Effect Of Platelet-rich Plasma Therapy Research Articles

A Prospective Observational Study to Evaluate the Effectiveness of Platelet-Rich Plasma Therapy for Complex Wounds: Influential Clinical Variables on Wound Healing Outcomes.

Objective: Autologous platelet-rich plasma (PRP) has shown promising outcomes in treating wounds, but the profile of patients benefiting most from this therapy is not known. This study aimed to identify influential variables in the success of this therapy, analyzing its personalized therapeutic potential for complex wounds. Approach: A prospective observational study was conducted in elderly patients with complex wounds receiving autologous PRP. Patient's data about sociodemographic parameters, comorbidities, frailty (FI-VIG score), complete blood count including albumin, wound depth, location, chronicity, and etiology were collected at the beginning of the study. The wound area was monitored weekly. The data were analyzed using descriptive and inferential statistics, longitudinal data analysis, and survival analysis. Results: Ninety-seven elderly patients were included. The FI-VIG, baseline wound area, depth, and etiology were significantly correlated with wound outcome. Strong differences in wound area variation from treatment initiation were observed in healed wounds (13% reduction/week) compared with stagnant and complicated wounds (1 and 2% reduction/week, respectively). The healing time analysis showed that nearly 80% of patients required at least 15 weeks for complete healing. In addition, patients with smaller wound sizes, younger age, or lower FI-VIG scores had shorter healing times. Innovation: This is the first study that identifies prognostic indicators for wound outcomes to guide clinician decision-making for using autologous PRP. It also highlights the relevance of patient health baseline and wound features and evolution for the success of this therapy. Conclusion: This study demonstrates that personalizing autologous PRP therapy to treat complex wounds in elderly patients is possible.

Platelet-Rich Plasma Therapy for Rotator Cuff Injuries: A Comprehensive Review of Current Evidence and Future Directions.

Rotator cuff injuries are a prevalent cause of shoulder pain and disability, significantly impacting daily activities and quality of life. Platelet-rich plasma (PRP) therapy has emerged as a potential treatment for these injuries, aiming to enhance healing by delivering concentrated platelets and growth factors. This review comprehensively evaluates the current evidence regarding PRP therapy for rotator cuff injuries. It examines clinical trial data, comparing PRP therapy with conventional treatments such as physical therapy and surgical intervention. The review also explores the biological mechanisms of PRP, including its role in promoting tendon repair and regeneration through growth factors and cytokines. In addition, it addresses variables that may affect PRP therapy outcomes, including preparation techniques, injection methods, and patient-specific factors. The review highlights the need for standardized protocols and further research to optimize PRP therapy and address existing gaps in knowledge. Future directions include exploring combined treatment approaches and assessing long-term outcomes to refine PRP therapy's role in rotator cuff injury management. This review aims to provide valuable insights into the effectiveness of PRP therapy, contributing to improved treatment strategies and enhanced patient outcomes.

Platelet-Rich Plasma (PRP) in Hair Restoration Treatments: A Comprehensive Review of Existing Literature

Hair loss is a common concern affecting individuals worldwide. With various therapies available to address this issue, it prompts the search for effective treatments and prevention methods. Platelet-Rich Plasma (PRP) therapy has emerged as a promising option for hair restoration, leveraging the regenerative properties of platelets to stimulate hair growth. This comprehensive review aims to synthesize the existing literature on the use of PRP in hair restoration treatments. A systematic search of major databases was conducted to identify relevant studies evaluating the efficacy and safety of PRP therapy for hair loss of the scalp. Eligible studies were selected based on predetermined inclusion criteria, and data extraction was performed to capture key findings, including patient demographics, PRP preparation methods, treatment protocols, and outcomes measured. The review encompasses both clinical trials and observational studies, providing insights into the effectiveness of PRP therapy in promoting hair regrowth, improving hair density and therefore enhancing patient satisfaction. Additionally, safety considerations, adverse events, and limitations of current evidence are discussed. Overall, this review highlights the growing body of evidence supporting the use of PRP in hair restoration treatments while identifying areas for further research and clinical refinement.

THE USE OF PLATELET-RICH PLASMA IN THE TREATMENT OF ALOPECIA - A REVIEW OF THE LITERATURE

Alopecia is a commonly occurring medical condition. Various types of alopecia are distinguished, with the most common being androgenetic alopecia affecting both men and women. Standard treatments do not always yield the expected results, hence the search for alternative forms of therapy for this condition. Platelet-rich plasma (PRP) has been used in medicine for a long time, but it has gained popularity in aesthetic medicine and dermatology in recent years. The action of PRP includes stimulating collagen formation. The therapeutic effects of PRP therapy in alopecia are achieved through the synergistic action of various types of growth factors. Aim: The aim of our study was to evaluate the effectiveness of platelet-rich plasma therapy for baldness, to compare its effectiveness with other treatment methods and to present this issue to the reader. Methods: Analysis of issues related to baldness and platelet-rich plasma therapy from PubMed sources and comparison of the effectiveness of this therapy with other methods. Conclusions: Treatment with PRP for androgenetic alopecia results in an increase in overall hair density. In chronic plaque alopecia, such therapy leads, among other things, to increased hair regrowth. Combined therapy of PRP with minoxidil in androgenetic alopecia yields better results than using these methods separately. The same applies to combined therapy of PRP with finasteride. However, minoxidil with PRP yields better results than finasteride with PRP.

Value of Intrauterine Autologous Platelet-Rich Plasma Therapy on Endometrial Receptivity: A Literature Review.

Endometrial receptivity is an important factor that influences embryo implantation. Thus, it is important to identify an applicable approach to improve endometrial receptivity in women undergoing assisted reproductive technology. Recently, growing evidence has indicated that intrauterine platelet-rich plasma (PRP) infusion is an effective method to obtain a satisfactory reproductive outcome by increasing endometrial thickness and improving endometrial receptivity. Therefore, the present review aims to outline the possible mechanisms of PRP on endometrial receptivity and summarize the present literature on the effects of PRP therapy in improving endometrial receptivity.

Podium Presentation Title: The Effect of Platelet-Rich Plasma Therapy on Rate and Timing of Meniscectomy

Podium Presentation Title: The Effect of Platelet-Rich Plasma Therapy on Rate and Timing of Meniscectomy

РЕЗУЛЬТАТЫ КОМБИНИРОВАННОЙ МИНИИНВАЗИВНОЙ ФЛЕБЭКТОМИИ И PRP-ТЕРАПИИ ПРИ СОЧЕТАНИИ ВАРИКОЗНОЙ БОЛЕЗНИ С ГОНАРТРОЗОМ

Objective: To analyze the results of combined minimally invasive phlebectomy (CMIP) with platelet-rich plasma (PRP) therapy for the treatment of chronic venous insufficiency (CVI) and knee osteoarthritis (KOA). Methods: The study analyzed the treatment results of 26 patients (11 men, 15 women, average age of 49.3±4.6 years) with CVI and KOA who underwent CMIP with PRP therapy. The patients' average body mass index (BMI) was 28.9±2.1 kg/m². It was observed that patients with CVI exhibited different grades of severity according to the Clinical-Etiological-Anatomical-Pathophysiological (CEAP) classification. Out of 26 patients, 7 (27%) were classified as CEAP class 2, 15 (58%) as class 3, and 4 (15%) as class 4. Isolated insufficiency of the great saphenous vein (GSV) and its tributaries was noted in 9 (35%) patients and the small saphenous vein (SSV) – in 2 (8%) patients. Of the 26 patients, 15 (58%) had combined insufficient GSV and SSV trunks and tributaries. All patients presented with bilateral saphenous vein insufficiency, predominantly on the left side in 19 (73%) cases and on the right side in 7 (27%) cases. Of 26 patients, 17 (65%) had insufficient tibial perforators. According to the Kellgren JH & Lawrence JS classification of osteoarthritis (OA), 4 (15%) of the patients had grade I KOA, 14 (54%) had grade II, and 8 (31%) had grade III. Phlebological status was assessed visually and with duplex scanning (DS) of the venous system in the lower extremities. The knee joints were evaluated using the WOMAC Osteoarthritis Index. Results: The median total index on the WOMAC scale before treatment was 65.5 (61.0-74.0) points, including pain index – 14.0 (13.0-16.0) points, knee joint stiffness – 6.0 (5.0-6.0) points and joint functioning – 47.0 (45.0-49.0) points. All patients underwent CMIP as the first stage, followed by four sessions of PRP therapy, one per week as the second stage. The average duration of surgical procedures was 115.5±35.5 minutes, and patients stayed an average of 2.8±0.4 days in the hospital. There were no significant complications in any case. After the treatment, there was a substantial decrease in pain and stiffness and an improvement in knee joint function. Therapy was ineffective in 4 (15%) cases. The effectiveness of PRP therapy is lower when certain factors are present. These factors include an advanced stage of KOA with a longer duration of the degenerative process in the joint, chronic use of painkillers, and the combined insufficiency of the GSV and SSV trunks. There is a direct correlation between these factors and the low effectiveness of platelet-rich autologous plasma. Conclusion: In patients with CVI and KOA, performing CMIP and PRP therapy can significantly decrease pain and improve daily knee joint function. Keywords: Varicose veins, knee osteoarthritis, microphlebectomy, stripping, PRP therapy.

ПЕРСПЕКТИВЫ ПРИМЕНЕНИЯ PRP-ТЕРАПИИ В ПЕДИАТРИЧЕСКОЙ ПРАКТИКЕ

From the point of view of the characteristics of childhood and clinical and pathophysiological features of diseases in children, the injections of platelet-rich plasma (PRP) are an advantageous manipulation procedures characterized by minimal invasiveness, minimal risk of side effects, ease of obtaining material and manipulation technique, as well as the uselessness of anesthesia. The purpose of this research was to analyze the use and possible effectiveness of PRP therapy in pediatric practice and its application, in particular, in traumatology and orthopedics. The bibliographical search for the 2015 to 2022 sources was carried out using the electronic databases of scientific data in both Russian and English languages. In general, the PRP has a complex biological effect on regeneration, repair, and positive remodeling of connective tissue. Unfortunately, there is no sufficient experience worldwide in the use of PRP therapy in pediatrics, which makes it difficult to interpret the method, evaluate its effectiveness and indications for the use. In the authors’ opinion, the PRP therapy is very promising and of a great potential in pediatric traumatology and orthopedics, where it is important to combine it with additive technologies (kinesio taping, post-isometric relaxation etc.). The unresolved aspects of the pediatric PRP therapy call for pediatric practitioners of different schools to build an evidence database using both clinical observations and biological models.

Effectiveness of Platelet-Rich Plasma Therapy in Androgenic Alopecia-A Meta-Analysis.

Platelet-rich plasma (PRP) represents a novel therapy tested and is used more and more frequently in dermatology and cosmetic surgery for a variety of conditions, including androgenic alopecia (AGA), a common condition with a complex pathogenesis involving genetic factors, hormonal status and inflammation. We performed an extensive literature search which retrieved 15 clinical trials concerning the use in AGA of PRP therapy, alone or in combination, in male, female or mixed patient groups. A quantitative statistical meta-analysis of n = 17 trial groups proved significant increases in hair density from 141.9 ± 108.2 to 177.5 ± 129.7 hairs/cm2 (mean ± SD) following PRP (p = 0.0004). To the best of our knowledge, this is the first meta-analysis that proved a statistically significant correlation between the number of PRP treatments per month and the percentage change in hair density (r = 0.5, p = 0.03), as well as a negative correlation between the mean age of treatment group and the percentage change in hair density (r = −0.56, p = 0.016). Other factors considered for analysis were the PRP preparation method, amount used per treatment, hair diameter, terminal hairs and pull test. We conclude that PRP represents a valuable and effective therapy for AGA in both males and females if patients are rigorously selected.

Predictors of Effectiveness of Platelet-Rich Plasma Therapy for Knee Osteoarthritis: A Retrospective Cohort Study.

There has recently been growing interest worldwide in biological therapies such as platelet-rich plasma injection for the treatment of knee osteoarthritis. However, predicting the effectiveness of platelet-rich plasma therapy remains uncertain. Therefore, this retrospective cohort study was performed to assess a range of predictors for the effectiveness of platelet-rich plasma therapy in treating knee osteoarthritis. The study included 517 consecutive patients who underwent three injections of leucocyte-poor platelet-rich plasma therapy from 2016 to 2019 at a single institution. The treatment outcomes, including patient-oriented outcomes (visual analogue scale score and Knee Injury and Osteoarthritis Outcome Score), were analyzed and compared according to the severity of knee osteoarthritis based on Kellgren–Lawrence (KL) grading using standing plain radiographs. Fisher’s exact test, univariate regression, and multivariate regression were used for data analysis. Patient-oriented outcomes were significantly improved 6 and 12 months after platelet-rich plasma therapy. The overall responder rate in patients who met the Outcome Measures in Rheumatology (OMERACT)–Osteoarthritis Research Society International (OARSI) responder criteria was 62.1%. The responder rate was significantly lower in patients with severe knee osteoarthritis (KL4, 50.9%) than in those with mild (KL2, 75.2%) and moderate (KL3, 66.5%) knee osteoarthritis. The multivariate logistic regression analysis revealed that deterioration of the knee osteoarthritis grade (increased KL grade) was a significant predictor of a worse clinical outcome (odds ratio, 0.58; 95% confidence interval, 0.45–0.75; p < 0.001). The relative risk for non-responders in severe (KL4) KOA was 2.1 (95% CI, 1.5–3.0) at 6 months and 2.3 (1.6–3.2) at 12 months compared with mild-to-moderate (KL2-3) KOA. The efficacy of platelet-rich plasma therapy was not affected by age, sex, body weight, or platelet count. This study revealed that the effectiveness of platelet-rich plasma therapy for the treatment of knee osteoarthritis is approximately 60% and that the effectiveness depends on the severity of knee osteoarthritis. This observation is useful not only for physicians but also for patients with knee osteoarthritis.

P-050 The effectiveness of the platelet-rich plasma treatment of men with severe oligoasthenoteratozoospermia

Abstract Study question To evaluate the effect of platelet-rich plasma (PRP) testicular injections on spermogram parameters of men with severe oligoasthenoteratozoospermia (OAT). Summary answer The PRP testicular injections have beneficial effects on spermatogenesis and enhance sperm concentration and motility in infertile men with OAT. What is known already The use of PRP therapy in assisted reproductive technologies is debatable. Despite the recent evidence of its positive effects in promoting endometrial and follicular growth, data from clinical studies are limited. There are only a few papers on the effectiveness of PRP therapy in the treatment of male infertility and sexual dysfunction. In more detail, the influence of PRP on spermatogenesis was carried out only on experimental animals. Although the mechanisms of its action have not yet been clarified, it is assumed that PRP, containing many biologically active molecules, realizes its effect through the tissue regeneration and cell proliferation. Study design, size, duration This prospective study included 68 men (34.6±5.2) years old with severe OAT (≤4 million/ml, motility ≤30%, normal sperm morphology ≤1%) receiving hormonal and antioxidant (AO) therapy during 6 months before in vitro fertilization cycles. 33 of them were injected once with autologous PRP (0.5 ml in each testicle). Spermogram and testosterone level were analyzed before the treatment and in 3, 4 and 6 months after it. Participants/materials, setting, methods Sperm concentration, motility and morphology in ejaculate of 33 men of PRP group were compared with those in the group of 35 men without PRP within 6 months of starting the treatment. Total and free testosterone level were measured in blood serum. PRP was prepared by centrifuging the patient’s own blood in the anticoagulant-containing tubes. The final concentration of platelets in the obtained sample was 950.000 – 1.250 000 cells in 1 ml. Main results and the role of chance 4 months after the PRP injection, sperm concentration and motility increased in 18 of 33 men of the PRP group compared with the baseline (before the treatment) – 4.2 (1.0;6.9) vs 1.4 (0.1;3.4) mln/ml (p &amp;lt; 0.05) and 36.7 (30.6;45.8) vs 17.7 (6.7;28.2) % respectively (p &amp;lt; 0.05).The maximum increase in sperm motility (but not in sperm concentration!) was observed in 24 men in 6 months – 49.6 (39.6;56.4) % (p &amp;lt; 0.05). Percent of morphologically normal spermatozoa in ejaculate slightly increased only in 12 men in that time period from 0-1 % to 1-2%. The total testosterone level was 2.4 times higher than the baseline (31.6±7.2 vs 13.2±4.3 nmol/l, p &amp;lt; 0.05), the free testosterone level was 1.8 times higher (14.5±3.5 vs 7.9±3.0 pgl/ml, p &amp;lt; 0.05). Unlike the PRP group, in the group of men without PRP treatment, the sperm parameters did not changed compared with the baseline in 4 months after the starting hormonal and AO treatment. A significant increase of sperin concentration was observed only in 17 of 35 patients in 6 months. Sperm motility and percent of morphologically normal spermatozoa after the treatment did not differ from the baseline. Changes in the testosterone levels were similar to changes in PRP group. Limitations, reasons for caution Only young and middle-aged men were considered in the study. Large randomized controlled studies are required to confirm the PRP therapy efficacy and safety of f various fertility disorders. There are also no standardized protocols for PRP preparation. Wider implications of the findings PRP therapy may have great potential for the treatment of male infertility and improving spermatogenesis. Optimization of methods of PRP preparation and dosage of testicular injections can enhance reproductive outcomes in assisted reproductive technologies. Trial registration number not applicable

P–050 The effectiveness of the platelet-rich plasma treatment of men with severe oligoasthenoteratozoospermia

Abstract Study question To evaluate the effect of platelet-rich plasma (PRP) testicular injections on spermogram parameters of men with severe oligoasthenoteratozoospermia (OAT). Summary answer The PRP testicular injections have beneficial effects on spermatogenesis and enhance sperm concentration and motility in infertile men with OAT. What is known already The use of PRP therapy in assisted reproductive technologies is debatable. Despite the recent evidence of its positive effects in promoting endometrial and follicular growth, data from clinical studies are limited. There are only a few papers on the effectiveness of PRP therapy in the treatment of male infertility and sexual dysfunction. In more detail, the influence of PRP on spermatogenesis was carried out only on experimental animals. Although the mechanisms of its action have not yet been clarified, it is assumed that PRP, containing many biologically active molecules, realizes its effect through the tissue regeneration and cell proliferation. Study design, size, duration This prospective study included 68 men (34.6±5.2) years old with severe OAT (≤4 million/ml, motility ≤30%, normal sperm morphology ≤1%) receiving hormonal and antioxidant (AO) therapy during 6 months before in vitro fertilization cycles. 33 of them were injected once with autologous PRP (0.5 ml in each testicle). Spermogram and testosterone level were analyzed before the treatment and in 3, 4 and 6 months after it. Participants/materials, setting, methods: Sperm concentration, motility and morphology in ejaculate of 33 men of PRP group were compared with those in the group of 35 men without PRP within 6 months of starting the treatment. Total and free testosterone level were measured in blood serum. PRP was prepared by centrifuging the patient’s own blood in the anticoagulant-containing tubes. The final concentration of platelets in the obtained sample was 950.000 – 1.250 000 cells in 1 ml. Main results and the role of chance 4 months after the PRP injection, sperm concentration and motility increased in 18 of 33 men of the PRP group compared with the baseline (before the treatment) – 4.2 (1.0; 6.9) vs 1.4 (0.1; 3.4) mln/ml (p &amp;lt; 0.05) and 36.7 (30.6; 45.8) vs 17.7 (6.7; 28.2)% respectively (p &amp;lt; 0.05).The maximum increase in sperm motility (but not in sperm concentration!) was observed in 24 men in 6 months – 49.6 (39.6; 56.4)% (p &amp;lt; 0.05). Percent of morphologically normal spermatozoa in ejaculate slightly increased only in 12 men in that time period from 0–1% to 1–2%. The total testosterone level was 2.4 times higher than the baseline (31.6±7.2 vs 13.2±4.3 nmol/l, p &amp;lt; 0.05), the free testosterone level was 1.8 times higher (14.5±3.5 vs 7.9±3.0 pgl/ml, p &amp;lt; 0.05). Unlike the PRP group, in the group of men without PRP treatment, the sperm parameters did not changed compared with the baseline in 4 months after the starting hormonal and AO treatment. A significant increase of sperin concentration was observed only in 17 of 35 patients in 6 months. Sperm motility and percent of morphologically normal spermatozoa after the treatment did not differ from the baseline. Changes in the testosterone levels were similar to changes in PRP group. Limitations, reasons for caution Only young and middle-aged men were considered in the study. Large randomized controlled studies are required to confirm the PRP therapy efficacy and safety of f various fertility disorders. There are also no standardized protocols for PRP preparation. Wider implications of the findings: PRP therapy may have great potential for the treatment of male infertility and improving spermatogenesis. Optimization of methods of PRP preparation and dosage of testicular injections can enhance reproductive outcomes in assisted reproductive technologies. Trial registration number Not applicable

Leukocyte-dependent effects of platelet-rich plasma on cartilage loss and thermal hyperalgesia in a mouse model of post-traumatic osteoarthritis

Platelet-rich plasma (PRP) is an emerging therapeutic strategy for treatment of osteoarthritis (OA); however, there is a lack of preclinical and clinical evidence for its efficacy and its mechanism of action is unclear. In the current study, we utilized leukocyte poor-PRP (LP-PRP) and leukocyte rich-PRP (LR-PRP) to mimic clinical point of care formulations and assessed their potential to alter disease progression in a mouse model of post-traumatic OA. Three-month-old wild-type male FVB/N mice received destabilization of the medial meniscus (DMM) surgery to induce OA. To assess the efficacy of LP-PRP and LR-PRP, mice were given intraarticular injections at 2-, 7- and 28-days post-surgery. Mice were then assessed at 5-, 9-, and 13-weeks post-surgery for changes in chronic pain using the hot plate nociceptive assay. At 14-weeks, OA pathogenesis was evaluated using histology and phase-contrast μCT. Treatment with LP-PRP and to a lesser extent LR-PRP preserved cartilage volume and surface area compared to phosphate-buffered saline (PBS) as measured by phase-contrast μCT. However, both treatments had higher Osteoarthritis Research Society International (OARSI) and synovitis scores compared to sham, and neither substantially improved scores compared to PBS controls. With respect to thermal hyperalgesia, PBS-treated mice displayed reduced latency to response compared to sham, and LR-PRP but not LP-PRP improved latency to response at 5-, 9- and 13-weeks post-surgery compared to PBS. The results of this study suggest that effects of PRP therapy on OA progression and disease-induced hyperalgesia may be leukocyte-dependent. And while LP-PRP and to a lesser extent LR-PRP protect from volume and surface loss, significant pathology is still seen within OA joints. Future work is needed to understand how the different components of PRP effect OA pathogenesis and pain, and how these could be modified to achieve greater therapeutic efficacy.

Role of Intra-articular Platelet Rich Plasma in the Management of Osteoarthritis: A Review.

Intra-articular injections are a minimally invasive option developed for the management of patients with joint degenerative conditions. These injections can involve the use of steroid preparations, hyaluronic acid, and blood products. Platelet-rich plasma (PRP) is a cost-effective management modality developed for patients with joint degenerative conditions and has provided promising outcomes. It provides nourishment to the chondrocytes through a rich supply of growth factors and cytokines. This article demonstrates the beneficial effects of PRP therapy in patients with osteoarthritis.

Autologous platelet-rich plasma application for the optimization of bone tissue reparative regeneration in osteopenia

Objective: analysis of scientific literature on the effectiveness of using Plateled-Rich Plasma to optimize the treatment of compression fractures of vertebral bodies of thoracic and lumbar localization against the background of postmenopausal and senile osteoporosis. All the methods of using Platelet-Rich Plasma, described in the literature, can be divided into several main groups. Platelet-Rich Plasma can be mixed with bone material; is applied to the lesion site before application of bone material; is applied over the bone material; used as a biological membrane. Platelet-Rich Plasma contain fibrillar and cellular components and is able to act as a carrier of cells which are important for the regeneration of soft and bony tissues. It can strengthen the attachment of human osteoblasts to membranes and, as a consequence, induce osteogenesis. Many authors are the supporters of the stimulating effect of Platelet-Rich Plasma on reparative osteogenesis. After injection of Platelet-Rich Plasma in the case of complicated fracture the following was observed: odema in the damaged tissues is less pronounced, there are less signs of acute and chronic inflammation, the phase of alteration is changing more quickly by regenerative-reparative processes. The natural clot contains fibrin, fibronectin and vitronectin, they are also called adhesion molecules necessary for cell migration, osteoconduction, epithelialization and osseointegration. Biological properties of Platelet-Rich Plasma are due not only to the presence of growth factors (TGF-β and PDGF), but without them it immediately induces the formation of a fibrin clot, followed by stimulation of cell adhesion and collagen synthesis. Conclusion. Based on the published literature, a high potential of plasma therapy by Platelet-Rich Plasma for bone tissue regeneration is demonstrated. No adequate clinical studies on the effectiveness of Platelet-Rich Plasma therapy that would meet all modern criteria have yet been conducted. Therapy of Platelet-Rich Plasma is a promising branch in medicine and deserves further research in terms of new effective and safe method of application in medical practice.

Feasibility of improving platelet-rich plasma therapy by using chitosan with high platelet activation ability.

Platelet-rich plasma (PRP) is blood plasma containing a high number of platelets that release growth factors for wound healing and tissue regeneration. In the present study, the feasibility of improving PRP therapy by using chitosan that exhibits high platelet activation ability was investigated. A total of 13 chitosan samples with different molecular weight (Mw) and degree of deacetylation (DDA) were individually added to blood samples of rats and the amount of growth factors, albumin and fibrinogen in plasma was measured. To examine the influence of plasma activated by chitosan on the proliferation of fibroblasts and adipose tissue-derived stromal cells (ASCs), the plasma was added to the culture medium of human fibroblasts and adipose tissue-derived stromal cells. Chitosan with a DDA of >75% increased the release of platelet factor 4 into the plasma. The amount of growth factors released into the plasma and platelet activation varied depending on the Mw and DDA, while albumin and fibrinogen were hardly affected. The proliferation rate was highest when using plasma activated by chitosan with a DDA of 75-85% and an Mw of 50,000-190,000 Da. These results suggested that the effectiveness of PRP therapy may be improved by using chitosan with a DDA of 75-85% and an Mw of 50,000-190,000 Da.

Effect of Platelet-rich Plasma Therapy Associated With Exercise Training in Musculoskeletal Healing in Rats

BackgroundMuscle healing is a time-dependent process associated with an increase in the total amount of local collagen fibers. Platelet-rich plasma therapy (PRPT) associated with exercise may improve this healing process. The aim of this study was to demonstrate the regenerative effect of PRPT in association with exercise training on musculoskeletal healing. MethodsMale Wistar rats were submitted to an injury in the vastus lateralis muscle and randomly divided into 4 groups (n = 5/group): sedentary sham-operated (SSO); sedentary group submitted to PRPT (SPR); swim-trained (SWT); and swim-trained group submitted to PRPT (SWP). Serum lactate level was used to confirm the training protocol effectiveness to increase aerobic fitness. The collagen fiber concentration was measured by the polarization colors in picrosirius red-stained tissue sections. ResultsLactate levels decreased in both training groups (SWT and SWP; P < .05) after training (SWT: from 6.2 ± 0.44 to 4.7 ± 0.22 mmol/L; SWP: from 5.5 ± 0.99 to 4.0 ± 0.78 mmol/L). There were less type 1 collagen fibers in SWP group compared with other groups (SSO = 31.8 ± 10.3, SSP = 32.3 ± 13.5, SWT = 14.6 ± 13.4, SWP = 5.7 ± 4.7, P < .05), while there were more type 3 collagen fibers on SWP (SSO = 68.7 ± 9.8, SSP = 71.2 ± 12.2, SWT = 85.4 ± 13.4, SWP = 94.4 ± 4.6, P < .05) in the injured region. ConclusionExercise in association with PRPT enhances the skeletal muscle-healing process.

Osgood Schlatter Disease—An ultrasound grading system with practical application

Athletes who sustain a knee joint injury, namely to the anterior cruciate ligament and/or meniscus, are at an increased risk of subsequent osteoarthritis (OA) – the so-called ‘young people with old knees’. Surgical intervention does not appear to reduce this increased risk. There is no good evidence that moderate sporting activity in thepresenceofnormal jointspredisposes toOA.Whether high-level participation in sport, particularly impact type sports, is associatedwithOA is unclear as it is difficult to disentangle the confounding effect of joint injury. Attention to strategies that prevent joint injury in athletes, such as neuromuscular exercise, is therefore paramount to reduce the burden of OA. Optimal management is needed to minimize the onset and extent of joint symptoms in athletes following joint injury. Clinicians should counsel the athlete about their increased likelihood of future OA as this allows athletes to make informed decisions about return to sport as well as plan future management. Prevention and management of OA in athletes includes use of load-reducing strategies such as variable stiffness shoes, bracing, activity modification, muscle strengthening and weight control although these have not been tested in clinical trials in athletes. There are currently no pharmacologic agents with convincing structural disease-modifying efficacy for people with existing joint damage and most have been tested in midto late-term OA rather than early OA. There are no high quality clinical trials investigating the effects of platelet-rich plasma therapy in treatment of knee OA. Evidence for a possible structuremodifying effect of glucosamine, the most commonly used dietary supplement for OA, is still controversial.

Maximising joint health: Preventing and managing knee osteoarthritis in the athlete

Athletes who sustain a knee joint injury, namely to the anterior cruciate ligament and/or meniscus, are at an increased risk of subsequent osteoarthritis (OA) – the so-called ‘young people with old knees’. Surgical intervention does not appear to reduce this increased risk. There is no good evidence that moderate sporting activity in thepresenceofnormal jointspredisposes toOA.Whether high-level participation in sport, particularly impact type sports, is associatedwithOA is unclear as it is difficult to disentangle the confounding effect of joint injury. Attention to strategies that prevent joint injury in athletes, such as neuromuscular exercise, is therefore paramount to reduce the burden of OA. Optimal management is needed to minimize the onset and extent of joint symptoms in athletes following joint injury. Clinicians should counsel the athlete about their increased likelihood of future OA as this allows athletes to make informed decisions about return to sport as well as plan future management. Prevention and management of OA in athletes includes use of load-reducing strategies such as variable stiffness shoes, bracing, activity modification, muscle strengthening and weight control although these have not been tested in clinical trials in athletes. There are currently no pharmacologic agents with convincing structural disease-modifying efficacy for people with existing joint damage and most have been tested in midto late-term OA rather than early OA. There are no high quality clinical trials investigating the effects of platelet-rich plasma therapy in treatment of knee OA. Evidence for a possible structuremodifying effect of glucosamine, the most commonly used dietary supplement for OA, is still controversial.