Autologous Platelet-rich Plasma Injection Research Articles

Assessment of Efficacy of Platelet-Rich Plasma Injection for Facial Rejuvenation

AbstractBackground: Facial rejuvenation includes different ther-apeutic modalities of returning facial youthfulness. PRP injection delivers very high concentrations of growth factors that lead to accelerated tissue regeneration and remodeling.Aim of Study: The aim of this work was to evaluate the efficacy of single session of intradermal injection of autologous Platelet Rich Plasma (PRP) in facial rejuvenation.Patients and Methods: 20 subjects with different types of facial wrinkles were included in this study. They were selected from Dermatology and Venereology Department, Tanta University Hospitals. All of them received single session of intradermal injection of autologous PRP and were clinically assessed before and 2 months after PRP injection using Wrinkle Severity Rating Scale (WSRS), Skin Texture Scale, and Subject Satisfaction Scale.Results: All subjects showed significant clinical improve-ment of all types of facial wrinkles after PRP injection. At the end of follow-up period, there was statistically significant decrease in Wrinkle Severity Rating Scale (WSRS) comparable to that before PRP injection. Additionally, there was a statis-tically significant improvement of skin texture and subject satisfaction after PRP injection.Conclusion: Intradermal injection of autologous PRP is well tolerated and capable of rejuvenating the face and pro-ducing a significant correction of different types of facial wrinkles.

EFFECT OF AUTOLOGOUS PLATELET-RICH PLASMA ON ARRANGEMENT OF COLLAGEN FIBERS AT INJURED ACHILLES TENDON ENTHESES IN RABBITS

Objective: To evaluate the effects of autologous platelet-rich plasma on arrangement of collagen fibers at injured Achilles tendon entheses in rabbits.
 Study Design: Laboratory-based experimental study.
 Place and Duration of Study: Department of Anatomy, Army Medical College, Rawalpindi, in collaboration with National Institute of Health, Islamabad, from March to May, 2018.
 Material and Methods: Forty, healthy, male, “New Zealand white rabbits”, 4-6 months of age, weighing 2000- 2500g, were randomly divided into 4 equal groups (A, B, C and D). Group A served as control, while B, C and D were experimental groups. Injuries were surgically induced at Achilles tendon entheses of rabbits of experimental groups, which were treated with injections of autologous platelet-rich plasma, either at the time of inducing injury or two weeks after injury in groups C and D respectively while group B was left untreated. Animals were sacrificed after 12 weeks. Tissues were processed and stained for histological evaluation. Statistical analysis was done using SPSS version 22. A p-value of ≤0.05 was taken as significant.
 Results: Experimental group B showed marked deterioration in Bonar’s modified score for arrangement of collagen fibers as compared to the control group A. The scores were significantly improved in treatment groups C and D as compared to group B.
 Conclusions: Injection of autologous platelet-rich plasma effectively improved the Bonar modified score for arrangement of collagen fibers at injured entheses, 12 weeks after injury as compared to non-treatment group.

Functional outcome of ultrasound guided platelet rich plasma injection and corticosteroid injection for lateral epicondylitis

Platelet Rich Plasma (PRP) has created a huge significance in several medical grounds, including orthopaedics. Numerous studies have shown that Platelet Rich Plasma can be used in the management of bony as well as soft tissue injuries. Lately, Platelet Rich Plasma has been used for chronic enthesopathies like tennis elbow, plantar fasciitis, in sports medicine and also in cartilage regeneration. In this study we assessed and reported the efficacy of ultrasound guided autologous Platelet Rich Plasma and Corticosteroid injection

Treatment of Lateral Epicondylitis With Autologous Blood, Platelet-Rich Plasma, or Corticosteroid Injections: A Systematic Review of Overlapping Meta-analyses.

Background:Previous meta-analyses have been conducted to compare outcomes of various treatment injections for lateral epicondylitis (LE), including corticosteroid injection (CSI) and autologous blood products such as autologous blood (AB) and platelet-rich plasma (PRP).Purpose:To conduct a systematic review of overlapping meta-analyses comparing different injection treatments (CSI, AB, PRP) for LE to determine which meta-analyses provide the best available evidence.Study Design:Systematic review; Level of evidence, 2.Methods:A systematic review was performed by searching PubMed, Embase, and the Cochrane Library to locate meta-analyses that compared clinical outcomes of CSI, AB, and PRP for the treatment of LE. Search terms included “injection,” “corticosteroid,” “platelet-rich plasma,” “autologous blood,” “tennis elbow,” “lateral epicondylitis,” and “meta-analysis.” Results were reviewed to determine study eligibility. Patient outcomes were extracted from these meta-analyses. Meta-analysis quality was assessed with the Oxman-Guyatt and Quality of Reporting of Meta-analyses (QUOROM) systems. The Jadad decision algorithm was then used to determine which meta-analyses provided the best level of evidence.Results:Nine meta-analyses (two level 1 studies, seven level 2 studies) containing 8656 patients met the eligibility criteria. Seven meta-analyses found that autologous blood products such as AB and PRP significantly improved pain and elbow function in the intermediate term (12-26 weeks), while 4 studies found that CSI effectively relieved pain and improved elbow function in the short term (<12 weeks). The study by Arirachakaran et al in 2016 received the highest QUOROM and Oxman-Guyatt scores; therefore, this meta-analysis appears to have the highest level of evidence. In addition, this study was rated the highest-quality study in this systematic review according to the Jadad decision algorithm. Lower-quality meta-analyses indicated that dosage, number of injections, and differences in therapeutic duration between CSI and autologous blood products may be essential factors in determining the appropriate treatment injection protocol for LE.Conclusion:The current best available evidence suggests that CSI improves functional outcomes and pain relief in the short term, while AB and PRP are the most effective treatments in the intermediate term.

A comparative study between local injection of autologous platelet rich plasma and injection of corticosteroid in functional improvement of plantar fasciitis

Background: Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient’s daily activities and work. The primary objective of the study was to evaluate and compare the effectiveness of autologous platelet rich plasma (PRP) and steroid injections in chronic cases of plantar fasciitis (PF).Methods: A prospective, randomized study was conducted from December 2013 to December 2015 amongst 60 patients with chronic PF were randomized prospectively in single tertiary care center in India. All the patients were enrolled according to inclusion criteria and divided into 2 groups i.e. group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Roles and Maudsley score (RM Score) and Foot Function Index (FFI) was evaluated for all the included patients. The follow-up scheduled at 1 and 6 months after complete enrolment of patients.Results: Between both the groups, the significant difference was observed at 1 and 6 months follow-up from the baseline. At 1-month follow-up, statistically significant improvement in mean RM scores were seen in both the groups from baseline and when RM scores were compared between two groups, group B had statistically better mean scores. At 1-month follow-up there was no statistically significant difference between the mean FFI score values between two groups. At 6-month follow-up, statistically significant improvement in mean FFI scores were seen in both the groups, however when both groups were compared to each other, improvement in mean FFI scores was statistically better in group A as compared to group B.Conclusions: The present study concluded the use of PRP in chronic cases of plantar fasciitis seems more safe and effective in long term than the traditional treatment of steroid injection at different time period.

Effect of inflammatory marker activity after intra-articular injection of autologous platelet-rich plasma in dogs with osteoarthritis

Osteoarthritis (OA) is a common cause of lameness, pain, and dysfunction in dogs. To determine the levels of interleukin (IL) (IL-1β, IL-6, IL-10), tumor necrosis factor (TNF)-α, and prostaglandin E2 (PG-E2) in the synovial fluid after intra-articular injection of an autologous platelet-rich plasma concentrate to treat dogs with osteoarthritis. Twenty dogs with osteoarthritis (OA) were used as a materials. Fourteen dogs were used as a platelet-rich plasma (PRP) treatment group and 6 dogs were used as a control (0.9 % NaCl). PRP was obtained by the double centrifuge method. Affected joints were examined by radiography and ultrasonography. Lameness and pain severity were evaluated by attending clinicians. Samples were collected under sterile conditions at pre-treatment, days 1, 3, 5, 7, 15, and weeks 4, 8, and 12. The marker levels were determined by an enzyme-linked immunosorbent assay. No adverse effects of the injection of platelet concentrate or saline solution were observed. No significant differences were found in the Hudson Visual Analog Scale and Canine Brief Pain Inventory scores between weeks 0, 4, and 12 in the control dogs. No significant changes were observed in IL-1β, IL-6, IL-10, TNF-α, and PG-E2 levels (P&gt;0.05) in synovial fluid from the PRP treatment group compared to synovial fluid from the control group, although fluctuations in parameter levels were observed in both groups. Despite some variable results in inflammatory parameters, clinical improvement was recorded in the PRP-treated group. PRP injection could be an effective and safe method for treatment of dogs with osteoarthritis.

A prospective study of efficacy of autologous platelet rich plasma injection in tennis elbow

A prospective study of efficacy of autologous platelet rich plasma injection in tennis elbow

Role of platelet-rich plasma versus corticosteroid injection in the treatment of plantar fasciitis: A comparative study

Introduction: Platelet-rich plasma (PRP) is promoted nowadays as an ideal autologous biological blood-derived product. It enhances wound healing, bone healing, tendon healing and is currently being widely used. Aims and Objectives: A prospective cohort study was conducted to assess the efficacy of autologous PRP injection and to compare it with corticosteroid injection in the treatment of plantar fasciitis (PF). Materials and Methods: Fifty patients were included in the study and divided into two groups. Group I (25 patients) received PRP injection and Group II (25 patients) were given steroid injection. Patients were clinically assessed at different intervals. Functional outcome was evaluated on the basis of the visual analog scale (VAS) and foot and ankle ability measure (FAAM) scores. Plantar fascia thickness was assessed pre- and post-injection by ultrasound. Results: PRP and corticosteroid injection groups at the initial visit had VAS score of 8.86 and 8.60, respectively, which was reduced to 1.52 and 3.10 at the end of 6 months. The PRP and corticosteroid injection groups at the initial visit had FAAM score of 29.2 and 30.8, respectively, which increased to 84.2 and 68.3 at the end of 6 months. After injection, the PRP group had a significant reduction (34.80%) in the thickness of plantar fascia as compared to corticosteroid group (29.54%). Conclusion: Treatment of PF with PRP extract reduces pain and significantly increases function, exceeding the effect of steroid on long-term follow-up.

Efficacy of Autologous Platelet-Rich Plasma alone or in Combination with a Lotion Containing Growth-Factor like Polypeptides and Taurine in the Treatment of Androgenic Alopecia: A Randomized, Prospective, AssessorBlinded Trial

Introduction and objectives: Autologous Platelet-Rich Plasma (PRP) dermal injections are considered as a therapeutic option for the medical treatment of androgenic alopecia (AGA). However, clinical efficacy of this approach in some cases could be disappointing. Positive effects of PRP in AGA seem to correlate, at least in part, with a growth factors mimicking action. A hair scalp lotion containing high-purified, growth factors-like polypeptides (octapeptide 2, acetyl decapeptide 3, oligopeptide 20 and copper tripeptide) with the addition of glycine and taurine (GFM-L) is available. So far, no data regarding the potential synergistic effect of autologous PRP treatment combined with GFM-L are available. We therefore conducted a prospective, randomized, assessor-blinded trial to compare the efficacy and tolerability of PRP alone vs. PRP and GFM-L treatment in men and women with AGA. Materials and methods: The study was a prospective, randomized (with a balance ratio of 2:1), assessor-blinded, 3- month trial. Thirty subjects (18 men and 12 women; mean age: 41 years) were enrolled after their written informed consent. Twenty subjects were allocated to PRP treatment cycle followed by GFM-L application for 3 months (2 ml of lotion every other day) (Group A) and 10 subjects were allocated to PRP treatment alone (Group B). In both groups autologous PRP injections on the affected area were performed over a period of 3 months at interval of 3-4 weeks, using a volume of 10 cc of PRP for each session treatment. Primary end point was the Investigator Global Assessment (IGA) score of clinical efficacy at month 3 in comparison with baseline. IGA score ranged from 0 (no improvement) to 3 (strong improvement). Secondary endpoint was the evolution of Hamilton scale grading (HSG), evaluated at baseline and at the end of study period. IGA score and HSG were performed by an investigator unaware of the treatment allocation group. Results: All the enrolled subjects concluded the study period. At baseline HSG was 2.0 ± 0.6 in Group A and 2.1 ± 0.3 in Group B. At month 3, a significant reduction of HSG was observed in Group A subjects only, both in comparison with baseline and in comparison, with Group B values (1.3 ± 0.5 vs. 2.1 ± 0.37; P=0.0028). At month 3, IGA score was 2.1 ± 0.9 in group A and 0.8 ± 0.3 in group B (P=0.0031). GFM-lotion was well tolerated. Conclusion: The combination of GFM-lotion containing growth factors like peptides and taurine with autologous PRP treatment is superior in term of efficacy to the treatment with PRP alone in subjects with AGA.

Intravesical injections of platelet-rich plasma is effective and safe in treatment of interstitial cystitis refractory to conventional treatment-A prospective clinical trial.

Current treatments for interstitial cystitis/bladder pain syndrome (IC/BPS) are usually unsuccessful in achieving long-term bladder pain relief and irritable symptom improvement. This study investigated the clinical efficacy of platelet-rich plasma (PRP) intravesical injections on IC/BPS patients refractory to conventional therapies. Forty patients received four monthly intravesical injections of 10 mL PRP extracted from 50 mL of whole blood. The primary end-point was Global Response Assessment (GRA) at 3 months after the 4th PRP injection. Secondary endpoints included changes in O'Leary-Sant symptom score (OSS), visual analog scale (VAS) of pain, daily frequency, nocturia, functional bladder capacity (FBC), maximum flow rate, voided volume, post-void residual volume (PVR) from baseline to 3 months after the 4th PRP injection. All 40 patients (37 women and 3 men, aged 55.5 ± 11.1 years) completed the four injections and follow-up visits. GRA improved after the 1st PRP injection and the satisfaction persists till the primary end-point. The success rate was 45%, 52%, 70%, 70%, and 67.5% after the 1st, 2nd, 3rd, 4th, and 3 months after the 4th PRP injection, respectively. OSS and VAS also significantly decreased. The PVR did not change after repeated PRP injections, FBC increased, frequency, and nocturia were decreased after PRP injections. All patients were free of urinary tract infection or difficulty urinating. The study demonstrated that repeated intravesical injections of autologous PRP can increase bladder capacity and provide IC symptom improvement in patients with IC/BPS refractory to conventional therapy. Autologous PRP injection is safe and effective in selected patients.

The effect of platelet-rich plasma injection on post-internal urethrotomy stricture recurrence

Local injection of platelet-rich plasma (PRP) is postulated to work by delivering growth factors and cytokines that recruit healer cells and enhance recovery process at the injection site. As new scar formation leads to stricture recurrence after internal urethrotomy, we proposed to improve post-internal urethrotomy stricture recurrence rate by injecting local submucosal PRP at the time of urethrotomy. From July 2015 to June 2018, 87 male patients with symptomatic bulbar urethral stricture (diagnosed by retrograde urethrography) randomized into two groups of internal urethrotomy and submucosal normal saline injection (control group, 43 patients), and internal urethrotomy with submucosal autologous platelet-rich plasma injection (PRP injection group, 44 patients). According to the endpoint, which happened sooner, each patient was followed at 3-month intervals for 2years after internal urethrotomy or until urethral stricture recurrence. Twelve-month recurrence rates were 26.82 and 9.09% in the control and the PRP injection groups, respectively (p 0.032). After 2years of follow-up, stricture recurrence was identified in 18 (43.90%) and 9 (21.95%) patients in the control and the PRP injection groups, respectively (p 0.34). In our study, submucosal PRP injection at the site of internal urethrotomy decreased the rate of stricture recurrence a year after the intervention. This protective effect lasted for 24months, at least. Submucosal PRP injection at the time of internal urethrotomy also decreased the length of stricture in case of recurrence.

Nonsurgical treatment of partial ACL tears: intraarticular injection of Platelet-rich plasma did not change the progression rate to knee instability

ObjectiveDiagnosis and treatment of partial tears of the ACL remains controversial. Patients that present a hard end positive Lachman and negative pivot shift in the context of a partial tear in the magnetic resonance imaging (MRI) have a healing potential that could avoid surgery. Platelet-Rich-Plasma (PRP) provides certain growth factors that could improve healing and therefore, clinical outcomes after partial ACL tears. The aim of this study was to report the results of autologous intraarticular PRP injection in patients with partial ACL tears.MethodsProspective cohort of patients between 2015 and 2017 with acute ACL partial tear, treated either with autologous PRP therapy combined with a rehabilitation protocol (group 1) or rehabilitation alone (group 2). The primary outcome was to evaluate return to sports and recurrent knee instability requiring surgery. We performed pre and postoperative subjective evaluation using Tegner, IKDC and Lysholm scores and an objective evaluation using KT1000 arthrometer. and return-to-sports were performed. An MRI was performed at 6 months. Platelets and leukocyte concentration in PRP preparation was analyzedResultsA total of 40 patients were included in this study, 21 in group 1 and 19 in group 2. Median age was 26 yeas (IQR 22-35), 85% (n=34) were men with a median follow up of 12 months (IQR 8–15). Eighteen patients (85%) in group 1 and 15 (79%) patients in group 2 were Tegner 7 or above.All patients returned to sports at a mean of 3.8 months in group 1 and 4.2 months in group 2. Five (23,8%) patients in group 1 (1 proximal and 4 mid-third lesions) and four (21%) in group 2 (3 proximal and 1 mid-third lesion) failed and had an ACL reconstruction because of knee instability (p 0.99). All after a new sport trauma.Lysholm score improved from 62 (SD 20) to 70 (SD 24) in group one and from 67 (SD 14) to 74 (SD 16) in group 2. IKDC score improved from 51 (SD 11) to 68 (SD 19) in group 1 and from 55 (SD 17) to 69 (SD 9) in group 2. Side-to-side difference in arthrometric KT1000 evaluation was less than 3 mm in 80% of patients that did not fail. In MRI studies, twenty-two (55%) had a proximal ACL lesion and eighteen (45%) a mid-substance ACL lesion. Fifteen (71%) patients in group 1 and twelve (63%) in group 2 presented an improvement in signal intensity at 6 months.The platelet concentration was 478% and the leukocyte concentration was 9% in relation to the patient´s baseline serum concentration.ConclusionReturn to sports after a partial ACL tear was similar in both groups. Almost 25% of patients progressed to knee instability, without significant differences between those treated or not with an intra-articular PRP injection. Longer follow-up is required before any conclusions.

Percutaneous piercing cortical bone at fracture ends and local injection of autologous concentrated bone marrow aspirate and platelet rich plasma for treatment of delayed fracture union

Objective To evaluate the clinical efficacy of percutaneous piercing cortical bone at fracture ends and local injection of autologous concentrated bone marrow aspirate (cBMA) and platelet rich plasma (PRP) in the treatment of delayed fracture union. Methods A retrospective study was performed on the clinical data of 34 patients with delayed fracture union who had been treated at Department of Orthopaedics, Luoyang Zhenggu Hospital of Henan Province from April 2014 to February 2017. They were 26 males 8 females, aged from 18 to 63 years (average, 36.7 years). There were 15 femoral, 11 tibial, 5 humerus and 3 ulnar fractures. According to the Weber-Crech classification, 14 cases belonged to the type of rich blood supply-active end hypertrophy and 20 to the type of poor blood supply and malnutrition. There were 28 closed and 6 open fractures. Of this cohort, 21 cases had their primary fixation, 7 had revision once, 4 had revision twice, and 2 had revision more than thrice; 19 cases had intramedullary fixation, 12 had plate fixation and 3 had external fixation. Autologous iliac bone grafting was performed previously in 19 cases. Kirschner wire was used under fluoroscopy to pierce percutaneously the cortical bone at fracture ends; bone marrow blood and peripheral venous blood were collected to prepare autologous cBMA and PRP which were to be injected locally at the fracture ends after mixture. At the last follow-up, the patients were evaluated by visual analogue scale (VAS), SF-36 health survey summary scores and modified Radiographic Union Score for Tibia (RUST). Results The patients were followed up for 12 to 42 months (average, 21.5 months). Thirty-one patients healed after surgery, yielding a healing rate of 91.2%. The healing time averaged 5.3 months (from 4 to 10 months). No patient reported such complications as infection or neurovascular injury. At the last follow-up, the VAS scores of the 34 patients were 1.3±0.6 points, significantly lower than the preoperative 5.4±3.6 points (P<0.05); the postoperative SF-36 scores 74.8±16.5 points, significantly increased than the preoperative 44.8±15.6 scores (P<0.05); the RUST scores 3.3±0.4 points, significantly higher than the preoperative 1.6±0.8 points (P<0.05). Conclusions Minimally invasive percutaneous piercing of K-wire on the cortical bone at the fracture ends may result in fluid leakage and restart bone healing process. At the same time, local injection of autologous cBMA and PRP may increase the number and concentration of local bone marrow mesenchymal stem cells and growth factors, promoting fracture healing. Key words: Fractures, bone; Bone marrow; Platelet-rich plasma; Surgical procedures, minimally invasive; Delayed healing

Platelet-rich plasma to rescue an ulcerated orbital dermal fat graft.

Central graft ulceration is a rare complication of an orbital dermal fat graft caused by diminished blood supply to the implant. This study reports on the efficacy and safety of the use of a single subconjunctival injection of autologous platelet-rich plasma to rescue an ulcerated orbital dermal fat graft. Three patients, who had undergone autologous dermal fat graft to treat their anophthalmic socket, were given a 2-mL subconjunctival platelet-rich plasma injection in the exposed graft margins. Demographic and clinical features, treatment protocol, clinical course, complications and follow-up time are reported. In the preoperative examination, all the patients presented a primary epithelial defect of the dermal fat graft. There were no major complications such as necrosis or infection. One patient presented a small conjunctival granuloma at 1-month follow up. Mean postoperative follow-up duration was 13 (range: 10-16) months. By 1 month, the chronic epithelial defect had resolved with the graft integrated within the orbital tissues in all cases. All patients were referred for artificial prosthesis placement. Although further work is needed, our findings suggest that a single subconjunctival platelet-rich plasma injection could be an effective, safe and economic alternative to surgery to rescue an ulcerated orbital dermal fat graft.

The comparative and prospective study on efficacy and functional outcome of autologous platelet rich plasma injection vs hydrodissection in adhesive capsulitis of shoulder

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Adhesive capsulitis of should is also called frozen shoulder which describes a chronic, indolent pathological process in which the body forms excessive adhesions across the glenohumeral joint which in turn leads to pain, stiffness, and loss of range of movements which compromises the quality of life. The objective of the study was to evaluate the efficacy and functional outcome of autologous PRP injection and hydrodissection in adhesive capsulitis of shoulder.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; After excluding the patients who failed to satisfy the study protocol, the remaining 100 patients are divided equally into two groups namely group A (n=50) who receive autologous PRP injection and group B (n=50) who receive hydrodissection for adhesive capsulitis of shoulder. Both group participants are followed up pre-procedurally and post-procedurally at the end of 1&lt;sup&gt;st&lt;/sup&gt;, 6&lt;sup&gt;th&lt;/sup&gt; and 12&lt;sup&gt;th&lt;/sup&gt; month for pain relief and range of movements. The improvements in pain and range of movements are charted in terms of VAS and DASH scoring system.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The statistical analysis were done for 46 patients in group A and 45 patients in group B which showed a statistical improvement in pain and range of movements (p&amp;lt;0.001 for VAS score and p&amp;lt;0.01 for DASH score) in group A who received autologous platelet rich plasma therapy. Autologous PRP therapy improves the functional quality of life with a long term outcome.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; For adhesive capsulitis of shoulder, autologous PRP therapy remains functionally superior than hydrodissection as autologous PRP is a constructive procedure by rejuvenating the degenerative tissues.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Efficacy of intralesional corticosteroid versus autologous platelet rich plasma injection in the management of chronic plantar fasciitis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Plantar fasciitis is a common pathological condition affecting the hind foot, and a common cause of heel pain. The present study was taken up to assess the efficacy of intralesional corticosteroid compared to autologous platelet rich plasma injection in the management of chronic plantar fasciitis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Patients were randomized into two groups (Group A and Group B) of 30 each. Group-A received Corticosteroid injection while Group-B received PRP injection. Patients were assessed functionally using American Orthopaedic Foot and ankle score (AOFAS), Visual analogue scale (VAS) scores before treatment and on follow-up visit at 6 weeks, 3rd month, and 6th month. Ultrasound of heel for plantar fascia thickness was measured before treatment and follow up visit at 6th month.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; A significant decrease in VAS score was observed in the corticosteroid group compared to PRP group at 6 weeks while the VAS score continued to decrease in the PRP group at 3 months and 6 months with an increase in the corticosteroid group at 3 months and 6 months. A significant increase in AOFAS was observed in the Corticosteroid group compared to PRP group at 6 weeks which increased in the PRP group at 3 months and 6 months. However it decreased in the corticosteroid group at 3 months and 6 months. Ultrasonographic evaluation showed improvement in fascial thickness in both the groups, but was better in the PRP group.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; To conclude our study shows that corticosteroid is more effective for short term relief and PRP is more effective for long term relief.&lt;/p&gt;

COMPARATIVE STUDY BETWEEN AUTOLOGOUS BLOOD AND PLATELET RICH PLASMA IN TREATMENT OF RECURRENT TEMPOROMANDIBULAR JOINT DISLOCATION

INTRODUCTION: Temporomandibular joint (TMJ) dislocation is an excessive forward movement of the condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. OBJECTIVES: the aim of the study was to compare clinically between the effect of autologous blood injection and platelet rich plasma injection in treatment of chronic recurrent temporomandibular joint dislocation through evaluation of mandibular range of motion. MATERIALS AND METHODS: Twenty patients with bilateral chronic recurrent condylar dislocation were included in this study. In group I 3mL autologous blood was injected. For group II 3ml of concentrated platelet rich plasma (PRP) was injected. Preoperative and postoperative assessment included a thorough history and physical examination to determine mandibular range of motion. RESULTS: Mandibular range of motion was significantly reduced post operatively in both groups, however on comparing the two groups there was statistically insignificant difference in mandibular range of motion. CONCLUSIONS: Both autologous blood and PRP injections are simple, low cost, and minimally invasive approaches which can be easily and safely injected. Both Autologous blood injection and PRP significantly decrease mandibular range of motion to normal range in patients with chronic recurrent TMJ dislocation.

Platelet-rich plasma and corticosteroid injection in lateral epicondylitis: Who is great

Elbow epicondylar tendinitis is a common problem that usually resolves with nonoperative treatments. When these measures fail, there is a role of Platelet-rich plasma (PRP) for tissue repair. The trial was conducted in Bangabandhu Sheikh Mujib Medical University Hospital during the period August 2016 to February 2017. One hundred patients with chronic lateral epicondylitis were randomly assigned to a leukocyte-enriched PRP group ( n = 51) or the corticosteroid group ( n = 49). Patients received either a corticosteroid injection or an autologous PRP injection through a peppering needling technique. Outcome was measured in terms of Visual Analog Scale (VAS) and Disabilities of the Arm, Shoulder and Hand (DASH). Success was defined as a reduction of 25% on VAS or DASH scores without a re-intervention within 6 months. When baseline VAS and DASH scores were compared with the scores of 6 months follow-up, both groups significantly improving within this time (intention-to-treat principle). But the DASH scores of the corticosteroid group come back to baseline levels, while the PRP group is unchanged at the end of 6 months (as-treated principle). The PRP group shows better outcome than the corticosteroid group ( P < 0.0001). There were no complications shown in the use of PRP. Patients with chronic lateral epicondylitis treated with PRP reduces pain and increases function, exceeding the effect of corticosteroid injection.

Platelet Rich Plasma: Is it Effective in Treatment of Atrophic Scar?

Introduction: Atrophic scar is the result of decreasecollagen production and matrix formation, that's why managementof atrophic scar is challenging for plastic surgeons.PRP plays an important role in tissue regeneration duringwound healing via release of growth factors that have animportant role in the regulation and proliferation of mesenchymaland fibroblast cells, hence it increase collagen productionand improve wound healing. The main goal of thearticle is to evaluate the efficacy and safety of autologousplatelet-rich plasma (PRP) injections in improvement ofatrophic scar.Patients and Methods: Twenty patients with atrophic scarwere included in this study at plastic surgery department,Assiut university hospital, in duration from July 2016 toFebruary 2017. Mean age was 22.68±6.75 years. Patientswere randomly divided into 2 groups to allow equal distribution.Group 1 (control), underwent scar revision only. Group2 (study), underwent scar revision, followed by immediatelyintradermal autologous Platelet rich plasma (PRP) injectionat the edges of the wound. This was followed by PRP injectionevery month for the next five months. Patients with atrophicnon pigmented scars at any region of the body were included.Any case with history of medical co-morbidities also wasexcluded. Scar width, Vancouver scar scale (VSS), surgeonassessment scar scale, patient assessment scar scale andcomplications, were the outcome measurements.Results: Surgeon assessment scar scale, VSS, and patientassessment scar scale showed no significant difference (pvalue<0.05) between the two groups preoperative, whilethere was significant clinical improvement of the resultingscar in group II compared to group I six months postoperatively,No complications were noticed in both groups.Conclusion: We conclude that intradermal injection ofautologous PRP in an atrophic scar after its revision could beconsidered as a promising option for atrophic scar managementas it improves wound healing process that appears in theimprovement of clinical appearance of the scar.

Treatment of lateral epicondylitis with autologous platelet rich plasma injection

Outcomes of traditional treatment methods of lateral epicondylitis are variable because of poor tendon healing properties secondary to poor vascularization. Platelet rich plasma provides locally high concentration of growth factors and have shown its efficacy in many tendinopathies and wound healing. We tried to measure the efficacy of locally injected autologous PRP, subjectively by functional oxford elbow score and pain score as well as objectively by ultrasonographic evaluation of the morphologic changes (focal hypoechoic, odema, tendon thickness, fraying, tear, cortical erosion, calcification) in common extensor origin in 30 patients with mean age of 39.3 years of recalcitrant lateral epicondylitis. The mean pain VAS Score improved from 7.7 before injection to 1.8 at final follow up i.e. after 6 months post injection. The Oxford elbow score improved from a mean of 19.2 prior to treatment to 41.3 after the injection at final follow. Ultrasonography of the involved elbow showed decrease in focal hypoechoic, decreased edema, improvement in thickness of the tendon and healing of the tear at the origin site. This study confirms that local PRP by supplying growth factors helps to enhance the stromal and mesenchymal stem cell proliferation and increases tendon vascularity and prevents angiofibroblastic degeneration and thus improves tendon repair and healing property by releasing growth factors and increasing vascularity, which can be documented by improved tendon morphology.