Local Injection Of Platelet-rich Plasma Research Articles

Treatment of Epicondylitis By Ultrasound-guided Local Injections of Platelet-rich Plasma: A Double-blind Placebo-controlled Randomized Clinical Trial with 1-year Follow-up

Treatment of Epicondylitis By Ultrasound-guided Local Injections of Platelet-rich Plasma: A Double-blind Placebo-controlled Randomized Clinical Trial with 1-year Follow-up

The effect of platelet-rich plasma on arthroscopic double-row rotator cuff repair: a clinical study with 12-month follow-up.

The aim of the study was to assess the effect of platelet-rich plasma on arthroscopic double-row rotator cuff repair. The study included 60 patients with arthroscopic rotator cuff repair. Thirthy patients (mean age: 57.2±7.4; 16 males and 14 females) underwent arthroscopic double-row repair alone (Group 1), another 30 (mean age: 56.9±6.0; 15 males and 15 females) had an injection of platelet-rich plasma (PRP) (Group 2). The groups were compared with DASH as a primary outcome score and Constant-Murley score, visual analog scale, measurement of active forward flexion, and external and internal rotation as secondary outcome measures. Magnetic resonance imaging was used to assess the integrity of the repair at 12 months postoperatively. Primary and secondary outcome measures statistically improved in both groups postoperatively (p<0.05). Overall mean primary and secondary postoperative outcome measures were not significantly different between the 2 groups. A retear was seen in 9 subjects (30%) in Group 1 and 4 subjects (14%) in Group 2 (p<0.05). The local injection of PRP into a primary arthroscopic double-row cuff repair resulted in lower recurrence rates than repairs without the novel biological augmentation material.

The Effect of Platelet-Rich Plasma on Muscle Contusion Healing in a Rat Model

Background: Current therapy for muscle contusions is usually limited to nonsteroidal anti-inflammatory drugs and/or use of the RICE principle (rest, ice, compression, elevation); thus, other forms of treatment that can potentially accelerate the rate of healing are desirable. Hypotheses: A local injection of platelet-rich plasma (PRP) would lead to accelerated healing rates compared with controls; also, delayed administration of PRP would lead to a blunted response compared with immediate treatment. Study Design: Controlled laboratory study. Methods: Forty-six male Lewis rats each underwent a single blunt, nonpenetrating impact to the gastrocnemius muscle via a drop-mass technique and subsequently received either a single injection of saline into the area of injury immediately after injury (controls, n = 11) or rat PRP (either immediately after injury [PRP day 0, n = 12], the first day after injury [PRP day 1, n = 12], or the third day after injury [PRP day 3, n = 11]). The primary outcome was maximal isometric torque strength of the injured muscle, which was assessed before injury as well as on postinjury days 1, 4, 7, 10, and 14. All animals were sacrificed on postinjury day 15. Histological and immunohistochemical analyses were performed on 6 specimens from each group after sacrifice. Results: The mean platelet concentration in the PRP was 2.19 × 106 (±2.69 × 105)/μL. The mean white blood cell count in the PRP was 22.54 × 103/μL. Each group demonstrated statistically significant decreases in maximal isometric torque strength after injury when compared with preinjury levels, followed by significant increases back toward baseline values by postinjury day 14 (controls, 90.6% ± 7.90%; PRP day 0, 105.0% ± 7.60%; PRP day 1, 92.4% ± 7.60%; PRP day 3, 77.8% ± 7.90%) (P = .121). There were no statistically significant differences between the treatment and control groups at any of the time points. There were also no statistically significant differences between any of the groups in the percentage of centronucleated fibers (controls, 3.31% ± 5.10%; PRP day 0, 0.62% ± 1.59%; PRP day 1, 3.24% ± 5.77%; PRP day 3, 2.13% ± 3.26%) (P = .211) or the presence of inflammatory cells and macrophages. Conclusion: In this rat contusion model, a local injection of PRP into the injured gastrocnemius muscle resulted in no significant differences in functional or histological outcomes, indicating no likely benefit to healing. Additionally, there was no significant difference between immediate or delayed administration of PRP. Clinical Relevance: Before PRP can be recommended for the treatment of muscle contusion injuries, further translational and clinical investigations need to be performed.

OP0013 Treatment of Epicondylitis by Ultrasound-Guided Local Injections of Autologous Conditioned Plasma (ACP®): A Double-Blind Placebo-Controlled Randomized Clinical TRIAL with 1-Year Follow-Up

BackgroundLocal injections of corticosteroid represent a standard of care for epicondylitis, albeit it may adversely impair the healing process (1). Recently, local injections of growth factors-containing platelet-rich plasma (PRP) have...

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

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

Treatment of Chronic Lateral Epicondylitis: Platelet Rich Plasma versus Extra-Corporeal Shock Wave Therapy

Background: Several treatment options have been proposed to treat lateral epicondylitis. Both Platelet rich plasma (PRP) and Extra-corporeal Shock Wave Therapy (ESWT) are new treatment modalities for tendinopathy. Patients and Methods: Thirty seven patients suffering from chronic lateral epicondylitis (tennis elbow) for at least six months were treated in this study. The patients were divided into two treatment groups, the first group including 20 patients treated by ESWT and the second group including 17 patients treated by local injection of platelet-rich plasma. The results were evaluated using the visual analogue scale and the DASH score. Results: In the first group (treated by ESWT), the average follow-up period was 21.55 months. The average VAS improved from 8.2 to 1.95 and the average DASH score improved from 72.25 to 51.7. Moreover, 11 cases were satisfied (55%), 3 cases (15%) were satisfied with reservation and 6 cases (30%) were not satisfied. In the second group (treated by PRP), the average follow-up period was 18.47 months. The average VAS improved from 8.52 to 1.47, the DASH score improved from 72 to 48.23. Concerning patient satisfaction, 13 cases were satisfied (83.33%), 3 cases (10.52%) were satisfied with reservation and 1 case (5.55%) was not satisfied. Conclusion: Platelet rich plasma was proved to achieve superior results when compared to ESWT as regards pain relief, improvement of elbow function and patient satisfaction at follow-up.

The Efficacy of Platelet Rich Plasma Combined with Steroid Injection in the Treatment of Resistant Lateral Epicondylitis

OBJECTIVE: To evaluate the impact of autologous platelet rich plasma (PRP) combined with steroid injection on hand grip strenght, pain and patient satisfaction in the treatment of lateral epicondylitis.METHODS: 84 patients, mean age 42.6 (23-62) years, diagnosed with unilateral resistant lateral epicondylitis was evaluated retrospectively. Group1 consisted of patients treated with local steroid injection (0,5ml Bethametasone+0.25 ml Prilokain) and PRP within 1 week interval to extensor carpi radialis brevis origo while group 2 consisted of patients who were subjected to single dose local PRP injection to the same localisation. Pretreatment and posttreatment 15-30-60 day hand grip strenght and Verhaar functional score data were evaluated.RESULTS: Mean pretreatment grip strenght of group1 patients were 0.42±0.17 (0.18-0.61) bar whereas posttreatment day 60 increased to 0.68±0.11(0.50-0.85). Group 2 mean pretreatment grip strenght was found to be 0.45±0.15 (0.19-0.84) bar, whereas posttreatment day 60 increased to 0.66±0.10 (0.44-082). Compared to group 2, the percentage of grip strenght increase in group 1 was significantly higher at days 15 and 30, whereas there was no difference at day 60 between groups. (p=0.277). Compared to group 2, Verhaar scores were found to be higher in group1 at days 15 and 30, whereas there was no difference between groups at day 60.CONCLUSION: Compared to PRP alone, steroid injection 1 week prior PRP administration can be preferred as an effective and safe method in cases which early maintanance of decreased grip strenght is mandatory.

Effects of Autologous Platelets Rich Plasma on Full-thickness Cutaneous Wounds Healing in Goats

This investigation was designed to evaluate the role of Platelet-Rich Plasma (PRP) on healing of experimentally wounded skin in ten adult bucks, aged 2-3 years and weighing 25-30 kg. The animals divided randomly and equally into (control and treatment groups). Four of 3×3 cm of full-thickness square cutaneous wounds was induced on both sides of the lateral thoracic region of each animal under the effect of local anesthetic proceeding by xylazine hydrochloride as a sedative. A pair of left wounds was treated by injection with 5 mL of autonomous PRP (treatment group), 2 mm lateral to the wound edges and in the wound center. While, the right wound were injected by 5 mL of sterile saline by the same procedure (control group). Each group was divided into five subgroups (four wounds of each), for morph metrical and histopathological evaluations of wound healing process represented by percent of wound contraction, epithelialization and total healing at 3, 7, 14, 21 and 28 days post-wounding. The morphometrical appearance of the wounds which treated with PRP, showed that the contraction, re-epithelialization and healing percent were statically significant (p<0.05) in comparison with control wounds during four weeks study. Based on histopathological results, there was re-epithelialization of epidermis, with highly cellular granulation tissue, well differentiated keratinocytes of epidermis with scar formation in the dermis of the sectioned skin. We conclude that local injection of PRP leads to accelerate and improvement of wound healing in comparison to control wounds.

The Effect of Immediate and Delayed Injection of Platelet-Rich Plasma (PRP) on Muscle Contusion Healing in the Rat

Objectives:Muscle contusions are among the most common injuries in sport. Though typically self-limiting, more severe types of contusions can lead to marked pain and diminished function with significant delay in return-to-play. Current therapy is usually limited to NSAIDs and/or use of the RICE principle. Other forms of treatment that can potentially accelerate the rate of healing are desirable. Platelet-rich plasma (PRP) is a novel therapy produced from autologous whole blood that holds promise for treating muscle injuries. However, data both at the translational and clinical level is still limited. This study seeks to investigate the effects of PRP on muscle contusion healing in rats and to determine if the timing of injection plays any role in recovery.Methods:Forty-six (46) male Lewis rats each underwent blunt, non-penetrating impact to the gastrocnemius muscle via a drop-tower model. The rats were separated into 4 groups, with each rat undergoing injection into the injured gastrocnemius muscle according to the following schema: those in Group 1 underwent a single injection of 100ul of rat PRP on the day of injury; those in Group 2(controls) underwent a single injection of 100ul of saline on the day of injury; those in Group 3 underwent a single injection of 100ul rat PRP on post-injury day #1; those in Group 4 underwent a single injection of 100ul of rat PRP on post-injury day #3. After the injury, rats were allowed unrestricted activity. The primary outcome measurement was maximal isometric torque strength of the injured muscle, which was performed prior to impaction injury as well as on post-injury days 1, 4, 7, 10, and 14. All animals were sacrificed on post-injury day 15.Results:Mean rat weight was 319 (±15) grams. The mean platelet concentration in the PRP solution was 2.19x106 (±2.69x105) per ul, which was greater than 4 times whole blood baseline levels and the concentration of PDGF-AB, VEGF, and TGF-β was increased by a factor of 2.6, 1.8, and 2.7, respectively. Each group demonstrated statistically significant decreases in maximal isometric torque strength after injury, followed by significant increases back towards baseline values by post-injury day 14 (figure 1). There were no statistically significant differences between the treatment and control groups at any of the time-points.Conclusion:PRP is being used clinically to treat numerous soft tissue injuries, though clinical data is limited. In this rat contusion model, local injection of PRP into the injured gastrocnemius muscle resulted in no significant differences in maximal isometric torque strength at various post-injury time-points, indicating no likely benefit to healing. Additionally, there was no significant difference between immediate or delayed administration of PRP. Further translational and clinical investigation needs to be performed before PRP can be recommended for the treatment of muscle contusion injuries.

The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis

In this study, the results of local injection of platelet-rich plasma (PRP) and corticosteroids in the treatment of plantar fasciitis were compared. Sixty patients who were diagnosed as plantar fasciitis and treated conservatively for at least 3 months and had no response to conservative treatment modalities were involved in this study. The first 30 consecutive patients were treated by local injection of 2 mL of 40 mg Methylprednisolone with 2 mL of 2% prilocaine (metilprednizalone) and the second 30 patients were treated by injecting 3 mL PRP after 2 mL of 2% prilocaine injection. Patients were evaluated according to the modified criteria of the Roles and Maudsley scores and visual analog scale before injection and 3 weeks and 6 months following injection. The mean VAS heel pain scores measured 6 months after treatment were 3.4 in steroid group and 3.93 in PRP group, and the scores in both groups were significantly lower when compared with pretreatment levels (6.2 in steroid group and 7.33 in PRP group). There was no significant difference between steroid and PRP groups in visual analog scale scores and modified criteria of the Roles and Maudsley scores measured at 3 weeks and 6 months (P > 0.05). Our results revealed that both methods were effective and successful in treating plantar fasciitis. When the potential complication of corticosteroid treatment was taken into consideration, PRP injection seems to be safer and at least having same effectivity in the treatment of plantar fasciitis.

Successful Treatment of Nonhealing Ulcer Using Local Injection of Platelet-Rich Plasma

Successful Treatment of Nonhealing Ulcer Using Local Injection of Platelet-Rich Plasma

Platelet-rich plasma (prp) and tendon healing: animal model

IntroductionThe tendon is a tissue which does not heal easily. Recently, several studies have demonstrated the positive effects of platelets on the healing process of tendons. A local injection of...