Local Injection Of Platelet-rich Plasma Research Articles

Facial Artery Branch Thrombolysis for Nasal Vascular Embolism Induced by Hyaluronic Acid Injection.

Vascular embolism is a severe complication following hyaluronic acid (HA) filler injections, with hyaluronidase injection being the most effective treatment. The nasal region, including the nose and nasolabial fold, is the most common site of vascular embolism after facial HA injections. Currently, there is insufficient clinical evidence regarding the benefits of facial artery thrombolysis. This article aimed to evaluate the efficacy of hyaluronidase injection via the facial artery as an emergency treatment for vascular embolism induced by facial aesthetic HA fillers. We reviewed 14 patients who experienced nasal vascular embolism following facial HA filler injections. All 14 patients underwent percutaneous facial artery thrombolysis with a combination of hyaluronidase and urokinase administered intravascularly. For patients with longer occlusion duration and severe necrosis, femoral artery interventional thrombolysis was performed, with local injection of platelet-rich plasma to promote recovery. Follow-up ranged from 1 month to 1 year. Following facial artery hyaluronidase injection, all cases showed improvement in nasal skin lesions. Twelve patients fully recovered, while 2 patients were left with minor superficial scars and defects in the nasal wings. Early thrombolysis postnasal embolism is crucial, and percutaneous facial artery puncture is an effective emergency treatment. Arterial intervention targeting the facial artery in the nasolabial fold may offer more precise thrombolysis. The combined use of hyaluronidase and urokinase is both safe and effective.

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

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

PROSPECTIVE STUDY ON THE EFFECTIVENESS OF PLATELET-RICH PLASMA IN MANAGING CHRONIC PLANTAR FASCIITIS

Objectives: The objectives of this study were as follows: (1) Assess the impact of a single dose of platelet-rich plasma (PRP) injection on visual analog scale (VAS) scores for heel pain. (2) Evaluate the functional outcome scores following PRP treatment for chronic plantar fasciitis. (3) Measure and confirm the restoration of plantar fascia thickness through ultrasound (USG) assessments. (4) Determine the safety and viability of local PRP injection as a treatment option for individuals with chronic plantar fasciitis. Methods: This hospital-based prospective case series, spanning January 2019 to January 2020, enrolled 40 participants aged 25–65 with unilateral, persistent plantar fasciitis resistant to conservative treatment. Exclusion criteria included BMI ≥30, various pathologies, and recent injections. Ethical clearance was obtained, and participants received autologous PRP injections, with ultrasound measuring plantar fascia thickness. Post-injection, patients were monitored for adverse reactions, initiated stretching exercises, and progressed to weight-bearing activities after 6 weeks. Results: The study cohort, averaging 45 years (standard deviation [SD] 7.7), primarily comprised females with the right-foot prevalence. Symptom duration averaged 20 weeks (SD 4.5). Pre-injection VAS scores (6.7±1.2) significantly improved at 6 weeks (2.9±0.6) and 12 weeks (2.0±0.9) post-PRP injection (p<0.001). Plantar fascia thickness reduced from 5.1 mm (SD 0.6) to 4.1 mm (SD 0.5) at 12 weeks (p<0.001) and regular foot thickness: 3.7 mm (SD 0.5). Conclusion: The study reveals that a singular PRP injection brings about substantial and clinically meaningful enhancements in heel pain, functional outcomes, and the restoration of plantar fascia thickness, supported by ultrasound measurements. This underscores local PRP injection as a viable and safe therapeutic choice for those grappling with chronic plantar fasciitis.

Evaluating the Injection of Platelet-Rich Plasma on Second Lower Molars Protraction: A Randomized Controlled Clinical Trial.

Background The use of platelet-rich plasma (PRP) in dentistry was entered several decades ago, yet its clinical use in orthodontics still requires further investigation. The aim of this study was to evaluate the possible effects of local injection of PRP on the rate and typeof mandibular second molar protractionmovement compared with the comparator (no PRP) group. Material and methods Eighteen patients aged between 17 and 25 years were randomly allocated in a split-mouth study design to receive PRP injections on one sideimmediately before the start of molar protraction (PRP group), while the other side received only saline solution (comparator group). Eligibility criteria included bilaterally extracted mandibular first molars casesand indicated mandibular second molars protraction. The primary outcome of the study consisted of measuring the rate of molar protraction from the beginning of protraction (T0) to the end of the seventh month (TF), using a digital gauge. The secondary outcome included measuring the typeof second molar protraction movement between T0 and TFby lateral cephalometric images. Randomization of the intervention side was performed by picking out opaque sealed envelopes. The blinding of the principal investigator was impossible but blinding of the patient was achieved by injection of saline. Analyses were done using paired samples T-test to compare the changes in all variables between T0 and TF. The level of significance was taken at a P-value < 0.05. Results No significant difference was detected between the PRP and comparator groups in the rate of second lower molar protraction during seven months (0.56±0.07 mm per month in the comparator group, whereas, was 0.6±0.11 mm per month in the PRP group). Molar protraction parameters in both groups showed second lower molars moving by controlled tipping closer to bodily movement (Root Movement:Crown Movement≈0.8). Conclusions Platelet-rich plasma (PRP) is ineffective in accelerating the rate of orthodontic tooth movement (OTM) during molar protraction, and it has no effect on the type of tooth movement. In addition, the mechanics that we used (6 mm power arm in combination with miniscrews) are effective in mandibular second molar protraction by controlled tipping closer to bodily movement.

Efficacy and Safety of Platelet-Rich Plasma Injection for Chronic Plantar Fasciitis: A Prospective Study on Functional Restoration and Pain Relief.

Background Heel discomfort and functional impairment are frequently caused by plantar fasciitis, and treating it can be extremely difficult for clinicians and occasionally have unfavorable clinical consequences. Recently, platelet-rich plasma (PRP) has been used as an alternative therapy for plantar fasciitis (PF) to reduce heel pain and improve functional restoration. We evaluated the current evidence concerning the efficacy and safety of PRP as a treatment for PF. Methodology This was a hospital-based prospective study on patients with plantar fasciitis with a symptom duration of six months or more with failed conservative therapy. All patients included in the study were assessed clinically and by a visual analog score (VAS) for heel pain, the Ankle-Hindfoot Scale (AHS) component of the American Orthopedic Foot and Ankle Society (AOFAS) and Foot and Ankle Ability Measure (FAAM) scores before injection, and at three weeks, three and six-months post-PRP treatment follow-up. Ultrasonography (USG) measurement of plantar fascia thickness was done pre-injection and at the six-month follow-up for clinical outcomes and any complications. Results The study included 25 patients with plantar fasciitis, with the majority (48%) in the age group of 21-30 years. Females accounted for 64% of the patientswhile males accounted for 36%. Most patients (56%) had a moderately active daily activity level. The study found that 16 patients had bilateral plantar fasciitiswhile nine had unilateral plantar fasciitis. Among the patients with bilateral plantar fasciitis, a total of 32 heels were affectedwhile the 9 patients with unilateral plantar fasciitis had 9 affected heels. Most female patients (75%) had bilateral plantar fasciitiswhile most male patients (56%) had unilateral plantar fasciitis. Before PRP therapy, both male and female patients reported high pain scores on theVASfor both heels. However, after PRP infiltration, the VAS scores significantly decreased at three weeks, three months, and six months post-injection, indicating pain relief. The AOFAS hindfoot and ankle scores and FAAM scores showed improvement over the follow-up period. Both male and female patients experienced significant improvements in functional outcomes, with increases in AOFAS (p-value 0.45) and FAAM scores (p-value 0.31) at three weeks, three months, and six months post-injection compared to baseline. Statistical analysis revealed a significant decrease in pain scores (73% pain relief), as well as significant improvements in AOFAS scores with an average of 22.33 from baseline (mean = 67.75±9.7) to final follow-up (mean = 90.08±7.9) and FAAM scores with an average of 23.72 from baseline (mean = 49.38±5.2) to final follow-up (mean = 73.10±5.2) after PRP infiltration. Conclusion The outcomes of a single dosage of PRP injections demonstrate clinically and statistically substantial improvements in functional outcome scores, plantar fascia thickness evaluated by USG, and VAS scores for heel pain. According to the results of this study, local PRP injection is an effective treatment for chronic plantar fasciitis.

Analysis of the effects of platelet-rich plasma injection on the human body depending on the site of administration – review article

Introduction: Platelet-rich plasma (PRP) is an autologous material. It is created by drawing the patient's blood and preparing it properly. In that, a several-fold increase in platelets and growth factors is achieved. By applying the PRP prepared this way to the appropriate tissue, it is possible to improve the clinical condition of many disorders. Purpose: Analysis of the effects of platelet-rich plasma injection on the human body depending on the site of administration. Review of literature. Material and methods: We have selected, in our opinion, the most important information from articles about the use of PRP in: androgenetic alopecia, hair regrowth, wound healing, atrophic acne scars, erectile dysfunction, gynecology and improving women's sexual satisfaction, osteoarthritis and skin rejuvenation. Summary (conclusion): Thanks to its properties, platelet-rich plasma (PRP) can stimulate the human body to regenerate. Androgenetic alopecia, hair regrowth, acceleration of wound healing, acne scars, erectile dysfunction and osteoarthritis are just some of the disorders in which the use of platelet-rich plasma proves to be promising. From the studies above it can be concluded that the effects of local PRP injections can be complementary to the therapy of many other diseases. However, more adequate research is needed to register the application of local platelet-rich plasma as a form of treatment for these diseases.

Efficacy of platelet-rich plasma injection in the treatment of frozen shoulder: A systematic review and meta-analysis.

Frozen shoulder (FS) is characterized by progressive shoulder pain and a limited range of motion. Recently, platelet-rich plasma (PRP) injection is a newly developed treatment option for patients with FS and its efficacy needs to be examined. By conducting a systematic review and meta-analysis, this study attempted to evaluate the efficacy of PRP injection in the treatment of patients with FS. PubMed, EMBASE, Web of Science, Elsevier, The Cochrane Library, WanFang Data and CNKI databases were searched up to May 31, 2020. This study included randomized controlled trials as well as prospective cohort studies. Two reviewers independently screened the title, abstract and full text in order to extract data from qualified studies. The main outcome was pain visual analogue score (VAS) while the secondary outcome was range of motion (ROM) of the shoulder joint that consists of four parts: internal rotation, flexion, external rotation and abduction. Three randomized controlled trials and one prospective cohort study met the inclusion criteria. Accordingly, a total of 359 cases were analyzed and followed up to 3 months. The control group included corticosteroids (CS), ultrasound therapy, and stellate ganglion block. Compared to other groups, VAS was statistically significant after 1 month and 3 months of treatment (SMD: -0.46, 95% CI: -0.75 to -0.18, P= 0.002; I=2 43.2%), (SMD: -0.87, 95% CI: -1.23 to -0.50, P= 0.00, I=2 61.9%). Compared to the control group, only flexion of the patients treated with PRP demonstrated no significant improvement at 1 month, whereas internal rotation, flexion, external rotation and abduction of the shoulder were found to be improved following 3months of treatment. The corresponding findings illustrate that compared to other non-operative treatments, local injection of PRP can effectively improve pain and shoulder motion in patients with FS. However, due to the short follow-up time and limitations regarding the quantity and quality of studies, the above conclusions require further elucidation by performing additional high-quality studies.

Prospective Comparative Short-Term Study of Autologous Leucocyte-Rich Platelet-Rich Plasma vs. Local Steroids in Chronic Plantar Fascitis

Background Plantar fasciitis is the most common cause of heel pain and is difficult to treat in most chronic and severe forms. Management of plantar fasciitis includes non-surgical options such as non-steroidal anti-inflammatory drugs and corticosteroids, physical therapy, orthotics, and surgical management includes plantar fasciotomy. Local injection of platelet-rich plasma as well as local steroids is an emerging concept in treating recalcitrant tendon and ligament pathology, including plantar fasciitis. Objectives The aim of the study was to evaluate and compare the outcome of patients treated with a single injection of autologous leucocyte-rich platelet-rich plasma with single-injection local steroids triamcinolone in chronic plantar fasciitis. Methodology The study was conducted for a duration of 24 months. In total, 60 patients with clinically diagnosed chronic plantar fasciitis were selected for study and divided in two groups using the single allocation randomization method as those treated with autologous injection leucocyte-rich platelet-rich plasma and those with injection local steroid triamcinolone and prospectively followed and compared. Results Both groups were evaluated subjectively and functionally at primary visit and then on follow-up at 2 weeks, 4 weeks, 8 weeks, and 12 weeks by VAS and hind foot AOFAS score. Conclusion We concluded that both injection platelet-rich plasma-treated and injection local steroid-treated patients provide symptomatic relief in the treatment of chronic plantar fasciitis both subjectively and functionally. The steroid treated group showed early symptomatic improvement at 2 weeks, and results at 12 weeks to further follow-up were suggestive that single-injection leucocyte-rich platelet-rich plasma provided better functional results.

Local autologous platelet rich plasma injection combined with platelet rich fibrin filling as the main treatment for refractory wounds: A case series.

Refractory wounds are a major global health problem that not only affects the quality of life, but also causes significant physical, psychological and economic burdens. How to promote wound healing has become the main goal of clinicians. To evaluate the safety and efficacy of local autologous platelet rich plasma (PRP) injection combined with platelet rich fibrin (PRF) filling as the main treatment for refractory wounds. In the study, autologous PRP and PRF were prepared from whole blood. Twelve patients, each having a refractory wound, were included. The wounds were debrided first to remove necrotic and infected tissues, and then were given once or twice local PRP injection combined with PRF filling treatment. The total healing time (the time from admission to wound healing) and the healing time after PRP/PRF combined treatment (the time from PRP treatment to wound healing), as well as the adverse events were recorded. The results showed that the wound duration before the combination treatment was 10.48 ± 3.66 weeks, and the mean area/volume (for sinus or fistula) of the wounds was 8.23 ± 2.67 cm2/9.54 ± 2.13 cm3 (for sinus or fistula). All wounds healed after once or twice PRP/PRF combined treatment. The total healing time was 26.91 ± 8.01 days, and the healing time after the combined treatment was 16.36 ± 7.47 days. No adverse events were reported during the treatment and follow-up period. Our case series demonstrate the safety and synergistic effectiveness of local autologous PRP injection combined with PRF filling as the main treatment for refractory wounds. Platelet concentrates is not only an adjuvant treatment for chronic wounds, but a potential substitute for chronic wounds, especially in sinuses and fistulas.

The Effect of Platelet Rich Plasma (PRP) Injection to the Wound Compared to PRP Jel Local Application Compared to Classic Dressing on Diabetic Foot Healing Ulcer

Background: The goal of our work-study was to detect the net result and potency of of PRP local jnj. Dressings compared to PRP in jel to the wound for DFU healing compared to a control therapy of traditional classic dressing (PRP) also to decrease the recurrence (DFUs). Diabetic foot is a more famous and face any surgeon in his clinic or hospital. It has a new promise therapy of diabetic foot ulceration (DFU), with cellular and tissue regeneration, because of several methods in wound care management. All hope to attain good healing and hope to decrease recurrent rate. Patients and Methods: Forty-five patients with DFU were matched and grouped for (PRP) local injection dressings (n = 15), PRP jel to wound edges (n = 15), or classic dressing (n = 15) from August 2019 to March 2021. There were additional complications and ulcer recurrences were detected Ulcer or raw area healing and reduction were the primary objectives at 1; 3, 6, and 12 months. The study comprised 36 (80.0%) males and 9 (20.0%) females between the ages of 30 and 65 who had DFU for 1 to 10 years. Results: Local PRP injections improved healing 12/15 (80%) greater than local PRP jel dressings 10/15 (66.7%) and classic dressings 7/15(46.7%). However, PRP wound injection increase the healing of diabetic ulcers raw area more than PRP local jel or traditional classic dressing the healing period following local PRP injection was much shorter. At all follow-up visits, the in all the groups had similar rates of recurrence and complications. All of them had similar recurrence and variant safety. Conclusions: PRP injection is a more potent technique for treating DFU than local PRP jel administration and classic wound dressings, with slight the same recurrence. Less Amputation rates, infection rates, and discharges are all reduced with PRP injection than PRP jel than classic treatment.

PLANTAR FASCIITIS TREATMENT WITH PLATELET-RICH PLASMA INJECTION VERSUS STEROID INJECTION

Objective: Plantar fasciitis is characterized by heel pain that worsens when you bear weight after a long period of rest. Injections of steroids are one of the numerous therapeutic techniques that are frequently used to control plantar fasciitis. Numerous studies demonstrate that short-term pain alleviation with steroid injections is not long-lasting. According to recent studies, autologous platelet-rich plasma (PRP) injections encourage healing, which improves both short- and long-term pain alleviation. To compare the effects of local PRP injection and corticosteroid in the management of chronic plantar fasciitis, the current study was conducted. Methods: Sixty patients who met the criteria for this prospective double-blind trial were randomly assigned to one of two groups. Patients in Group I received an injection of steroid, whereas those in Group II received an injection of PRPs. The PNS numerical pain score (NPS) and a visual analog scale (VAS) were used to evaluate the patients. An evaluation was conducted before the injection as well as at 6 weeks, 3 months, and 6 months after the injection. Results: The mean VAS in Group I reduced from 7.00 before injection to 2.31 and that in Group II decreased from 7.81 before injection to 1.12. At the 6-month follow-up, the mean NPS score in Group I increased from 7.05 to 1.41 and in Group II from 7.86 to 1.02. The VAS and NPS improvements were statistically significant. In both groups, the plantar fascia thickness had decreased at the conclusion of the 6-month follow-up period (5.88 mm in Group I to 4.03 mm and 5.96 mm to 3.27mm in Group II), and the difference was statistically significant. Conclusion: When compared to steroid injection, local PRP injection is an excellent therapeutic option for persistent plantar fasciitis with long-lasting positive effects.

Evaluation of the effect of local administration of PRP vs vitamin D3 on the rate of orthodontic tooth movement and the associated external apical root resorption.

BackgroundIncreased orthodontic treatment duration is associated with iatrogenic risks such as root resorption, white spot lesions etc. Recent research using pharmacological agents to accelerate tooth movement has mostly been conducted on animals and there is no reported research conducted on humans comparing the effects of Vitamin D3 and Platelet Rich Plasma (PRP) in the same subjects using a split mouth technique.ObjectivesTo determine and compare effects of local injection of PRP and Vitamin D3 on the rate of tooth movement. Also, to assess association of external apical root resorption with the use of PRP, Vitamin D3 and compare it to a control group.Materials & methods11 subjects who diagnosed with Class I bi-maxillary malocclusion and who gave informed consent were recruited in the study. The patients were randomly divided using split mouth design and each quadrant served as either experimental or control group one. At the beginning of retraction phase, Vitamin D3 and PRP were injected to the randomly assigned quadrants while the contralateral side served as a control. The amount of space closure in 4 months was measured from distal surface of canine to mesial surface of 2nd premolar. Root resorption was assessed using CBCT taken at the beginning and at the closure of retraction phase.ResultsMean rate of tooth movement was higher in PRP and Vitamin D3 groups compared to their controls. In the PRP group, the increased rate of tooth movement was observed throughout the study interval, but in the Vitamin D3 group it was only seen in first two months. Also, the PRP group demonstrated a higher rate of tooth movement compared to Vitamin D3 group. Root resorption was lesser in both experimental groups. Among the teeth assessed, lateral incisor showed maximum root resorption and canine the least.ConclusionsPRP is a more efficient pharmacological agent compared to Vitamin D3 for accelerating tooth movement.

Platelet-Rich Plasma in Acute Achilles Tendon Ruptures: A Systematic Review and Meta-Analysis

Category: Trauma; Sports Introduction/Purpose: Platelet Rich Plasma (PRP) is known to exert multi-directional biological effects favouring tendon healing. However, conclusions drawn by numerous studies on its clinical efficacy for acute Achilles tendon rupture are limited. We performed a systematic review and meta-analysis to investigate this and to compare to those without PRP treatment. Methods: The Cochrane Controlled Register of Trials, Pubmed, Medline and Embase were used and assessed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria with the following search terms: ('plasma' OR 'platelet-rich' OR 'platelet-rich plasma' or 'PRP') AND ('Achilles tendon rupture/tear' OR' calcaneal tendon rupture/tear' OR 'tendo calcaneus rupture/tear'). Data pertaining to biomechanical outcomes (heel endurance test, isokinetic strength, calf- circumference and range of motion), patient-reported outcome measures (PROMs) and incidence of re-ruptures were extracted. Meta-analysis was performed for same outcomes measured in at least three studies. Pooled outcome data were analysed by random and fixed-effects models. Results: After abstract and full-text screening, 6 studies were included. In total there were 510 patients of which 256 had local PRP injection and 254 without. The average age was41.6 years, mean time from injury to treatment 5.9 days and mean follow-up at 61 weeks. Biomechanically, there was similar heel endurance, isokinetic strength, calf circumference and range of motion between both groups. In general, there were no differences in patient reported outcomes from all scoring systems used in the studies. Both groups returned to their pre-injured level at a similar time and there were no differences on the incidence of re- rupture (OR 1.13, 95% CI, 0.46 to 2.80, p = 0.79). Conclusion: PRP injections for acute Achilles tendon ruptures do not improve medium to long-term biomechanical and clinical outcomes. However, future studies incorporating the ideal application and biological composition of PRP are required to investigate its true clinical efficacy.

Sport-Specific Rehabilitation, but Not PRP Injections, Might Reduce the Re-Injury Rate of Muscle Injuries in Professional Soccer Players: A Retrospective Cohort Study.

Platelet-rich plasma (PRP) injections are extremely popular in the management of sports injuries in elite athletes. However, data on the use of various administration protocols of PRP are contradictory. The efficacy of platelet-rich plasma in the treatment of muscle injuries in professional soccer players has to be contextualized within the sport-specific rehabilitation program. Despite the questionable role of PRP, a well-structured rehabilitation program is still regarded as the gold standard. We examined the efficacy of various PRP protocols in the management of muscle injuries in professional soccer players in respect to treatment duration and injury recurrence. A retrospective cohort study. Muscle injuries in professional soccer players (n = 79, height 182.1 ± 5.9 cm, weight 76.8 ± 5.8 kg, BMI 23.1 ± 1.4 kg/m2) from three elite soccer clubs from the Russian Premier League were recorded during the 2018–2019 season. The injuries were graded based on MRI, using the British Athletic Muscle Injury Classification. Treatment protocols included the POLICE regimen, short courses of NSAID administration, and the specific rehabilitation program. The sample group of players were administered PRP injections. The average treatment duration with PRP injection was significantly longer than conventional treatment without PRP, 21.5 ± 15.7 days and 15.3 ± 11.1 days, respectively (p = 0.003). Soccer-specific rehabilitation and obtaining MRI/US before the treatment was associated with significantly reduced injury recurrence rate (p < 0.001). There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in respect of grade 2A–2B muscle injuries. The total duration of treatment of type 2A–2B injuries was 15 days among all players. In the group receiving local injections of PRP, the total duration of treatment was 18 days; in the group without PRP injections, the treatment duration was 14 days. In our study, PRP treatment was associated with longer treatment duration, regardless of which muscle was injured. This may reflect the tendency to use PRP in higher-degree injuries. Soccer-specific rehabilitation significantly reduced the injury recurrence rate when compared to the administration of PRP injections. MRI/US imaging before returning to play was also associated with a lower injury recurrence rate. There was no significant difference between the PRP injection protocol applied to any muscle and the treatment duration in treatment of type 2A–2B muscle injuries.

Comparing the efficacy of PRP vs hyaluronic acid vs placebo injections in the management of supraspinatus tendinopathy; randomized controlled trial

Objective: To compare the effect of local injection of platelet-rich plasma (PRP), Hyaluronic acid, or Placebo for management of Supraspinatus tendinopathy (SST) and their outcomes regarding functional scores and MRI changes. Design: Double-blind randomized controlled trial with 1-year follow-up. Methods: 60 Participants recruited from an outpatient Orthopaedic clinic had clinically and radiologically (MRI)–demonstrated SST refractory to physical therapy. They received a local injection of either 3.5 mL of PRP, Hyaluronic acid (2 doses a week apart), or 3.0 mL of 1% xylocaine at the lesion and surrounding tendon (20 participants each). Patients aged from 21 to 65 years with symptoms of SST for 3 months or more do not improve after at least 4 weeks of formal physical therapy with magnetic resonance imaging (MRI) changes indicating tendinopathy without RC tears or labral lesions, or significant glenohumeral arthrosis. Exclusion criteria included joint instability, patients on anticoagulation therapy, history of shoulder surgery, full-thickness Supraspinatus tear, Type 3 or 4 acromions, and corticosteroid injection within 3 months. Primary outcome: 0-10 visual analog scale (VAS) and functional shoulder tests assessing rotator cuff strength and endurance (at baseline and 8 and 12 weeks).

Effectiveness of Lateral Elbow Tendinopathy Treatment Depends on the Content of Biologically Active Compounds in Autologous Platelet-Rich Plasma.

Autologous platelet-rich plasma (PRP) injection is an alternative treatment option for patients with lateral elbow tendinopathy. The treatment is supposed to accelerate tissue regeneration by providing high concentrations of growth factors derived from platelets. The aim of the study was to assess the relationship between the content of biologically active compounds in PRP and the clinical effect of the treatment. Thirty patients with lateral elbow tendinopathy treated with a single PRP injection, were evaluated. The pain intensity (measured by a visual analogue scale (VAS)), the pressure pain threshold (PPT), the grip strength and strength of the main arm and forearm muscle groups, and the functional outcome (measured by the Disability of Arm, Shoulder and Hand (DASH) and Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaires), were assessed before PRP injection and at one- and three-months follow-up. Flow cytometry measurements of the growth factors and inflammatory cytokines in PRP were performed, and the results were used to establish the relationship between those molecules and the clinical outcome. After three months from the intervention, the minimal clinically important difference in pain reduction and functional improvement was observed in 67% and 83% of patients, respectively. Positive correlations were found between the extent of pain reduction after three months and concentrations in the PRP of platelets, epidermal growth factor (EGF), vascular endothelial growth factor, and platelet-derived growth factors. The concentration of EGF in the PRP significantly correlated with an improvement in grip strength, strength of wrist extensors, and the size of functional improvement measured by the PRTEE. The local injection of PRP is a safe and effective treatment option for lateral elbow tendinopathy, and the clinical outcome is correlated with concentrations of its biologically active compounds.

A Prospective Study Comparing the Efficacy of Local Injection of Platelet-Rich Plasma (PRP) vs Methylprednisolone in Plantar Fasciitis

IntroductionPlantar fasciitis is a common musculoskeletal problem in Orthopaedic practice. Heel pain caused due to plantar fasciitis, if persistent, can cause distress to the patient, so the correct intervention at the right time is needed. Plantar fasciitis is also common in the rural population.ObjectivesTo compare the efficacy of local injection of platelet-rich plasma (PRP) and corticosteroid (CS) (methylprednisolone) in patients with chronic plantar fasciitis, and to evaluate the safety, side effect and complications of two different modalities of treatment.Materials and methodsThe study period was between August 2018 and September 2020. After obtaining proper written consent, 110 patients, who were above the age of 18 years and suffering from plantar fasciitis for more than three months, were included in the study. The patient characteristics including gender, age, weight, history of heel pain, duration of symptoms and types of prior treatment were noted. All the 110 patients were subjected to four parameter assessments before administration of the PRP/CS injections. Out of the 110 patients, 55 patients received PRP injection and 55 received CS - 2 ml (40 mg) methylprednisolone with 2 ml of sterile water injections. Post administration of injections, the patients' clinical, radiological, subjective and functional outcomes were assessed at the first, third and sixth month by using the Visual Analog Scale (VAS), Foot and Ankle Outcome Instrument Core Scale (FAI), Roles and Maudsley Scores (RMS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hind foot scale and ultrasonogram of plantar fascia thickness.DiscussionIn this study, 110 patients were screened and evaluated. Out of these 110 patients, five patients who received PRP and five who received CS were lost for follow-up. Out of the 110 patients, 59 were females and 41 were males. The majority of the patients were in the BMI range of 18.5 to 24.9, with a mean BMI of 23.6. Comparing the results in both the groups reflected an improvement in the group of patients who received PRP injections. Two patients had post-operative complications (superficial infection) in the PRP injection group, while 10 patients had post-procedure complications (five patients developed superficial infections, three patients developed skin depigmentation, and two patients had atrophy of fat pad) in the corticosteroid injections (CSI) group. Infections subsided in all the patients as observed during subsequent follow-up.ConclusionThis study shows that PRP administration is a good method of managing patients suffering from chronic plantar fasciitis, presenting with some discomfort following activity, with more than three months of symptoms and with a VAS score of more than 6 and plantar fascia thickness of 5 mm and failed conservative management. This is evidenced by a comparison of AOFAS, FAI score and thickness of plantar fascia using an ultrasonogram before and after the procedure. This study reflects better treatment outcomes with PRP injection compared to local steroid infiltration. This is the largest series of cases studied compared to other previously available studies in the literature. PRP injections may thus be used as a superior alternative to the already available treatments for chronic heel pain.

Effects of platelet-rich plasma local injection on dentin sialo protein and dentin matrix acidic phosphoprotein 1 levels of secretion in gingival sulcular fluid during orthodontic movement in animal samples

Prolonged orthodontic treatment causes complications such as root resorption, gingivitis, and caries. Platelet-rich plasma (PRP) can accelerate the dental movements of orthodontic treatments. The aim of the present study was to evaluate the effect of local PRP injection on the secretion of dentin sialoprotein (DSP) and dentin matrix acidic phosphoprotein (DMP1) biomarkers in gingival crevicular fluid during orthodontic movements in animal samples. In this experimental study, one maxillary quadrant of six beagle dogs was randomly selected as the experimental group, and the other side was considered as the control group. Afterward, maxillary of the first premolars was extracted, and then, a titanium nickel coil spring (150 g) was then used between the second premolar and the canine. PRP that was previously activated with CaCl 2-thrombin was injected intraligaman to the experimental side at days 0, 21, and 42. Moreover, the mixture of the CaCl 2-thrombin with placebo was injected in to the control side. The study period was 63 days. Sampling was performed on days 0, 1, 2, 7, 21, 42, and 63. Then, in all the samples, the DSP and DMP1 level was measured using special kits by ELISA method. Data were analyzed by the analysis of variance and t-test. Upon the application of orthodontic forces, the mean DMP1 and DSP levels in the experimental group at different times were significantly increased compared to the control group (P < 0.001). PRP injection enhanced DMP1 and DSP level with probable rise in the rate of root resorption.

Effect of Autologous Platelet–Rich Plasma on Cesarean Section Scar; A Randomized, Double-Blinded Pilot Study

Background: One of the complications of cesarean section (C/S) is related to the incision site. Considering the effectiveness of platelet–rich plasma (PRP) on healing of wounds and management of scars, the present study aimed to inquire the effect of PRP on the thickness and completeness of the uterine scar. Methods: In a randomized double-blinded, placebo-controlled clinical trial, the women who underwent C/S from November 2019 to 2020 were included and randomized into two studied groups, including the control (n = 15) and intervention (n = 15) groups. In the intervention group, PRP, extracted from patients’ blood samples, was injected to the incision site (between decidua and myometrium), while the control group did not receive this treatment. The scar thickness of C/S as the primary outcome and postpartum hemorrhage as the secondary outcome were compared between the groups. Both groups were followed for 12 weeks. Results: The two groups (intervention and control) were not significantly different in terms of weight, height, BMI, age, parity, gravidity, duration of surgery, and blood hemoglobin (HB) level (P &gt; 0.05). Comparison of scar characteristics showed the creation of a niche in the PRP group, which was almost one-fourth of that of the control group; a difference that was statistically significant (P = 0.002). The thickness of adjoining myometrium was comparable between the two groups. Mean uterine niche height in the intervention group was lower than in the control group, which was statistically significant (P = 0.048). The mean of residual myometrium thickness (RMT) in the intervention and control groups were 7.62 ± 0.95 and 5.6 ± 3.5 mm, respectively, a difference that was statistically significant (P &lt; 0.001). Conclusions: Local injection of PRP is an effective and viable measure for reducing the uterine niche; therefore, it is suggested to be included in the routine wound care of CS. Future studies are needed to confirm PRP efficacy in different settings.

The effect of Platelet-Rich Plasma and Stromal Vascular Fraction combination on Epidermal Growth Factor serum level for anal trauma healing in the Wistar rat model

IntroductionStromal Vascular Fraction cells (SVFs) and Platelet Rich Plasma (PRP) are clinically proven to aid in cell regeneration and wound healing. The healing effects can be measured by the level of Epidermal Growth Factor (EGF). This study aims to investigate the effect of an SVFs and PRP combination on EGF levels in the anal trauma model. MethodTwenty-eight adult Wistar rats were divided into 3 groups: Group A consisted of healthy rats as a normal control group; Group B and C underwent modified anal surgical trauma and repair. Group B was treated with saline only and Group C was treated with local injection of a combination of SVFs and PRP after anal surgical repair. The EGF level was subsequently assessed on days 1, 7, and 14. ResultsEGF levels were generally increased in Group C compared to Group B. A one-way ANOVA test result showed significantly increased EGF levels on days 7 (p = 0.038) and 14 (p = 0.018). Based on the linear regression test results, we found that local injection of PRP and SVFs after anal repair on an anal surgical trauma model can increase the EGF level in group C by 36.9% more than that of group B. ConclusionThe combination of PRP and SVFs can increase the EGF level in the wound healing process of anal trauma. EGF is critical in the anal trauma healing process.