Effect Of Platelet-rich Plasma Injection Research Articles

Effect of Platelet-Rich Plasma Injection for Rejuvenation of Photoaged Facial Skin

There remains little experimental evidence and no randomized clinical trial to date to confirm the benefit of platelet-rich plasma (PRP) for facial rejuvenation. To investigate whether PRP injection improves the visual appearance, including texture and color, of photodamaged facial skin. In this randomized clinical trial, participants and raters were masked to groupings. The setting was an academic-based, urban outpatient dermatology practice in Chicago, Illinois. Participants were adults aged 18 to 70 years with bilateral cheek rhytids of Glogau class II or greater. The duration of the study was August 21, 2012, to February 16, 2016. Each participant received 3 mL intradermal injections of PRP to one cheek and sterile normal saline to the contralateral cheek. Primary outcomes were photoaging scores (with subscores for fine lines, mottled pigmentation, roughness, and sallowness) as rated by 2 masked dermatologists. Secondary outcomes included participant self-assessment scores of improvement on a 5-point scale (worsening, no change, mild improvement, moderate improvement, or significant improvement), participant overall satisfaction scores on a 4-point scale (not satisfied, slightly satisfied, moderately satisfied, or very satisfied), and participant-reported or investigator-observed adverse events. Of 27 enrolled participants, 19 (mean [SD] age, 46.37 [10.88] years; 17 female) were analyzed. Reported adverse events, which were not associated with the study agent, included redness (n = 18), swelling (n = 16), bruising (n = 14), pruritus (n = 1), skin scaling (n = 1), and dryness of skin (n = 1). No participants reported any adverse events at 12 months. Mean (SD) photoaging scores rated by 2 dermatologists showed no significant difference between PRP and normal saline for fine lines (baseline, 1.00 [0.75] vs 1.05 [0.78]; 2 weeks, 0.95 [0.71] vs 0.95 [0.71]; 3 months, 0.95 [0.71] vs 0.95 [0.71]; 6 months, 0.95 [0.71] vs 0.95 [0.71]), mottled pigmentation (baseline, 1.21 [0.53] vs 1.21 [0.54]; 2 weeks, 1.16 [0.60] vs 1.16 [0.60]; 3 months, 1.00 [0.47] vs 1.11 [0.46]; 6 months, 1.16 [0.69] vs 1.16 [0.69]), skin roughness (baseline, 0.47 [0.61] vs 0.47 [0.61]; 2 weeks, 0.47 [0.61] vs 0.47 [0.61]; 3 months, 0.47 [0.61] vs 0.47 [0.61]; 6 months, 0.37 [0.60] vs 0.37 [0.68]), and skin sallowness (baseline, 1.11 [0.88] vs 1.11 [0.88]; 2 weeks, 0.95 [0.85] vs 0.95 [0.85]; 3 months, 0.58 [0.61] vs 0.58 [0.61]; 6 months, 0.37 [0.68] vs 0.37 [0.68]). At 6 months after a single treatment, participants rated the PRP-treated side as significantly more improved compared with normal saline for texture (mean [SD] self-assessment score, 2.00 [1.20] vs 1.21 [0.54]; P = .02) and wrinkles (mean [SD] self-assessment score, 1.74 [0.99] vs 1.21 [0.54]; P = .03). Masked participants noted that both fine and coarse texture improved significantly more with a single treatment of PRP than with normal saline. Both participants and raters found PRP to be nominally but not significantly superior to normal saline. ClinicalTrials.gov Identifier: NCT01372566.

The effect of platelet-rich plasma injection on lateral epicondylitis following failed conservative management

Introduction: Pain from the lateral aspect of the elbow was first described in 1873, and has since then been given different names such as tennis elbow, lateral epicondylitis, epicondylitis, epicondylalgia and lateral elbow pain. The etiology and pathogenesis of tennis elbow is not known, but the condition is considered to be an overuse injury of degenerative nature (Jozsa and Kannus, 1997 et al.). The pathology found in tennis elbow is addressed to the extensor carpi radialis brevis (ECRB) muscle origin (Nirschl and Pettrone, 1979) Materials and Methods: 50 patients in the age group of 20 to 70 years of either sex presenting pain on the lateral epicondyle of either elbow after being clinically diagnosed as suffering from Lateral Epicondylitis / Tennis Elbow after having ruled out other possible causes of pain in this region presenting after 7 days of onset of pain with failed conservative management for 2 weeks attending OPD/ emergency of the Post Graduate department of Orthopaedics, GMC Jammu were included in this study. The response to treatment was graded using Oxford elbow score. Observations: In the present study of 50 patients there were 26 males and 24 females. In the present study of 50 patients the mean age was 43.98 years ( Range between 22 to 74 years). In this study it was observed that the pretreatment mean oxford elbow score was 38.32 (20.83-56.24) which improved to 46.73 (20.83-66.65) at 1 month, 58.60 (33.32-81.23) at 3 months and 70.15 (35.41-87.48) at 6 months. Discussion: Nonoperative treatment is successful in 95% of patients with tennis elbow. There have been several randomized controlled trials (RCTs) that have compared autologous whole blood with PRP injection, autologous whole blood with steroid injection and PRP with steroid injection. However, results as to whether PRP, autologous whole blood or corticosteroids is more beneficial are still unclear. Conclusion PRP: improves pain and function in patients suffering from LE where conservative management has failed.

Synergistic effect of platelet-rich plasma injections and scalp lifting in androgenetic alopecia

Androgenetic alopecia (AGA) is a common hair loss disorder, especially in men and the elderly. In this study, we analyzed the therapeutic effects of platelet-rich plasma (PRP) injections and embedded sutures in patients with AGA. In each participant, we administered different treatments in one area of hair loss that was divided into four sections. Each section received one of the following treatments: No treatment, PRP injection, suture embedding, and combined PRP injection/suture-embedded areas. The thickness of the scalp, and scalp perfusion were measured using an ultrasound imaging system and Moor FLPI full-field laser perfusion imaging system, respectively. The diameters of the hair were measured using optical microscopy. Our results show that PRP injection treatments increased the diameter of the hair (P = 0.034), and the combined PRP injection/suture-embedded treatments had a significant effect on the thickness of the scalp (P = 0.002), the blood flow (P = 0.014) through the scalp, and the diameter of the hair (P= 0.013). This study has demonstrated that there is a synergistic effect between PRP injections and suture embedding for increasing the thickness and blood flow of the scalp, and diameter of the hair. Combined PRP injection/suture-embedded PRP injections might have therapeutic benefit for patients with AGA.

The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection

Background: Gluteus medius/minimus tendinopathy is a common cause of lateral hip pain or greater trochanteric pain syndrome. Hypothesis: There would be no difference in the modified Harris Hip Score (mHHS) between a single platelet-rich plasma (PRP) injection compared with a corticosteroid injection in the treatment of gluteal tendinopathy. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: There were 228 consecutive patients referred with gluteal tendinopathy who were screened to enroll 80 participants; 148 were excluded (refusal: n = 42; previous surgery or sciatica: n = 50; osteoarthritis, n = 17; full-thickness tendon tear, n = 17; other: n = 22). Participants were randomized (1:1) to receive either a blinded glucocorticoid or PRP injection intratendinously under ultrasound guidance. A pain and functional assessment was performed using the mHHS questionnaire at 0, 2, 6, and 12 weeks and the patient acceptable symptom state (PASS) and minimal clinically important difference (MCID) at 12 weeks. Results: Participants had a mean age of 60 years, a ratio of female to male of 9:1, and mean duration of symptoms of >14 months. Pain and function measured by the mean mHHS showed no difference at 2 weeks (corticosteroid: 66.95 ± 15.14 vs PRP: 65.23 ± 11.60) or 6 weeks (corticosteroid: 69.51 ± 14.78 vs PRP: 68.79 ± 13.33). The mean mHHS was significantly improved at 12 weeks in the PRP group (74.05 ± 13.92) compared with the corticosteroid group (67.13 ± 16.04) (P = .048). The proportion of participants who achieved an outcome score of ≥74 at 12 weeks was 17 of 37 (45.9%) in the corticosteroid group and 25 of 39 (64.1%) in the PRP group. The proportion of participants who achieved the MCID of more than 8 points at 12 weeks was 21 of 37 (56.7%) in the corticosteroid group and 32 of 39 (82%) in the PRP group (P = .016). Conclusion: Patients with chronic gluteal tendinopathy >4 months, diagnosed with both clinical and radiological examinations, achieved greater clinical improvement at 12 weeks when treated with a single PRP injection than those treated with a single corticosteroid injection. Registration: ACTRN12613000677707 (Australian New Zealand Clinical Trials Registry).

Effect of Platelet-rich Plasma Injection on Disability and Pain in Individuals with Osteoarthritis Knee: A Follow-up Study of Six Months

Effect of Platelet-rich Plasma Injection on Disability and Pain in Individuals with Osteoarthritis Knee: A Follow-up Study of Six Months

Effectiveness of PRP Injection in Reducing Recovery Time of Acute Hamstring Injury: A Critically Appraised Topic.

Clinical Scenario: Hamstring strains are common athletic injuries, with a high-recurrence rate (34%). Recently, platelet-rich plasma (PRP) injections have gained popularity as a potential treatment option to accelerate healing of hamstring injury. Focused Clinical Question: Does the combination of PRP injection and rehabilitation decrease recovery time of acute hamstring injury as compared to rehabilitation alone in college athletes? Summary of Key Findings: A literature search resulted in 3 randomized controlled trials. One study showed benefits in various outcome measures with PRP, compared to rehabilitation alone, while 2 showed no benefits. One study reported improved pain, ultrasonography regenerative indications, and recovery time with PRP injection following acute hamstring injury; however, larger studies have shown no benefits. The literature demonstrates conflicting evidence regarding benefits of PRP injections in hamstring injuries. Clinical Bottom Line: At this time, PRP injections cannot be recommended as having value for hamstring injuries, compared to rehabilitation alone. Strength of Recommendation: Due to inconsistent or limited quality patient-oriented evidence in existing literature, the strength of this recommendation is grade B, based on the strength of recommendation taxonomy.

Platelet-rich plasma versus corticosteroid injections for carpal tunnel syndrome

Background: Platelet-rich plasma therapy has the potential to promote peripheral nerve regeneration through the autologous supply of growth factors. Therefore, this study aimed to compare the effects of platelet-rich plasma injections with the effects of corticosteroid injections in the treatment of carpal tunnel syndrome.Methods: In total, 40 patients with mild carpal tunnel syndrome were equally divided into two groups. Nerve conduction studies were carried out, and the Boston Carpal Tunnel Questionnaire was administered to both groups before treatment. One group of patients received platelet-rich plasma injections, and the patients in the other group received corticosteroid injections into the carpal tunnel. The patients were followed for 6 months. After 3 and 6 months, the nerve conduction studies and the Boston Carpal Tunnel Questionnaire were repeated.Results: Although distal motor latencies did not change in either of the groups during the follow-up period, improvements in sensory nerve conduction were recorded after 3 months in both groups. However, there was no significant difference between the groups in the nerve conduction studies. In the Boston Carpal Tunnel Questionnaire, both the symptom severity score and the functional capacity score of the platelet-rich plasma group were significantly better than those of the corticosteroid group after 3 months, although there were no significant differences after 6 months.Conclusions: Platelet-rich plasma injections may be considered for the temporary symptomatic relief of mild carpal tunnel syndrome.

The effect of platelet-rich plasma injection on lateral epicondylitis following failed conservative management

ObjectiveWe assessed the effect PRP injection on pain and function in patients with lateral epicondylitis where conservative management had failed. MethodsWe prospectively reviewed 34 patients. The mean follow-up was 26 weeks (range 6–114 weeks). We used the Oxford Elbow Score (OES) and progression to surgery to assess outcomes. Results88.2% improved their OES. 8.8% reported symptom progression. One patient had no change. No patients suffered adverse reactions. Two patients underwent an open release procedure. One had the injection repeated. ConclusionAn injection of PRP improves pain and function in patients suffering from LE where conservative management has failed.

Utilisation du Plasma Riche en Plaquettes pour le traitement des tendinopathies rotuliennes et achilléennes

The purpose of this study was to retrospectively evaluate the effectiveness of Platelet-Rich Plasma Injection (PRP) for Achilles and patellar tendinopathy refractory to conventional conservative treatments. For this, we compared the data from 34 patients treated with one or two injections of PRP. Pain, functional ability, athletic recovery and satisfaction of patients were evaluated. The results show a significant reduction in pain after the PRP injection treatment, as a significant functional improvement and better sports recovery, without any significant difference according to the affected tendon or the sports. Patients are, on average, satisfied. The PRP is not the miracle treatment but can be however considered in cases of refractory tendinopathy as a possible chance of improvement. Despite the potentially positive effect of PRP injection therapy on patellar and Achilles tendinopathy, there is still not enough scientific literature of high methodological quality about it.

Exuberant Inflammatory Reaction as a Side Effect of Platelet-Rich Plasma Injection in Treating One Case of Tendinopathy

Platelet-rich plasma (PRP) contains a large number of growth factors, which may enhance tendon healing processes. Local injection of PRP represents a relatively new treatment for tendinopathies. To date, no side effects have been reported after injection of PRP to treat tendinopathy. We report a case of exuberant inflammatory reaction after 1 injection of PRP to treat jumper's knee in a 35-year-old male type 1 diabetic patient. Injections of PRP should be proposed only after careful consideration in cases of patients with morbidity risks linked to insulin-dependent diabetes.

The effect of platelet-rich plasma injections in the non-surgical treatment of a partial rotator cuff tear

Introduction: Rotator cuff tears are associated with significant morbidity and have a reported incidence of greater than 50% amongst the adult population. We present a case report of a partial rotator cuff tear treated with platelet-rich plasma injections. Case Report: A 60-year-old female was presented with a partial supraspinatus tear having failed to improve with physiotherapy. The patient underwent a course of three platelet-rich plasma injections to her tear. Patient outcome was measured using the numerical pain rating scale (NPRS), percentage perceived improvement (PPI) and also a handheld dynamometer assessment of rotator cuff strength. Repeat ultrasound examination was performed. The patient reported improvements in pain as measured by NPRS and PPI, though maximal improvement was not maintained through to final data collection at 52nd week. Dynamometer follow-up showed improvement in strength. Ultrasound at 52nd week showed evidence of ingrowth of tissue though this did not resemble normal tendon. The patient noted increased pain post her second platelet-rich plasma injection though this was self-limiting and managed with simple analgesia. Conclusion: In this case report, platelet-rich plasma injections for the treatment of a partial rotator cuff tear resulted in improvement in all recorded outcome measures. This highlights the need for more formal controlled trials to determine the use of platelet-rich plasma in the treatment of rotator cuff pathology. (This page in not part of the published article.) International Journal of Case Reports and Images, Vol. 5 No. 7, July 2014. ISSN – [0976-3198] Int J Case Rep Images 2014;5(7):524–530. www.ijcasereportsandimages.com Freitag et al. 524 CASE REPORT OPEN ACCESS The effect of platelet-rich plasma injections in the nonsurgical treatment of a partial rotator cuff tear Julien Freitag, Ross Lenssen, Drew Slimmon, Simon Balster

Sensory improvement of leprosy peripheral neuropathy in patients treated with perineural injection of platelet-rich plasma

Leprosy (Hansen's disease) is a chronic granulomatous infection caused by Mycobacterium leprae with peripheral neuropathy as cutaneous and neurological manifestations. Peripheral nerve regeneration may be stimulated by vascular endothelial growth factor and other growth factors (GFs) that have important roles in extracellular matrix regeneration. All of those GFs can be found in platelet-rich plasma (PRP) preparation. The effect of PRP injection in leprosy peripheral neuropathy has never been reported. A double-blind, randomized, control clinical trial was conducted among 60 patients with leprosy peripheral neuropathy. They were randomized to receive either a 1-ml injection of PRP as treatment or a 1-ml injection of platelet-poor plasma (PPP) as control. Skin sensibilities were measured by two-point discrimination test (TPDT) and visual analog scale (VAS), which were taken before and two weeks after treatment. Perineural injection of PRP was shown to be significantly more effective than PPP (P < 0.05) either in VAS or TPDT measurements. In both groups, the patients had a tingling sensation at the time of injection that disappeared shortly after. This study shows that perineural PRP injection could promote improvement of peripheral neuropathy sensibility in patients with leprosy. More research is needed to better determine the effects of PRP in nerve regeneration.

The Systemic Effects of Platelet-Rich Plasma Injection

Background:Platelet-rich plasma (PRP) is an autologous blood product used to treat acute and chronic tendon, ligament, and muscle injuries in over 86,000 athletes in the United States annually. The World Anti-Doping Agency (WADA) banned intramuscular PRP injections in competitive athletes in 2010 because of concerns that it may increase performance-enhancing growth factors. The ban on PRP was removed in 2011 because of limited evidence for a systemic ergogenic effect of PRP, but the growth factors within PRP remain prohibited.Purpose:To quantify the effect of PRP injection on systemic growth factors with performance-enhancing effects and to identify molecular markers to detect treated athletes.Study Design:Descriptive laboratory study.Methods:Six ergogenic growth factors monitored by WADA—human growth hormone (hGH), insulin-like growth factor–1 (IGF-1), insulin-like growth factor binding protein–3 (IGFBP-3), basic fibroblast growth factor (bFGF or FGF-2), vascular endothelial growth factor (VEGF), and pla...

Glenoid Labral Tear: follow up case series on ultrasound guided autologous platelet rich plasma in conjunction with a progressive rehabilitation program

Background: Labral tears commonly occur in both the general and sporting population, often leading to significant pain and dysfunction. Patients often engage in progressive rehabilitative programs, and surgical intervention may be required in severe cases. Autologous platelet rich plasma (PRP) injections have been growing in popularity in musculoskeletal medicine as an alternative to corticosteroid injections. This paper looks at the effectiveness of PRP injections in glenoid labral lesions.Methods: The clinical and radiological findings are presented for two patients who have been treated with autologous PRP into the glenohumeral joint adjacent to the labral tear, in conjunction with a progressive rehabilitative program. Follow up occurred at 18 months and 13 months, respectively.Results: Both subjects tolerated the PRP injection well with no adverse effects, and were compliant with their rehabilitative programs. On initial presentation, pain on the visual analogue scale (VAS) was 7/10 and 6/10 and at follow up it was reported as 0/10. Both subjects have now returned to normal sporting and work activities.Conclusions: The findings from this case series suggest that PRP in conjunction with appropriate rehabilitation can assist in the clinical recovery of glenoid labral tears. Further research is required with greater sample numbers and improved methodological parameters.

Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial

Objective: To compare the effects of platelet-rich plasma injection with those of dry needling on shoulder pain and function in patients with rotator cuff disease. Design: A single-centre, prospective, randomized, double-blinded, controlled study. Setting: University rehabilitation hospital. Participants: Thirty-nine patients with a supraspinatus tendon lesion (tendinosis or a partial tear less than 1.0 cm, but not a complete tear) who met the inclusion criteria recruited between June 2010 and February 2011. Intervention: Two dry needling procedures in the control group and two platelet-rich plasma injections in the experimental group were applied to the affected shoulder at four-week intervals using ultrasound guidance. Measurements: The Shoulder Pain and Disability Index, passive range of motion of the shoulder, a physician global rating scale at the six-month follow-up, adverse effects monitoring and an ultrasound measurement were used as outcome measures. Results: The clinical effect of the platelet-rich plasma injection was superior to the dry needling from six weeks to six months after initial injection (P < 0.05). At six months the mean Shoulder Pain and Disability Index was 17.7 ± 3.7 in the platelet-rich plasma group versus 29.5 ± 3.8 in the dry needling group (P < 0.05). No severe adverse effects were observed in either group. Conclusions: Autologous platelet-rich plasma injections lead to a progressive reduction in the pain and disability when compared to dry needling. This benefit is certainly still present at six months after treatment. These findings suggest that treatment with platelet-rich plasma injections is safe and useful for rotator cuff disease.

Platelet-Rich Plasma Effects on Degenerative Disk Disease: Analysis of Histology and Imaging in an Animal Model

Introduction The current conservative and surgical modalities of treating degenerative disk disease are aimed at relief of symptoms. At this time, there is no cure for the degenerative process. Platelet-rich plasma (PRP) is a bioactive component of autologous whole blood. The indications for the use of PRP in the treatment of musculoskeletal diseases continue to expand. The mechanism of action for PRP is due to the release of healing factors from platelets. While clinical evidence strongly supports the use of PRP for certain conditions, the potential benefit of PRP in treating or preventing progression of degenerative disk disease has not been critically evaluated. There is a preliminary evidence that certain growth factors in PRP, such as PDGF and IGF-1, may be beneficial in slowing the progression of disease. The objective of this study is to analyze the early and late phase effects of PRP injection into the intervertebral disk using an animal model. Materials and Methods After obtaining IRB and Institutional Animal Care and Use Committee (IACUC) approval, the L4-L5 intervertebral disk of adult Sprague Dawley rats were injured with a 21-gauge needle in 24 rats. After injury, animals received either an acute injection of PRP collected from matched donor animals, a delayed (2 week) injection of PRP after the degenerative process had commenced, or no further intervention (sham PRP). Magnetic resonance imaging was performed for each group at 0, 2, and 4 weeks. Three rats were euthanized at 2 weeks post-PRP injection, as well as three shams and a control rat. We collected traumatized and adjacent discs in test subjects, along with discs from control subjects. Each disk was sectioned axially and sagittally followed by histopathological and immunohistochemical analysis. Results The disks treated with PRP, both in the acute and delayed administration, had less degeneration than the sham group. The sham group had clear degenerative changes with near total loss of organizational structure, large amounts of empty space, fibrous (scar) tissue, and large numbers of inflammatory cells (Fig. 2). The PRP-treated group had annulus fibers that were damaged with some empty spaces and inflammatory cells. However, there was a maintenance of the ring structure and the nucleus pulposus, while having irregular borders and overall deceased size, appeared to have a healthy central portion (Fig. 3). Overall, the PRP treated group retained more normal morphologic features of the control disks (Fig. 1), contained fewer inflammatory cells than those not receiving PRP, and did not appear as damaged on MRI. The disk height did not seem to be greatly different between all three groups at the 2 weeks interval. Conclusion The needle puncture technique was validated as an effective method for creating a degenerative disk model. The administration of PRP has a protective effect on damaged disks and decreases the amount of inflammation at the 2-week interval and the 6-week interval. I confirm having declared any potential conflict of interest for all authors listed on this abstract Yes Disclosure of Interest R. Mcguire Grant/Research support from: spinal usa, stryker, Consultant for: synthes Chen WH, Liu HY, Lo WC, et al. Intervertebral disk regeneration in an ex vivo culture system using mesenchymal stem cells and platelet-rich plasma. Biomaterials 2009;29:5523–33. Epub 2009 Jul 30 Sawamura K, Ikeda T, Nagae M, et al. Characterization of in vivo effects of platelet-rich plasma and biodegradable gelatin hydrogel microspheres on degenerated intervertebral discs. Tissue Engineering Part A 2009;12:3719–3727 Nagae M, Ikeda T, Mikami Y, et al. Intervertebral disk regeneration using platelet-rich plasma and biodegradable gelatin hydrogel microspheres. Tissue Engineering 2007;1:147–158 Akeda K, An HS, Pichika R, et al. Platelet-rich plasma (PRP) stimulates the extracellular matrix metabolism of porcine nucleus pulposus and anulus fibrosus cells cultured in alginate beads. Spine 2006;31(9):959–966 Chen WH, Lo WC, Lee JJ, et al. Tissue-engineered intervertebral disk and chondrogenesis using human nucleus pulposus regulated through TGF-beta1 in platelet-rich plasma. Journal of Cellular Physiology 2006;209(3):744–754 Elliot DM, Yerramalli CS, Beckstein JC, Boxberger JI, Johannessen W, Vresilovic EJ. The effect of relative needle diameter in puncture and sham injection animal models of degeneration. Spine 2008;33(6):588–596