studies) (P = .007) and studies including large or massive tears (9 studies) (P < .001). Intraoperative PRP reduces the failure risk following rotator cuff repair and has a consistent effect regardless of tear size. However, because of the variability in PRP preparations, a specific recommendation cannot be made.

Platelet-Rich Plasma Enhances Distal Flap Viability and Underlying Vascularity in a Radiated Rotational Flap Rodent Model.

Importance: Autologous platelet-rich plasma (PRP) has received widespread attention due to its physiologic healing properties, augmenting the body's natural healing process through platelet activation and release of growth factors. The effects of PRP on radiated tissue have been inadequately studied in vivo. Objective: To determine whether PRP can be used to improve viability of radiated tissue subjected to a clinically meaningful stressor, in this case a rotational skin flap. Design, Setting, Participants: This is a prospective trial using a radiated rat abdominal rotational flap model in the laboratory. Male Sprague-Daley rats were used in this study. Harvested PRP or saline control was injected into rotational flaps immediately after surgery. Progression of necrosis was documented with photo analysis. After 1 week, animals were sacrificed and flap tissue was stained and analyzed for presence of vascular tissue. Intervention: PRP versus control injection into radiated skin tissue. Main Outcomes and Measures: Percentage necrosis of rotational flap and number of vascular channels stained with CD31 present in flap tissue. Results: PRP administration helped rescue the distal flap from necrosis, achieving viability similar to nonradiated controls. Superficial vascularity was similarly increased fivefold in radiated tissue if PRP was given postoperatively, mirroring the vascular density of nonradiated tissue. Conclusions and Relevance: PRP may enhance distal rotational flap viability after radiation, possibly by protecting superficial vessels from tissue necrosis when administered at the time of surgery.

Effect of Platelet-Rich Plasma (PRP) on testicular damage in streptozotocin-induced diabetic rats

Background: Diabetes mellitus (DM) is a condition which could lead to induce testicular damage due to oxidative stress by hyperglycemic stress. Several therapies have been elucidated to reduce the testicular damage; one of them is Platelet-Rich Plasma (PRP). PRP has known growth factor properties which may serve potential effects in the tissue regeneration. This study aims to determine the role of PRP on testes in streptozotocin-induced diabetic rats by evaluating its impact on testosterone serum level.Methods: A randomized clinical trial with control group design has been conducted among 20 rats in this study. The sample of rats was divided into four groups such as control, DM (streptozotocin-induced), DM-Ins (treated with insulin daily), and DM-Ins-PRP (treated with insulin daily and PRP thrice in 2 weeks). Six weeks later, the testosterone level was measured by ELISA, and the right testis was collected for histopathology findings. Data were analyzed using SPSS version 25 for Windows. Results: The testes weight in the control group was 1.61±0.37 grams, followed by DM group (0.86±0.22 grams), DM-Ins group (1.15±0.25 grams), and DM-Ins-PRP group (1.09±0.36 grams). DM reduced testicular weight, seminiferous tubules diameter, the thickness of the epithelium and testosterone serum level significantly (p&lt;0.05) compared with control. PRP administration increases the thickness of seminiferous epithelium (p&lt;0.05) significantly. Besides, it also increased the testicular weight, tubules diameter, lumen diameter, and testosterone serum level, but not significant (p&gt;0.05).Conclusion: The administration of PRP showed a significant role in repairing testicular damage among diabetic rats.

Effect of intra-articular administration of autologous PRP and activated PRP on inflammatory mediators in dogs with osteoarthritis

The aim of this study was to investigate the effects of the intra-articular use of platelet rich plasma (PRP) and bio-physically activated PRP (BPRP) on the inflammatory mediators for the treatment of osteoarthritis in dogs. The animals included in this study were 36 mix breed dogs diagnosed with osteoarthritis in the stifle as a result of the clinical and radiological examinations. The dogs were randomly divided into three groups: PRP (platelet-rich plasma), BPRP (biophysically activated platelet-rich plasma) and control (given 0.9% isotonic saline). These three main groups were each further divided into two groups as single and double according to the number of intraarticular administrations. Joint fluid analyses, a clinical examination (Hudson Visual Analog Scale and Canine Brief Pain Inventory Tests) radiographic and ultrasonographic examinations were performed on days 1, 15, 30, 60, and 90 for each group. Genesis System 2 branded and BPRP preparation kits were used in this study. An ELISA method was used to measure the cytokines in charge of the inflammatory mediation (IL-1β, IL-6, IL-10, TNF-α) in the synovial fluid samples. The records obtained from the walking and pain rating tests were subjected to a statistical analysis program and a Mann-Whitney U test was performed. The results of the ELISA were evaluated by a Tukey test. There was a significant difference between the single and double groups of the PRP administration on days 60 and 90 (P &amp;lt; 0.05) in the walking and pain scores. The double groups of the PRP had better results than the single groups. There was a significant difference between the single groups of the PRP and BPRP for the IL-10 on the 30&lt;sup&gt;th&lt;/sup&gt; day (P &amp;lt; 0.05). In the single application groups, the BPRP was better than the PRP on day 30 in the IL-10 measurements. In the comparison of the single and double administration groups, there was significant difference between the single and double groups of the BPRP on day 90 (P &amp;lt; 0.05). The double groups of the BPRP had better results than the single groups. In addition, the biophysically activated PRP was found to be superior to the PRP for the IL-10 content. In conclusion, the efficacy of the PRP and BPRP was related to the degree of the osteoarthritis (OA). Especially the success rate in the acute OA patients was higher due to the anti-inflammatory activity of the BPRP. Moreover, the double administration groups gave more positive results than the single administration groups.

Treatment With Platelet Lysate Inhibits Proteases of Synovial Fluid in Equines With Osteoarthritis

Osteoarthritis (OA) is the most prevalent arthropathy in sport horses. The administration of a platelet lysate (PL) is an alternative method for the treatment of musculoskeletal conditions. The mechanisms by which PL exerts its beneficial effects have not been determined, and less is known about its effect on the activity of the proteolytic enzymes of the synovial fluid of equines with OA. In this work, the effect of the administration of PL to horses with OA was analyzed both clinically and molecularly by determining the levels of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5), glycosaminoglycans (GAGs), and tissue inhibitor of metalloproteinase 1 (TIMP-1) in synovial fluid. One mL of PL was administered intra-articularly followed by the extraction of synovial fluid on days 0, 10, 30, and 60. Results were evaluated by an analysis of variance for repeated measures. The levels of MMP-9 decreased significantly (P < .05) on day 10 after treatment with PL. A disintegrin and metalloproteinase with thrombospondin motifs 5 decreased significantly on days 10 (P < .05), 30 (P < .05), and 60 (P < .01) after treatment. The levels of synovial TIMP-1 increased significantly on day 30 (P < .001) after treatment. Glycosaminoglycans showed a significant increase on days 10 (P < .05) and 30 (P < .01). A significant decrease was found for MMP-2 on day 10 (P < .01), 30 (P < .01), and 60 (P < .001). In conclusion, the beneficial effects of PL in OA could be attributed to the decreased activity of MMP-2, MMP-9, and ADAMTS-5 and the increased concentration of GAGs and TIMP-1 after the administration of platelet-rich plasma.

The influence of platelet-rich plasma (PRP) on colonic anastomosis healing impaired by intraperitoneal 5-flourouracil application. An experimental study

Purpose 5-flourourasil (5-FU) is commonly used for early intraperitoneal chemotherapy in colorectal or appendiceal cancer patients with peritoneal carcinomatosis. Due to its effect, anastomosis healing can be impaired and leads to anastomotic leakage. In this study, we aimed to investigate the potential healing effect of platelet-rich plasma (PRP) on colonic anastomosis impaired by intraperitoneal 5-flourouracil application.Methods After ten rats were sacrificed for preparing PRP, forty Wistar-albino rats were subjected to colonic anastomosis, and randomly allocated into four groups including 10 rats each. According to receiving PRP and/or 5-FU application, the groups were formed as control (C), 5-FU without PRP (CT), anastomosis with PRP (C-PRP), and 5-FU with PRP (CT-PRP). CT and CT-PRP groups also received 5-FU intraperitoneally on postoperative day 1 (POD 1). All animals were euthanized on pod 7. The body weight change, anastomotic bursting pressure (ABP), tissue hydroxiprolin (TH) and histopathological examination of each group were analyzed.Results 5-FU application significantly reduced ABP levels when compared with group C, C-PRP and CT-PRP (for each comparison, p<0,01). PRP application in CT-PRP group raised the measure of ABP up to the levels of C group. Although tissue hydroxyproline levels (THL) levels of CT-PRP group were found higher than CT group, it was not significant (p=0.112). Microscopically, comparing with CT group, PRP application significantly promoted the healing of colonic anastomosis subjected to 5-FU application by improving tissue edema, necrosis, submucosal bridging and collagen formation (p<0.05). Tissue healing in CT-PRP group was observed as good as the control groups. (C, C-PRP, p=0.181, p=0.134; respectively).Conclusion PRP administration on colonic anastomosis significantly promotes the healing process of anastomosis in rats receiving 5-FU. This result encourages further clinical use of PRP to reduce the frequency of AL in patients receiving EPIC.

Platelet-rich plasma accelerates skin wound healing by promoting re-epithelialization.

BackgroundAutologous platelet-rich plasma (PRP) has been suggested to be effective for wound healing. However, evidence for its use in patients with acute and chronic wounds remains insufficient. The aims of this study were to comprehensively examine the effectiveness, synergy and possible mechanism of PRP-mediated improvement of acute skin wound repair.MethodsFull-thickness wounds were made on the back of C57/BL6 mice. PRP or saline solution as a control was administered to the wound area. Wound healing rate, local inflammation, angiogenesis, re-epithelialization and collagen deposition were measured at days 3, 5, 7 and 14 after skin injury. The biological character of epidermal stem cells (ESCs), which reflect the potential for re-epithelialization, was further evaluated in vitro and in vivo.ResultsPRP strongly improved skin wound healing, which was associated with regulation of local inflammation, enhancement of angiogenesis and re-epithelialization. PRP treatment significantly reduced the production of inflammatory cytokines interleukin-17A and interleukin-1β. An increase in the local vessel intensity and enhancement of re-epithelialization were also observed in animals with PRP administration and were associated with enhanced secretion of growth factors such as vascular endothelial growth factor and insulin-like growth factor-1. Moreover, PRP treatment ameliorated the survival and activated the migration and proliferation of primary cultured ESCs, and these effects were accompanied by the differentiation of ESCs into adult cells following the changes of CD49f and keratin 10 and keratin 14.ConclusionPRP improved skin wound healing by modulating inflammation and increasing angiogenesis and re-epithelialization. However, the underlying regulatory mechanism needs to be investigated in the future. Our data provide a preliminary theoretical foundation for the clinical administration of PRP in wound healing and skin regeneration.

Platelet-Rich Plasma Promotes Spinal Ligament Healing after Injury.

Spinal ligament injury is often a comorbidity in spine fracture. Although the spinal ligament is important to maintain spinal stability, little is done to improve its healing after injury. Platelet-rich plasma (PRP) has been shown effective in treating many tendon and ligament disorders, but its role in spinal ligament injury remains to be evaluated. Supraspinous ligament and interspinous ligament were cut in rabbits to simulate spinal ligament injury after spine fracture. After the injury, the administration of autologous PRP was performed and compared with saline injection control. Morphology and histological analysis were utilized to assess PRP effect and compare it to the saline control group. To understand potential molecular mechanisms of PRP on ligamentous healing, bioinfor-matics analysis of the microarray dataset (GSE70918) from the Gene Expression Omnibus database was conducted. The PRP group was more likely to have a better appearance both morphologically and histologically than did the saline control group. Pathway analysis determined that IL-17 signaling pathway and TNF signaling pathway were the two significantly induced signaling pathways in tendon fibroblasts treated by PRP. In the protein-protein interaction network analysis, interleukin 6 had the highest degrees of connectivity. PRP improves spinal ligament healing through the activation of pathways related to inflammation. Further studies are required to determine the dosing and timing of PRP administration to achieve better longterm treatment outcome.

Treatment of canine osteoarthritis with allogeneic platelet-rich plasma: review of five cases.

Background:Osteoarthritis (OA) is a major cause of chronic pain and lameness in dogs. Platelet-rich plasma (PRP) is a concentrate of growth and differentiation factors from the blood, which can be used in regenerative medicine strategies.Aim:The main aim of this study was to evaluate the effect of allogeneic PRP on the treatment of canine OA.Methods:Five dogs from several breeds, between 6 and 12 years old, and from both genders were studied. Clinical and imageological examinations diagnosed OA in the knee, tibiotarsal, elbow, and intercarpal joints. These dogs were refractory to medical therapy and to physical rehabilitation protocols that included shockwave therapy, laser therapy, electrostimulation, hydrotherapy, and diathermy.Animals were treated with allogeneic PRP obtained from the blood of the five dogs, which was processed in a pool. Echoguided intra-articular PRP injection was administered under sedation and after aseptic field preparation. Lameness at walk and trot (five grades) and pain (five scores) were evaluated before treatment and 30, 60, and 90 days post-treatment. Results:All animals presented improvements at 30 and 60 days in both parameters. Four dogs showed a decrease of three grades of lameness after 90 days and there was complete absence of lameness in 2 days. Pain was reduced from severe and moderate to mild in all the dogs after 30 days, and among them, three revealed no pain after 90 days.Conclusion:This study sheds light on the applicability and safety of a single administration of allogeneic PRP in osteoarthritic dogs.

Effects of local administration of platelet-rich plasma and guided tissue regeneration on bone healing in early inserted dental implants - a histomorphometric analysis

Introduction. In order to provide the most favorable conditions for bone healing following implant loading, new techniques such as the use of growth factors to directly or indirectly regulate cell and tissue growth are becoming increasingly popular. Simplicity in producing concentrated thrombocytes derived from platelet-rich plasma has led to increasing application of growth factors derived from thrombocytes, such as PDGF, TGF-?, IGF and VEGF, in order to increase the percentage of bone-to-implant contact that provides better implant stability and possibly earlier functional loading. The aim of the study was to determine the effects of platelet-rich plasma and guided tissue regeneration on bone regeneration in the case of bone defects in early dental implant insertion. Materials and Methods. This experimental study was conducted on 10 study dogs that received 40 BCT implants, i.e., 4 implants per dog. The study included early dental implant placement in the sites of the extracted premolars. Artificial bone defects, resembling peri-implantitis defects, were made on the mesial side of each site, and the defects were filled using suitable guided tissue regeneration protocols with platelet-rich plasma derived from each experimental animal an hour before surgery. Histopathologic and histomorphometric evaluations were performed 10 months following the implantation. Results and Conclusion. The applied protocols had different effects on bone healing. According to the results obtained, the use of platelet-rich plasma combined with deproteinized bovine bone and bovine-derived resorptive membrane provided superior bone defect ossification

Treatment of Male-Pattern Alopecia with Platelet-Rich Plasma

Background: Androgenetic alopecia (AGA) affects up to 80% of men and 50% of women throughout their lifetime, causing significant discomfort. Minoxidil, finasteride, and low-level laser light therapy are the only Food and Drug Administration-approved treatments for AGA, and they have shown positive results in randomized controlled trials and meta-analyses. However, their efficacy is limited, and new therapies are needed. Injection of platelet-rich plasma (PRP), a minimally invasive technique, has been described by several authors as a promising treatment for AGA. Although many studies report beneficial effects of PRP on AGA, there is no standardized practice for PRP preparation and administration or a standard method to evaluate results. Objective: The aim of this study was to evaluate the efficacy of manually prepared PRP in the treatment of male AGA. Materials and Methods: We treated 20 male patients with AGA with 3 monthly injections of PRP and analyzed results by TrichoScan®. Results: In this study, there was no statistically significant improvement in hair count or proportion of anagen hairs. Conclusions: This lack of response could be related to any of the variables during PRP preparation described above and also to the limited number of patients in the study.

Clinico-immunological efficiency of age-related skin changes correction by neofibrolifting

The aim of the work is to develop a procedure for isolation of lymphocytes from biopsied skin samples, to study the content of CD4 + and CD8 + cells of αβT-lymphocytes subpopulations in patients of different age groups in the process of neofibrolifting and to evaluate the possible role of the skin immune system in achieving an effective clinical result by the indicated method of involutional changes correction. Materials and methods . In total, 99 patients of different ages with signs of skin chrono- and photoageing on the face who visited the Clinic “Virtus” were examined and treated. Clinical and dermatological examinations were conducted, as well as neofibrolifting with the sequential intradermal administration of platelet-rich plasma (PRP) and dermal autofibroblasts (DFBs). PRP was prepared by standard centrifugation on a Harvest Smart PReP2 special centrifuge. DFBs were obtained from biopsied skin samples of the postaural area and accumulated ex vivo in the biotechnological laboratory. Lymphocytes from the skin biopsies were isolated by enzymatic treatment. Phenotyping of cells for CD4 and CD8 antigens was performed by flow cytofluorimetry. Results. It was established that the clinical manifestation of involutional changes in the skin is accompanied by a decrease in the number of CD4 + and CD8 + lymphocytes. As a result of neofibrolifting, a significant clinical correction of age-related disorders is observed. At the same time, the number of CD4 + cells increases within 2 weeks of the PRP administration and increases further as a result of autofibroblasts transplantation and remains at a high level over the entire follow-up period (12 months). The number of CD8 + lymphocytes in the skin is changed in the opposite direction. The clinical improvement was clearly pronounced after autofibroblast transplantation and throughout the 12-month period. Conclusions. The number of CD4+ and CD8+ cells in patients aged 45-55 and 56 years and older is significantly reduced compared with the indices of younger patients, which indicates aging of the skin T-cell immunity. As a result of neofibrolifting, there is a significant increase in the number of CD4+ lymphocytes after the PRP introduction followed by an increase in their level due to autotransplantation of fibroblasts, which remains significantly higher than baseline for 12 months. The number of CD8+ lymphocytes changes in the opposite direction. The results indicate that the skin immune system is partly involved in the implementation of neofibrolifting mechanisms.

Involvement of PDGF-BB and IGF-1 in Activation of Human Schwann Cells by Platelet-Rich Plasma.

Platelet-rich plasma contains high concentrations of growth factors that stimulate proliferation and migration of various cell types. Earlier experiments demonstrated that local platelet-rich plasma administration activates Schwann cells to improve axonal regeneration at a transected peripheral nerve lesion. However, the optimal concentration of human platelet-rich plasma for activation of human Schwann cells has not been determined, and mechanisms by which platelet-rich plasma activates Schwann cells remain to be clarified. Human Schwann cells were cultured with various concentrations of platelet-rich plasma in 5% fetal bovine serum/Dulbecco's Modified Eagle Medium. Cell viability, microchemotaxis, flow cytometry, and quantitative real-time polymerase chain reaction assays were performed to assess proliferation, migration, cell cycle, and neurotrophic factor expression of the human Schwann cells, respectively. Human Schwann cells were co-cultured with neuronal cells to assess their capacity to induce neurite extension. Neutralizing antibodies for platelet-derived growth factor-BB (PDGF-BB) and insulin-like growth factor-1 (IGF-1) were added to the culture to estimate contribution of these cytokines to human Schwann cell stimulation by platelet-rich plasma. An addition of platelet-rich plasma at 5% strongly elevated proliferation, migration, and neurotrophic factor production of human Schwann cells. Both PDGF-BB and IGF-1 may be involved in mitogenic effect of platelet-rich plasma on human Schwann cells, and PDGF-BB may also play an important role in the migration-inducing effect of platelet-rich plasma. Neutralization of both PDGF-BB and IGF-1 cancelled the promoting effect of platelet-rich plasma on neurite-inducing activity of human Schwann cells. This study may suggest the optimal concentration of platelet-rich plasma for human Schwann cell stimulation and potential mechanisms underlying the activation of human Schwann cells by platelet-rich plasma, which may be quite useful for platelet-rich plasma therapy for peripheral nerve regeneration. Therapeutic, V.

Alleviation of synovitis caused by joint instability with application of platelet-rich plasma

IntroductionSynovitis is an early set and persistent change during the progression of osteoarthritis, which causes symptoms such as pain and swelling of the joints. Platelet-rich plasma (PRP) can release quantities of growth factors and cytokines, and is proved effected in promoting restoration of multiple soft tissues. Materials and methodsIn this study, twenty rabbits were used to establish animal model of synovitis, with the method of severing the anterior and posterior cruciate ligaments and removing the medial meniscus. Then the rabbits were evenly divided into the PRP group and the control group, and each group received injections of PRP and saline respectively once a week for 3 weeks consecutively, with the first injection administered 3 weeks postoperatively. ResultsThe platelet count, the concentrations of growth factors in PRP and whole blood were investigated, and the IL-1β concentration in the joint fluid was detected via ELISA. The synovium as well as the adjacent articular cartilage were collected for histological assessment. The platelet concentration in PRP is 6.8 fold of that in the whole blood. The IL-1β level in the PRP group was lower than that in the control group 2 and 3 weeks after the administration of PRP. Histological investigation showed that the inflammatory reaction of the synovium and impact on the cartilage was much abated in the PRP group. ConclusionsPRP can effectively alleviate the synovitis caused by osteoarthritis following loss of joint stability. Given the autologous origin, its low cost and low risk features of PRP, it's a promising choice for OA patients to control the symptoms caused by synovitis.

Platelet-rich plasma another add-on treatment getting out of hand? How can clinicians preserve the best interest of their patients?

Add-on treatments in IVF are utilized to a great extent but without sufficient evidence showing their effectiveness. Since the offered treatments are usually costly and may be associated with yet unknown risks, this practice is not in the best interest of couples that may go to great lengths to conceive and have an offspring carrying their own genetic make-up. A recent addition to this armamentarium is the administration of platelet-rich plasma (PRP) in women with diminished ovarian reserve, implantation failures, and a thin endometrium. The only evidence for PRP comes from small scale and mostly before and after studies with clinically irrelevant end points. PRP has not been subjected to a rigorous clinical trial. It is a typical example of an add-on gaining widespread popularity based on biological plausibility and mind-bending theoretical presumptions. We should be extremely cautious prior to implementing PRP on a widescale and await the results of well-designed studies.

Treatment of degenerative meniscal tear with intrameniscal injection of platelets rich plasma

PurposeThe purpose of this retrospective study was to describe our preliminary results of intra-meniscal administration of platelet rich plasma (PRP) in patients with degenerative meniscal tears of the knee. Material and methodTen patients with degenerative meniscal tears according to the Stoller classification and without knee osteoarthritis were included. There were 7 men and 3 women with a mean age of 40.4±13.6 [SD] years (range: 18–59 years). Patients were prospectively assessed at baseline and 3- and 6-months after intra meniscal PRP administration. Evaluation included the knee injury and osteoarthritis outcome score (KOOS), pain visual analog scale, and return to competition and training. MRI follow-up was performed 6 months after PRP administration. Adverse events were recorded. ResultsVolume of injected PRP was standardized to 4.0mL. Adverse events during PRP administration was moderate pain in 8 patients (8/10; 80%). Mean KOOS total score significantly improved from 56.6±15.7 (SD) to 72.7±18.5 (SD) (P=0.0007). All six patients practicing sports regularly were able to recover competition or training. In seven patients who underwent MRI follow-up at 6 months, MRI showed stability of the meniscal tears and similar Stoller grades. ConclusionIntra-meniscal administration of PRP under ultrasound guidance directly into meniscal degenerative lesions is feasible and safe. Further randomized controlled studies are needed to definitely confirm the effectiveness of this procedure.

Effect of Platelet-rich Plasma on Mankin Scoring in Chemically-induced Animal Model of Osteoarthritis.

To evaluate the effects of platelet-rich plasma injection on histological changes of osteoarthritis using the modified Mankin score in monoiodoacetate-induced rat knee model. Laboratory-based experimental study. Department of Anatomy, Army Medical College, Rawalpindi and National Institute of Health (NIH), Islamabad from March to May 2018. Thirty-two pathogen-free male rats aged 3-4 months were selected and divided into two groups with 8 and 24 animals, respectively. Groups A was used as control. Experimental group B was further subgrouped as B1, B2 and B3 with 8 animals, in each subgroup. Monoiodoacetate solution was injected into the articular cavity of the right knee joint of all the animals in group B. Both the control (A) and experimental group B1 were sacrificed after 2 weeks of MIA injection, for observing the histological changes in the articular cartilage. Group B2 received a single injection of platelet rich plasma (PRP) while group B3 was reared as such. Both groups were sacrificed after 4 weeks of intra-articular administration of PRP. Articular cartilage was collected, processed and stained with hematoxylin and eosin (H and E) and toludine blue (T.B). Routine histological study was done and Mankin score was calculated to determine the grade of arthritis. SPSS Version 21 was used for the statistical analysis and p-value was considered significant at the cut-off value of 0.05. The mean Mankin score of group B3 (9.37) was significantly higher than that of group B2 (7.37, p=0.003). Platelet-rich plasma treatment controls the histological changes of chemically-induced osteoarthritis in rat knee.