Platelet-rich Plasma Research Articles

Platelet-Rich Plasma Injections Do Not Improve the Recovery After Arthroscopic Partial Meniscectomy: A Double-Blind Randomized Controlled Trial

Background: Arthroscopic meniscectomy is one of the most performed surgical procedures in orthopaedics. Different approaches have been proposed to improve patient recovery but with unsatisfactory results. Platelet-rich plasma (PRP) augmentation has been proposed as a strategy to improve the recovery after meniscectomy. Purpose: To investigate the clinical benefits of an intra-articular PRP injection after meniscectomy, in terms of faster and better patient recovery. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Ninety patients were randomized into a treatment group, with arthroscopic partial meniscectomy immediately followed by a 5-mL injection of autologous conditioned plasma, and a control group with partial meniscectomy alone. Patients were evaluated at baseline and at 15, 30, 60, and 180 days of follow-up with the visual analog scale (VAS) score for pain (primary outcome), as well as with International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score subscales, Tegner score, and EuroQol-Visual Analog Scale score. Objective evaluation was performed analyzing knee range of motion and circumference and the International Knee Documentation Committee objective score. Complications, patient judgment, and satisfaction were documented as well. Results: No major complications and an overall significant improvement in the clinical scores were observed in both groups. Overall, the comparative analysis did not demonstrate significant between-group differences in absolute values or improvements of both subjective and objective scores, as well as activity level. The improvement in terms of VAS pain score for the treatment group was significant already at 15 days (from 4.3 ± 2.5 to 2.5 ± 2.5; P = .014), while in the control group it became significant at 30 days (from 3.7 ± 2.3 to 2.0 ± 2.4; P = .004). No significant differences were observed between the 2 groups in terms of judgment of treatment results and satisfaction. Conclusion: A single postoperative injection of PRP was not able to significantly improve patient recovery after arthroscopic partial meniscectomy. PRP augmentation did not provide overall benefits at a short-term follow-up (6 months) in terms of pain relief, function, objective parameters, and return-to-sport activities. Registration: NCT02872753 (ClinicalTrials.gov identifier).

The role of fibrinogen combined with platelet-rich plasma in enhancing microfracture for cartilage damage: a retrospective study of 113 patients with knee osteoarthritis

ObjectiveKnee osteoarthritis is the most common osteoarthritis and imposes a significant burden on patients’ lives. Several treatment methods can promote cartilage repair to varying extents, but there are limited studies on the combined application of different treatments. The purpose of this study is to evaluate the clinical efficacy of microfracture combined with fibrinogen and platelet-rich plasma (PRP) under arthroscopic in treating knee osteoarthritis, so as to provide a basis for clinical treatment decisions.MethodA total of 113 patients with knee osteoarthritis who received orthopedic treatment from January 2021 to June 2022 were selected. They were divided into two groups according to whether they received fibrinogen and PRP treatment in addition to microfracture treatment. The two groups were analyzed to compare the differences in knee joint function and quality of life at different points.ResultsThe study compared changes in knee joint function scores and quality of life between the two groups after treatment and found that the quality of life of patients in the combined treatment group was significantly better than that of patients who received microfracture only (at 12-month follow-up, EuroQol-VAS scores were 64.32 ± 5.63 for the microfracture group (MFx) and 75.65 ± 8.57 for the fibrinogen combined with platelet-rich plasma-assisted microfracture group (FPRPA MFx); P = 0.015; at 24-month follow-up, EuroQol-VAS scores were 66.47 ± 5.18 for the MFx group and 79.40 ± 7.43 for the FPRPA MFx group, P = 0.022). There was also a strong correlation between patients’ quality of life and knee joint function score index (IKDC score correlation coefficient r=-0.375, Lysholm score correlation coefficient r = 0.497, MOCART score correlation coefficient r = 0.579, VAS score correlation coefficient r = 0.242, T2 value correlation coefficient r=-0.293, P < 0.001). Age-stratified analysis of the patients in the microfracture combined with fibrinogen platelet-rich plasma treatment group showed that the effect of the combined treatment was more pronounced in elderly patients.ConclusionsThe results of the study showed that compared with microfracture alone, microfracture combined with fibrinogen platelet-rich plasma therapy can further improve patients’ knee joint-related function and their quality of life after treatment. The improvement was more obvious in elderly patients.

The Biological Effect of Enriching the Plasma Content in Platelet-Rich Plasma: An In Vitro Study.

Platelet-rich plasma (PRP) formulations have become valuable therapeutic tools in regenerative medicine. In addition, these blood derivates have been successfully included in cell therapy as fetal bovine serum substitutes, due to the real need to avoid the risk of host immunologic reactions and the animal disease transmission associated with reagents from animal origin. However, the protocols for obtaining them should be optimized to improve their biological potential. PRP-derived preparations with different concentrations of the platelet and plasma components were obtained from the blood of five donors by freeze-drying. Measurements of the pH, protein, and growth factor concentration were performed. Moreover, their biological effects on cell proliferation and migration and their angiogenic potential were assessed. An increased plasma component concentration resulted in an augmented quantity of the total protein content, a significative variation in the hepatocyte growth factor concentration, and an experimental but clinically irrelevant alteration of the pH value. No significant changes were induced in their potential to enhance proliferative and migratory responses in epithelial cells, with the latter being reduced for dermal fibroblasts. The endothelial cell capacity for tube formation was significatively reduced. An increased blood plasma content did not improve the biological potential of the formulations. However, they have emerged as a promising approach for regenerative therapies where neovascularization must be avoided.

Is platelet-rich plasma as safe as we think?: a case report

BackgroundPlatelet-rich plasma (PRP) is an autologous plasma product in which the concentration of platelets is several times higher than the physiologic level in peripheral blood and is a kind of concentrated form of platelet growth factor. It is widely used in dentistry, sports medicine, dermatology and cosmetology, gynecology and reproductive medicine, and ophthalmology. It has also been used in neurology for pain alleviation and regeneration of neurons. Herein, a 4-year-old patient, who was diagnosed with acute disseminated encephalomyelitis and received PRP subcutaneous injection was presented.Case presentationA 4-year-old patient, who was diagnosed with acute disseminated encephalomyelitis at the age of 3 years old and recovered with severe neurological sequelae despite treatment, received PRP subcutaneous injection in a private center to provide neuronal regeneration. The patient was admitted to our hospital 5 days after PRP with fever, refusal to feed, and decreased urine output. He was intubated due to respiratory distress. Inotropic treatments were initiated when hypotension and circulatory disturbance did not improve despite appropriate intravenous fluid administration. Staphylococcus epidermidis bacteremia was detected. Unfortunately, the patient died despite all interventions.ConclusionIn this case, it should not be ignored that the PRP procedure, which can be performed easily and quickly for various indications in many health institutions today, may be associated with serious side effects that may result in death. PRP injection must be performed in competent hands, following disinfection recommendations.

Regenerative therapies for erectile dysfunction: a systematic review, Bayesian network meta-analysis, and meta-regression.

Current guidelines advocate a shared decision-making process approach to erectile dysfunction management, and while there is growing interest in regenerative therapies such as stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy for erectile dysfunction, comparative data on the efficacy of these modalities are limited. This systematic review and network meta-analysis aims to compare stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy for managing erectile dysfunction and quantify their impact on the International Index of Erectile Function (IIEF). In January 2024, a systematic search of online databases was performed to identify randomized clinical trials related to stem cell therapy, platelet-rich plasma injections, and low-intensity shockwave therapy in erectile dysfunction. Eligible articles reported outcomes using the IIEF score. Data were inputted into Review Manager 5.4 for pairwise meta-analysis. Data were then used to build a network in R Studio. These networks were used to model 200 000 Markov Chains via MonteCarlo sampling. The results are expressed as standardized mean difference (SMD) with 95% credible intervals (CrI). Meta-regression was used to adjust for PDE5is use. Impact on the International Index of Erectile Function. A total of 16 studies involving 907 patients were analyzed. The standardized mean difference (SMD) vs control for stem cell therapy was 0.92 [95% CrI -0.49, 2.3]. For platelet-rich plasma, the SMD vs control was 0.83 [95% CrI 0.15, 1.5], and for low-intensity shockwave therapy, the SMD vs control was 0.84 [95% CrI 0.49, 1.2]. When stratifying low-intensity shockwave therapy by dose, the SMD vs control at 0.15mJ/mm2 was 1.1 [95% CrI 0.36, 1.9], while at 0.09mJ/mm2, it was 0.75 [95% CrI 0.26, 1.2]. Meta-regression adjusting for the administration of PDE5 inhibitors yielded non-significant results. The findings suggest that stem cells, platelet-rich plasma, and low intensity shockwave therapy, particularly at 0.15 and 0.09mJ/mm2, may offer improvements in erectile function. The strength is the robust statistical methods. Limitations are in heterogeneity in control groups and follow-up durations among included studies. Shockwave therapy and platelet-rich plasma demonstrated statistically significant improvements, though the clinical relevance and extent of their impact remain questionable. Further research is necessary to determine the efficacy of stem cell therapies for erectile function.

Impact of Platelet-Rich Plasma on Sciatic Nerve Injury in Rats: HSP 70 Expression and Histological Changes in the Anterior Horn of the Spinal Cord

Peripheral nerve injuries are a significant and growing cause of disability worldwide, as reported by the World Health Organization (WHO). These injuries initiate complex cellular and molecular responses, including the activation of protective pathways that upregulate proteins such as Heat Shock Protein 70 (HSP 70), which plays a crucial role in neuroprotection and the inhibition of neuronal apoptosis. This study investigates the effects of Platelet-Rich Plasma (PRP) on peripheral nerve regeneration, focusing on neuron density, Nissl body presence, and HSP 70 expression as key indicators of recovery. The study utilized 36 rat spinal cord samples, divided into two main groups based on the evaluation time points, day 7 and day 42 post-injury. Each time point group was further subdivided into three: control, sciatica injury, and sciatica injury treated with PRP. Results demonstrated that PRP treatment significantly enhances peripheral nerve regeneration. This was evidenced by increased neuron density, improved Nissl body formation, and a modulation of HSP 70 expression levels, leading to accelerated recovery of motor function, particularly noticeable by day 7 post-injury. These findings suggest that PRP could be a promising therapeutic option for enhancing nerve regeneration and functional recovery after peripheral nerve injuries.

Ultrasound-Guided Approach to the Distal Tarsal Tunnel: Implications for Healthcare Research on the Medial Plantar Nerve, Lateral Plantar Nerve and Inferior Calcaneal Nerve (Baxter's Nerve).

The tibial nerve, commonly misnamed the "posterior tibial nerve", branches into four key nerves: the medial plantar, lateral plantar, inferior calcaneal (Baxter's nerve), and medial calcaneal branches. These nerves are integral to both the sensory and motor functions of the foot. Approximately 15% of adults with foot issues experience heel pain, frequently stemming from neural origins, such as tarsal tunnel syndrome (TTS). TTS diagnosis remains challenging due to a high false negative rate in neurophysiological studies. This study aims to improve the understanding and diagnosis of distal tarsal tunnel pathology to enable more effective treatments, including platelet-rich plasma, hydrodissections, radiofrequencies, and prolotherapy. Ultrasound-guided techniques were employed to examine the distal tarsal tunnel using the Heimkes triangle for optimal probe placement. The results indicate that the tunnel consists of two chambers separated by the interfascicular septum, housing the medial, lateral plantar, and inferior calcaneal nerves. Successful interventions depend on precise visualization and patient positioning. This study emphasizes the importance of avoiding the calcaneus periosteum to reduce discomfort. Standardizing nerve involvement classification in TTS is difficult without robust neurophysiological studies. The accurate targeting of nerve branches is essential for effective treatment.

Repeated intravesical injections of platelet-rich plasma are safe and effective in the treatment of interstitial cystitis/bladder pain syndrome

ABSTRACT Objectives: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a challenging chronic inflammatory condition affecting the urinary bladder, with limited treatment options. This study aims to assess the clinical efficacy of repeated intravesical platelet-rich plasma (PRP) injections for promoting urothelial regeneration and reducing inflammation in patients with IC/BPS and investigate its correlation with subjective and objective treatment-related outcomes. Materials and Methods: Four monthly intravesical PRP injections were given to 98 patients with non-Hunner-type IC/BPS. Treatment outcomes were assessed using a global response assessment (GRA) score 3 months posttreatment. In addition, clinical symptom scores, pain severity, voiding diary data, uroflowmetry parameters, and GRA scores were compared before and after treatment and between different treatment outcome groups (satisfactory: GRA≥2 unsatisfactory: GRA&lt;2). Baseline urine biomarkers were analyzed to identify potential treatment outcome predictors. Results: After four PRP injections, 54 (55.1%) patients reported satisfactory outcomes. Lower urinary tract symptoms, bladder pain, urinary frequency, anxiety, and flow rate significantly improved from baseline (P &lt; 0.05) in all patients, regardless of the treatment outcome. All patients experienced improved treatment outcomes and increased maximum bladder capacity with successive PRP treatments, and no major complications were reported. Urine biomarkers indicated elevated inflammation and oxidative stress biomarkers in patients with IC/BPS compared to controls. Conclusion: Repeated PRP injections are safe and effective for reducing symptoms and bladder pain and improving bladder capacity in a majority of IC/BPS patients, with better outcomes observed in patients with a mild form of bladder inflammation. These results support PRP as a promising novel bladder therapy for IC/BPS.

EXPLORING THE FEASIBILITY OF PLATELET-RICH PLASMA INJECTIONS FOR INTERVERTEBRAL DISCOPATHY: A PILOT STUDY.

This longitudinal pilot study aimed to evaluate the feasibility, safety and potential benefits of Platelet-Rich Plasma injections into the lumbar intervertebral discs in patients with low back pain and degenerative intervertebral monodiscopathy, assessing potential efficacy on disability. Longitudinal pilot study. Six participants with chronic low back pain and lumbar degenerative intervertebral disc (monodiscopathy) disease underwent 1 Platelet-Rich Plasma injection, with a 1-year follow-up. Platelet-Rich Plasma injections were administered into the lumbar intervertebral disc, and outcomes were measured using the Roland Morris Disability Questionnaire, numeric rating scale for pain, Tampa scale for kinesiophobia and lumbar flexion range. Magnetic resonance imaging analysis assessed disc changes. No adverse events were reported. At the end of the 1-year follow-up, half of the patients showed significant improvements in disability scores at 1 year, while 3 of the 6 patients had no change. Magnetic resonance imaging revealed no significant disc changes. Platelet-Rich Plasma injections show promise for some patients with low back pain and degenerative intervertebral discopathy patients. However, caution is warranted due to study limitations, including small sample size and lack of a control group. Further research is needed to define Platelet-Rich Plasma therapy protocols.

The Effect of Platelet-Rich Plasma and Hyaluronic Acid Nasal Injections in the Treatment of Traumatic Olfactory Dysfunction.

Objective: Platelet-rich plasma (PRP) has been injected into the olfactory cleft to treat olfactory dysfunction related to coronavirus disease 2019. In this study, we aimed to evaluate the effect of PRP combined with hyaluronic acid (HA) nasal injection in the treatment of traumatic olfactory dysfunction. Methods: Patients who had lost olfactory function after experiencing head trauma and were willing to receive PRP and HA nasal injections for treatment were enrolled. Before nasal injection, 10 cc of blood was drawn from the patients. The drawn blood was injected into a centrifuge tube for processing, and finally, 5 cc of the PRP mixed with HA was drawn out using an empty syringe. The PRP mixed with HA was injected into the upper part of the middle nasal septum and the medial side of the middle turbinate of the patient's nasal cavity under a nasal endoscope. The olfactory function of each patient was evaluated by the phenyl ethyl alcohol (PEA) odor detection threshold test before and at both 1 and 3 months after nasal injection and the traditional Chinese version of the University of Pennsylvania Smell Identification Test at 3 months after nasal injection. Results: A total of 28 patients received PRP and HA nasal injections between August and December of 2023 and came back for evaluation of the effect. In all, 20 (71.4%) patients felt their olfactory function improved 1 month after injection, and 24 of 28 (85.7%) patients reported their olfactory function improved at 3 months after injection. The bilateral or unilateral PEA threshold decreased in 22 (78.6%) patients 1 month after injection, and decreased in 15 (53.6%) patients 3 months after injection. Conclusions: Our results show that PRP and HA nasal injections were associated with favored patient-reported outcomes and improved the olfactory threshold in the treatment of traumatic olfactory dysfunction.

Evaluating the impact of platelet-rich plasma injection in spinal endoscopic nucleotomy on MRI pfirrmann grading and clinical outcomes in lumbar disc herniation

BackgroundThis study investigates the clinical efficacy and safety of percutaneous endoscopic nucleotomy combined with platelet-rich plasma (PRP) injection in treating lumbar disc herniation (LDH) in young and middle-aged adults.MethodsFrom April 2022 to September 2023, 60 patients diagnosed with LDH were randomly divided into two groups (n = 30/group). The observation group underwent percutaneous endoscopic nucleotomy combined with autologous PRP gel injection into the disc, while the control group underwent percutaneous endoscopic nucleotomy alone. Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) scores were recorded preoperatively and at three time points postoperatively: three days, three months, and six months. The modified Macnab criteria were employed to evaluate efficacy at the final follow-up. Additionally, MRI Pfirrmann grading of the operated disc segment and potential complications were assessed both preoperatively and at the final follow-up.ResultsAll patients were followed for a minimum of six months. VAS and ODI scores at all postoperative time points (three days, three months, and six months) exhibited significant differences compared to preoperative scores in both groups (P < 0.05). Notably, a significant difference was observed in VAS and ODI scores between the two groups at three days postoperatively (P < 0.05). Preoperative MRI Pfirrmann grading indicated no significant difference between groups (P = 0.669). However, at the final follow-up, the observation group demonstrated superior recovery compared to the control group (P = 0.013). The modified Macnab criteria revealed no significant difference in the rates of excellent and good outcomes between the observation group (96.67%) and the control group (93.33%) (P > 0.05). Furthermore, no patients experienced complications such as dural tears, nerve root injury, infection, or hematoma.ConclusionThe combination of percutaneous endoscopic nucleotomy and PRP injection could be a safe and effective treatment for LDH in young and middle-aged adults to promote disc repair following endoscopic procedures.

Autologous platelet concentrates in root coverage procedures.

Gingival recessions are vastly prevalent among the general population. With regards to their treatment, recent advancements in periodontal and microsurgical procedures, focusing on minimal invasiveness and patient-centered therapies, have propelled a shift in their contemporary treatment, highlighting the field of biologics and bioactive mediators. Among different classes and types of biologics, autologous platelet concentrates (APCs), also referred to as autologous blood-derived products, are commonly used and preferred among many clinicians. These are essentially obtained via venipuncture (intravenous access) followed by centrifugation, for which numerous protocols and preparation methods have been used, leading to varieties of blood-derived products. In this review, via a systematic search, we explored the efficacy of the different utilized preparation methods and centrifugation protocols of APCs (e.g., platelet-rich plasma (PRP), platelet-rich fibrin (PRF), leucocyte-PRF, advanced-PRF, concentrated growth factor (CGF), etc.) for the treatment of type 1 gingival recessions (RT1, without interproximal attachment loss or noticeable tooth displacement), as well as their effectiveness relative to a common control (treatment with flap advancement alone without any additional material). Based on the available literature from randomized trials found in our systematic search, we observed that utilization of PRF can significantly enhance treatment outcomes when performing a coronally advanced flap, in terms of the amount of root coverage. The improvement in root coverage was further enhanced in the presence of baseline keratinized tissue width, and with an increasing relative magnitude (the more the baseline keratinized tissue width, the better the root coverage outcomes when using PRF). The efficacy of these products needs to be further explored with different graft substitutes and matrices, as well as relative to other commonly applied biologics, through well-conducted and adequately-powered randomized clinical trials.

Comparison between Effects of Intralesional Platelet Rich Plasma and Corticosteroid Injection on Pain and Functional Outcome in Patients with Lateral Epicondylitis of Elbow

Background: A debilitating and painful elbow problem is lateral epicondylitis. Objective: In this study, pain and functional outcomes were examined in relation to intralesional platelet-rich plasma (PRP) and corticosteroid injections patients with lateral epicondylitis. Methodology: This randomized experimental study was done in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU) from March 2017 to February 2018. Thirty patients with diagnosed lateral epicondylitis, aged between 21- 60 years and had been ill for more than a month were enrolled and randomly assigned into two groups. In Group A received two doses of intralesional PRP injection, and Group B received two doses of intralesional corticosteroid injection. Pain and functional outcomes were evaluated by using a visual analog scale (VAS) for pain and a patient-rated tennis elbow assessment (PRTEE) questionnaire, respectively. In the lateral epicondylar region, intralesional PRP or corticosteroids were administered during the first (week 1=W1) and fourth (week 7=W7) treatment visits. Results: The findings revealed a statistically significant decline in pain over time, as well as improvements of functional outcomes in both groups as evidenced by significantly lower VAS scores and lower PRTEE scores up to 11 weeks post-injection. There was no discernible difference in progress between the two groups up until W1 to W9 scores, however at the eleventh week, group A showed greater improvement than group B (p&lt;00.5). Conclusions: Intralesional PRP injection is a promising therapy option for lateral epicondylitis, offering sustained pain relief and improved functional outcomes over time compared to corticosteroid injection. Journal of Monno Medical College June, 2024; 10 (1):30-35

Frontiers in Safety and Efficacy: Introduction

There are increasing numbers of people suffering with osteoarthritis and other musculoskeletal disorders. Current treatments for these conditions have significant side effects and comorbidities. Surgery in some cases may be inappropriate or ineffective. The use of regenerative medicine in the form of orthobiologics has been growing. The purpose of these treatments is to treat pain and to possibly enhance the healing of tissue pathology by augmenting the body’s inherent healing capabilities. Orthobiologic products commonly used include platelet rich plasma, adipose and bone marrow derived cellular products and birth tissue products. This review of the current medical literature has been prepared to provide evidence-based information to patients, clinicians, researchers, and regulatory and payer organizations with regard to the safety, efficacy, and cost effectiveness of orthobiologic treatments.

Influence of Platelet Concentration on the Clinical Outcome of Platelet-Rich Plasma Injections in Knee Osteoarthritis

Background: Platelet-rich plasma (PRP) is one of the most frequently used orthobiologic products for the injection treatment of patients affected by knee osteoarthritis (OA). Some preliminary evidence supports the influence of platelet concentration on patients’ clinical outcomes. Purpose: To analyze if platelet concentration can influence the safety and clinical efficacy of PRP injections for the treatment of patients with knee OA. Study Design: Cohort study; Level of evidence, 3. Methods: This study consisted of 253 patients with knee OA (142 men, 111 women; mean ± SD age, 54.8 ± 11.4 years; Kellgren-Lawrence grades 1-3) who were treated with 3 intra-articular injections of 5 mL of autologous leukocyte-rich or leukocyte-poor PRP. All patients were prospectively evaluated at baseline and at 2, 6, and 12 months. Patients were clinically assessed thorough the Knee injury and Osteoarthritis Outcome Score (KOOS) subscales and the International Knee Documentation Committee (IKDC) Subjective score. Platelet concentration was correlated with clinical outcome. Further analysis was performed by stratifying patients into 3 groups (homogeneous for OA severity) based on platelet concentration (high, medium, and low). All complications and adverse events were reported, as well as failures. Results: An overall statistically significant improvement in all clinical scores was documented from baseline to each follow-up evaluation. Platelet concentration positively correlated with clinical outcome. KOOS Pain improved more with higher platelet concentration at 2 months (P = .036; rho = 0.132), 6 months (P = .009; rho = 0.165), and 12 months (P = .014; rho = 0.155). The same trend was shown by the other KOOS subscales and by the IKDC Subjective score, as well as by the comparison of the groups of high-, medium-, and low-platelet PRP. The highest failure rate (15.0%) was found in the low-platelet group as compared with the medium-platelet group (3.3%) and the high-platelet group (3.3%). No differences were observed among the 3 groups in terms of adverse events. Conclusion: This study demonstrated that platelet concentration influences the clinical outcome of PRP injections in knee OA treatment. PRP with a higher platelet concentration provides a lower failure rate and higher clinical improvement as compared with PRP with a lower platelet concentration, with overall better results up to 12 months of follow-up in patients with knee OA.

Evaluating the Efficacy of Platelet-Rich Plasma in Treating Primary Knee Osteoarthritis: A Prospective Interventional Study.

Knee osteoarthritis (OA) is a prevalent degenerative joint disorder causing pain, stiffness, and reduced function, significantly impacting the quality of life. Current treatments mainly provide symptomatic relief, with limited efficacy in halting disease progression. Platelet-rich plasma (PRP), a biological therapy rich in growth factors, has gained attention as a potential treatment for knee OA due to its regenerative properties. This study evaluates the efficacy of PRP in managing primary knee OA. This prospective interventional study included 100 patients diagnosed with primary knee OA, categorized using the Kellgren-Lawrence grading scale. Leukocyte-reduced PRP was prepared using the double-spin method and injected into the knee joint. The efficacy of PRP was assessed using the Western Ontario and McMaster Universities Arthritis (WOMAC) Index and Visual Analogue Scale (VAS) pain scores at six weeks, three months, and six months post-injection. Statistical analysis was performed using SPSS version 25.0, with significance set at p<0.05. Significant improvements in the WOMAC and VAS scores were observed at all-time points post-PRP injection. The WOMAC score decreased from a baseline of 81.06 to 63.52 at six months (p < 0.001), and the VAS score reduced from 7.53 to 3.09 (p < 0.001). PRP was more effective in patients with lower body mass index (BMI) and less severe OA (Grades 1 and 2). Adverse events were mild, with 18% reporting mild pain or swelling. PRP therapy significantly improves pain and function in patients with primary knee OA, particularly in early-stage disease. The treatment is generally safe, with minor adverse effects. PRP presents a promising non-surgical option, especially for those seeking to delay or avoid knee arthroplasty.

Harmony in Healing: Investigating Platelet-Rich Plasma Activation during Acetylsalicylic Acid Treatment

Platelet-rich plasma (PRP) therapy holds promise for treating various clinical conditions. The activation process is crucial in releasing growth factors and cytokines from platelets, enhancing the therapeutic properties of PRP. Standard activation methods involve autologous thrombin or collagen, with variations in efficacy and growth factor release. This study explores the impact of acetylsalicylic acid (ASA), a commonly used antiplatelet drug, on PRP activation. The results indicate that non-activated PRP extracted from the whole blood of ASA-treated patients exhibits increased inflammatory cytokine concentrations, notably TNFa. After activation with autologous thrombin/CaCl2 or collagen IV, the measured fluorescence intensities suggest varying release patterns between treated and non-treated groups. Understanding the influence of ASA on platelet activation holds implications for personalized medicine and optimizing outcomes for individual patients undergoing PRP therapy. This research sheds light on the potential challenges associated with using antiplatelet drugs, emphasizing the need for careful consideration in tailoring PRP-based regenerative therapies.

Comparison of the Effectiveness of Autologous Blood Injection and Steroid Injection in Managing Tennis Elbow.

Background Local depot steroid injections can consistently and predictably relieve tennis elbow pain in the short term. Prolotherapy, extracorporeal shockwave therapy, autologous blood, and local injections of platelet-rich plasma (PRP) are examples of novel treatment approaches. Objective The objective of this study is to compare the effectiveness of autologous blood injection and local steroid injection in providing pain relief for patients with lateral epicondylitis (tennis elbow)using the visual analog scale (VAS) over 12 weeks. Methods A descriptive case series was conducted from July 10, 2019, to July 9, 2021, at the Department of Orthopaedic and Spine Surgery, Ghurki Trust Teaching Hospital. A total of 396 patients with tennis elbow, aged 20 to 50 years, were included (198 in each group). Patients managed with non-operative methods and those with other associated injuries in the same elbow were excluded. Group I received an injection of 40 mg of methylprednisolone acetate with 1 ml of 2% lignocaine solution. Group II received an injection of 2 ml of autologous venous blood. The final outcome was assessed at 12 weeks. Results In Group I, the average age of the patients was 36.04 ± 8.26 years, while in Group II, it was 37.23 ± 7.32 years. The male-to-female ratio was2.3:1; 276 (69.81%) of the 396 patients were male, while 120 (30.19%) were female. Group I's mean baseline VASscore was 6.99 ± 0.99, while Group II's mean baseline VAS score was 6.99 ± 1.06 (p = 1.000). Group I had a mean post-therapy VAS score of 3.11 ± 1.62, while Group II had a mean score of 2.48 ± 1.26 (p = 0.0001). About 118 (59.60%) individuals in Group I and 156 (78.79%) patients in Group II experienced pain alleviation from lateral epicondylitis (p = 0.0001). Conclusion This study found that autologous blood injection significantly reduces pain in patients with lateral epicondylitis compared to steroid injection, with a statistically significant p-value of 0.0001. Pain relief was more frequent in the autologous blood group (78.79%) than in the steroid group (59.60%). These findings suggest that autologous blood injections may offer a more effectivetreatment, reducing the need for repeat procedures and improving patient outcomes.

Application of Autologous Platelet-rich Plasma Exerts Cryoprotective Effects on Biological Characteristics of Human Oligoasthenoteratospermia Samples after Freezing and Thawing Procedures.

Platelet-rich plasma (PRP) is enriched with active biological components which showed proliferative and cytoprotective properties in healing different injuries in medicinal fields. This study was designed to assess the cryoprotective effects of autologous PRP on the quality of oligoasthenoteratospermia (OAT) samples during freezing and thawing procedure. The present study is an experimental research. Twenty OAT semen samples were obtained from individuals and prepared by discontinuous density - gradients technique DGC). The control group is sperm samples after DGC. After the procedure, the specimen was divided into four groups. The Freeze group which has no additive and the other three groups were cryopreserved with different concentrations of PRP (1×105/ μL, 0.5×105/μL and 0.25×105/μL). Autologous PRP was provided by each participant. After thawing, sperm parameters, DNA fragmentation by sperm chromatin dispersion test (SCD), protamine deficiency by (Chromomycin A3) CMA3 staining, acrosome integrity and malondialdehyde (MDA) level were evaluated. Cryopreservation resulted in a significant decrease in all factors compared to the control group. There were no significant changes in sperm count, morphology, non-progressive motility and acrosome reaction by adding PRP as a cryoprotectant in comparison with the freeze group. PRP at all three concentrations showed a significant increase in progressive motility (3.05 ± 2.01 vs. 14.05 ± 4.13, 12.35 ± 4.90 and 12.15 ± 9.65, P < 0.001) and viability (36.85 ± 10.25 vs. 47.85 ± 5.86, 51.30 ± 5.54 and 50.05 ± 5.67, P < 0.001) compared to the sperm samples without PRP. The percentage of immotile sperms decreased at all PRP concentrations compared to the freeze group. Moreover, PRP at 1×105/μL concentration showed cryoprotective effects on DNA fragmentation, protamine deficiency and MDA level compared to the other three concentrations. Cryopreservation and thawing procedures may exert adverse effects on biological factors of sperm samples. Therefore, adding PRP as cryoprotectant at all three concentrations especially 1×105/μL can be promising strategy to reduce adverse effects of cryopreservation on OAT samples.

The Role of Platelet-Rich Plasma Therapy in Treating Sports Injuries

Introduction: Sports injuries are a significant health problem for both professional and recreational athletes. Standard treatment methods, including physiotherapy, pharmacotherapy, and surgical interventions, often fall short in cases of severe soft tissue damage. This has led to a growing interest in alternative therapies, such as platelet-rich plasma (PRP). In recent years, there has been growing interest in platelet-rich plasma (PRP) therapy due to its potential regenerative properties. PRP is increasingly used in the treatment of sports injuries, with the aim of accelerating tissue regeneration and facilitating a return to full physical fitness. This paper attempts to analyze available scientific studies to assess the effectiveness of PRP in the treatment of sports injuries. Purpose of the work: The aim of this study is to assess the effectiveness and safety of platelet-rich plasma (PRP) therapy in treating sports-related muscle, tendon, ligament, and joint injuries, and to compare its efficacy with other established treatment modalities, such as physiotherapy and pharmacotherapy. Results: Platelet-rich plasma (PRP) therapy has been shown to be highly effective in treating sports injuries, particularly muscle and tendon injuries. PRP accelerates tissue regeneration and shortens the time to return to physical activity, but the effectiveness of the therapy depends on the proper preparation protocol and individual patient characteristics. Compared to other treatment methods, PRP has a favorable safety profile and a lower risk of complications. Despite promising results, further studies are needed to better determine the long-term effectiveness and optimal conditions for using this therapy.