Local Platelet-rich Plasma Research Articles

The use of platelet-rich plasma in the treatment of patients with chronic dorsalgia

Background. The purpose of the study is to assess the clinical effectiveness of using platelet-rich plasma for functional recovery in patients with chronic back pain. Materials and methods. The research was carried out in the clinical units of the Ukrainian Research Institute of Transport Medicine and Petro Mohyla Black Sea National University in 2020–2023. Sixty patients with chronic dorsalgia were examined. Results. During the entire course of treatment, patients who received local platelet-rich plasma therapy did not experience any adverse reactions or intolerance, did not require adjustment or change of treatment regimen. After 2 weeks of therapy, compared to the initial level, a significant decrease in the severity of the pain syndrome according to the visual analog scale was found, by 2.1 ± 0.2 points in the main group and by 1.5 ± 0.3 points in the control group (p < 0.05). Conclusions. After the treatment, the functional capabilities of patients in the main group improved significantly — Neck Disability Index decreased from 51.9 ± 2.2 % to 34.5 ± 1.3 % in the main group and from 53.3 ± 2.4 % to 45.8 ± 2.4 % in the controls, and Oswestry Disability Index — from 68.8 ± 2.3 % to 49.6 ± 1.8 % and from 66.7 ± 2.6 % to 55.8 ± 1.6 % (p < 0.05), respectively.

Lumbar fusion efficacy with local bone grafting and platelet-rich plasma: a clinical investigation in treating degenerative lumbar spinal stenosis in the elderly.

The focus of this study was to comprehensively assess the clinical outcomes of lumbar fusion utilizing autogenous bone grafting and platelet-rich plasma (PRP) for the management of degenerative lumbar spinal stenosis (DLSS) in elderly individuals. A cohort of 40 senior individuals diagnosed with DLSS, who underwent treatment at our hospital between January 2020 and March 2022. The control group consisted of 20 participants who underwent local bone grafting for intervertebral fusion, while the observation group comprised 20 individuals who received a combination of local bone grafting and PRP for lumbar fusion. MRI imaging was employed for a comprehensive assessment of spinal structure. The efficacy of spinal fusion was evaluated through MRI imaging. Clinical treatment outcomes were assessed using the Japanese Orthopaedic Association (JOA) and Oswestry Disability Index (ODI) scoring systems. Postoperative low back pain was quantified using a Visual Analog Scale (VAS). During the final follow-up, the observation group demonstrated a significant increase in the inner diameter of the spinal canal and the height of the disc space compared to the control group (P < 0.05).Moreover, the observation group displayed a larger spinal canal than the control group (P < 0.05).A reduced lesion score in the bone grafting region was observed in the observation group compared to the control group during the final follow-up (P < 0.05). Furthermore, the observation group displayed a higher intervertebral fusion continuity score than the control group (P < 0.05).The JOA score in the observation group was significantly higher than in the control group (P < 0.05), while the ODI score was significantly lower (P < 0.05). Of note, the back pain VAS score in the observation group was lower than in the control group at both the three months post-surgery mark and the final follow-up (P < 0.05).The satisfaction rate and overall satisfaction rate in the observation group were significantly higher than those in the control group (P < 0.05), while the dissatisfaction rate in the observation group was evidently lower than in the control group (P < 0.05). In the management of DLSS in elderly individuals, the utilization of local bone grafting and PRP in lumbar spinal fusion yields notable outcomes.

A potential treatment for erectile dysfunction: Effect of platelet-rich plasma administration on axon and collagen regeneration in cavernous nerve injury.

Recent studies highlighted the role of platelet-rich plasma (PRP) in progenitor cell homing, migration, and nerve cell regeneration while also inhibiting fibrosis and apoptosis in cavernous nerve injury (CNI). The aim of this study was to investigate the effect of PRP administration on axon and collagen regeneration in CNI. A true experimental study using a post-test-only control group design was conducted. Twenty-five male Wistar rats (Rattus norvegicus), weighing 200-300 grams, were divided into five groups: two control groups (sham procedure and negative control), and three experimental groups receiving local PRP, intraperitoneal PRP, and a combination of local and intraperitoneal PRP. The cavernous nerve was injured with a hemostasis clamp for one minute before 200 µL of 200 PRP was injected locally, intraperitoneally, or both, depending on the group. After four weeks, the rats were euthanized, tissue segments (2 mm) from each cavernous nerve and mid-penis were collected and analyzed for collagen density, axon diameter, and number of myelinated axons. Our study found that collagen growth was slower in CNI group without PRP (sham procedure) compared to all PRP groups (local, intraperitoneal, and combination). The intraperitoneal PRP group had the highest collagen density at 5.62 µm; however, no significant difference was observed in collagen density among all groups (p=0.056). Similar axon diameter was found across the groups, with no statistically significant difference observed (p=0.856). In the number of myelinated axons, a significant difference was found among all groups with significantly more axons in local PRP and combined local and intraperitoneal PRP groups compared to others (p=0.026). In conclusion, PRP administration improved the number of myelinated axons in CNI, suggesting PRP role in CNI regeneration and the potential for an innovative approach to treating erectile dysfunction associated with CNI.

PLATELET RİCH PLASMA RESULTS IN THE TREATMENT OF FEMUR HEAD AVASCULAR NECROSIS

Purpose: It has been observed that the number of patients with hip avascular necrosis who applied to our clinic after Covid-19 and steroid treatment in Covid-19 treatment has increased. It is emphasized in the literature that core decompression therapy is effective in early stage femoral head avascular necrosis. Core It has been emphasized in many publications that the results of intraoperative platelet- rich plasma (PRP) application after decompression are effective. However, intraoperative The method of application of platelet- rich plasma (PRP) and its effectiveness in the post-Covid-19 period are not emphasized enough in the literature. The aim of this study is to evaluate the effect of local platelet-rich plasma (PRP) administered using the new technique after core decompression to patients diagnosed with avascular necrosis. Materials and methods: Local platelet- rich plasma (PRP) was applied to 15 hips diagnosed with femoral head avascular necrosis after core decompression with a new technique. Early results of the patients were evaluated with Ficat and Harris hip scores. Results: An improvement was detected in the early clinical and Magnetic resonance (MR) findings of a total of 15 hip avascular necrosis patients . Local treatment in patients with avascular necrosis with a medical history of Covid-19 The feasibility of PRP was demonstrated. Conclusion: This study shows the importance of the intraoperative application method of platelet- rich plasma (PRP) and that platelet- rich plasma (PRP) can also be applied to Covid-19 patients. But we believe long-term results are needed.

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&lt;0.001). Plantar fascia thickness reduced from 5.1 mm (SD 0.6) to 4.1 mm (SD 0.5) at 12 weeks (p&lt;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.

Addressing radiotherapy-induced fibrosis: the potential of platelet-rich plasma and infliximab for improved breast cancer management.

Breast cancer treatment encompasses various therapeutic modalities, including surgery, radiotherapy, and chemotherapy. Breast-conserving surgery has been an integral part of breast cancer management. However, radiotherapy, an important component of breast cancer management, can lead to complications, particularly fibrosis, affecting reconstructive surgery outcomes. We conducted an in vivo study using 48 female Wistar Albino rats, employing segmental mastectomy and radiotherapy to simulate post-mastectomy conditions. The rats were divided into six groups: control, mastectomy, mastectomy + radiotherapy, mastectomy + platelet-rich plasma (PRP) + radiotherapy, mastectomy + infliximab + radiotherapy, and mastectomy + infliximab + PRP + radiotherapy. Edema, hyperemia, inflammation, and fibrosis were assessed as indicators of tissue response. Histopathological analysis revealed that mastectomy + infliximab and mastectomy + infliximab + PRP groups showed significant reductions in fibrosis compared to other groups. Edema, hyperemia, and inflammation were also less severe in these groups compared to the control group. Radiotherapy-induced fibrosis is a major concern in breast reconstruction. Our study suggests that local PRP application and systemic infliximab administration, either alone or in combination, could mitigate the adverse effects of radiotherapy. This approach has the potential to improve reconstructive outcomes in patients undergoing or having the possibility to undergo radiotherapy. This is the first study showing the effectiveness of infliximab and PRP combination on wound healing. The provided experimental rat model might offer guidance for further research. This study provides insights into optimizing outcomes in reconstructive breast surgery, paving the way for further research and clinical studies.

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.

A comparative analysis of functional outcome of local steroid and PRP in plantar fasciitis

Abstract Background: Plantar fasciitis is a common orthopedic issue that affects the quality of life. Various modalities of treatment have been tried for this condition, extending from conservative treatment to surgical treatment. Various studies have been conducted in different parts of the world to compare the results of local platelet-rich plasma (PRP) and steroids with varying results. Materials and Methods: We collected data at Mahatma Gandhi Medical College and Hospital, Jaipur, India with the approval of the IEC (Ethical Committee). From April 2016 to March 2017, 67 patients were included in the study through random sampling after obtaining written consent. Results: Plantar fasciitis was more common in the age group between 31 and 40 years. Plantar fasciitis was seen more commonly in females than males. Plantar fasciitis was seen more commonly in housewives and service providers. Both local steroid injection and autologous PRP injection are effective modes of treatment for chronic plantar fasciitis, but local steroid injection is effective for short-term pain relief, afterwards its effect gradually deteriorates, while autologous PRP injection provides better long-term pain relief. Patients were evaluated using the AOFAS score and the Visual Analogue Score, ranging from 0 to 10, at the onset of treatment, the 12-week follow-up, and the 24-week follow-up. An assessment was conducted in both categories. Conclusions: Both local steroid injection and autologous PRP injection are effective modes of treatment for chronic plantar fasciitis, but local steroid injection is effective for short-term pain relief (up to 12weeks as per our study), afterwards its effect gradually deteriorates, while the autologous PRP injection has better long-term pain relief.

Clinical efficacy of Platelet-Rich Plasma versus local Methylprednisolone Injection in Lateral Epicondylitis.

To compare the results of local administration of platelet-rich plasma (PRP) with methylprednisolone in the treatment of tennis elbow. This retrospective cohort was conducted at Jinnah Postgraduate Medical Center (JPMC) during January 2017 to April 2018. Patients conservatively managed for lateral epicondylitis with local methylprednisolone injection or PRP injection were approached for possible inclusion in the study at 12 months of treatment. The primary outcome of the study was to determine the Numerical Pain Rating Score (NPRS) on resisted wrist extension. Whereas, the secondary outcomes were quick disability arm, shoulder, and hand score (qDASH), the grip strength and VAS for satisfaction. The baseline, six weeks and three month data on Grip strength, NPRS, and qDASH were extracted from the patients' medical records maintained at the hospital. The data were analyzed by using SPSS software. A total of 91 patients were approached, of them 81 (89.01%) agreed to participate. There were 46 (56.79%) who received local methylprednisolone injection and 35 (43.20%) received PRP. At 12 months follow up, there was no difference in NPRS pain scores between the two groups (p=0.691); pain decreased in both groups at six weeks and at 12 months. There was no significant difference in the functional outcome (qDASH score) in both groups. Both groups were equally satisfied with the treatment they had received. The study concluded that there is no difference between outcome and efficacy of both treatment modalities used for the treatment of tennis elbow in alleviating pain at 12 months.

EFFECT OF A COMPLEX ACTION OF OZONETHERAPY COMBINED WITH AUTOLOGOUS PLATELET-RICH PLASMA APPLICATION ON THE CHARACTER OF MORPHOFUNCTIONAL CHANGES OF THE TISSUE MACROPHAGES IN PATIENTS WITH DIABETIC FOOT SYNDROME

Summary. Objective: to study the character of ultrastructural changes in the tissue macrophages under the effect of a complex of auxiliary factors promoting reparative process activation in the wound including ozonetherapy, local application of autologous platelet-rich plasma (PRP) and vacuum therapy.&#x0D; Materials and methods. The patients examined were divided into three groups. The first group included 23 (32,85%) patients who were treated by means of regional ozone therapy. The second group included 23 (32,85%) patients treated by means of local PRP therapy. The control group included 24 (34,28%) patients who during the postoperative period received a complex of therapeutic measures according to the generally accepted method.&#x0D; Results. Stimulation of the macrophage functional activity under ozone effect with destructive changes found in the cells without necrotizing damage was found tobe explained by apoptosis mechanism involvement as a positive factor in the regulation of local homeostasis on completion of inflammatory (exudative) phase of the wound process.&#x0D; Conclusions. A complex of such auxiliary therapeutic measures confirm more determined level of the reparative process activation on the level of the tissue macrophages in both groups examined (№ 1 and №2) in comparison with the control one.&#x0D; Prospects of further research. The results obtained confirm and determine further necessity to carry out search in novations in the treatmen to diabetic foot syndrome using the factors of physical and biological effect directed to the activation of the wound reparative process.

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.

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.

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.

ULTRASTRUCTURAL CHANGES OF MONONUCLEAR MACROPHAGES UNDER THE ACTION OF OZONE THERAPY AND LOCAL APPLICATION OF AUTOLOGOUS PLATELET-RICH PLASMA IN THE TREATMENT OF DIABETIC FOOT SYNDROME

Objective – to study the character of ultra- structural changes in the tissue macrophages under the eff ect to complex of accessory factors promoting reparative process activation in the wound: ozone therapy, local application of autologous platelet-rich-plasma.Materials and methods. The patients were divided into three groups. The 1st group included 23 (32,85%) individuals who were treated by means of ozone therapy. The 2nd group included 23 (32,85%) patients treated by means of local platelet-rich plasma (PRP) therapy. The control group included 24 (34,28%) individuals who received a complex of therapeutic measures according to the generally accepted method. Surgery or all the patients was performed with maximum saving of the vessels in the plantar region, and the local treatment included topical vacuum therapy in the amount of 5-6 procedures. Electronic- microscopic examination used the fragments of tissue from the wound surface preserved in 2,5% glutaraldehyde solution on phosphate buff erі (рН – 7,2-7,4), followed by further processing in 1% anhydride solution. The material was dehydrated in increasing concentration alcohols and placed into araldite. The morphological structures were contrasted with a concentrated solution of uranyl acetate in the process of dehydration, and on the sections – with lead citrate. The sections 40-60 nm thick obtained by means of ultratome УМТП-3 were examined under the electron microscope TESLA БС-500. The specimens for examination were taken in the patients during dressings on the 7, 14 and 21-23 days of treatment. The dynamics of changes in the tissue macrophages was conducted by means of Astaldi principle generalizing percentage evaluation. It is a semi-quantitative method considering distinctive cytological changes determined in the similar amount of the cells examined (tissue macrophages).Results. Stimulation of the macrophage functional activity under the eff ect of ozone with destructive changes found in the cells without necrotizing damage was found to be explained by apoptosis mechanism involved as a positive factor in the regulation of local homeostasis at the completion of infl ammatory (exudative) phase of the wound process. Activation of phagocytic possibilities of the tissue macrophages with local application of autologous platelet-rich plasma occurs without any signs of apoptosis prevailing, and it is indicative of stimulation of their functional activity by antigenic or enzymatic mechanisms stimulating their functional activity.Conclusions. Stimulation of macrophage functional activity under ozone eff ect and availability of destructive changes in the cells without necrotizing damage can be explained by the involving of apoptosis mechanism as a positive factor in the regulation of local homeostasis at the completion of infl ammatory (exudative) phase of the wound process. Activation of phagocytic possibilities of the tissue macrophages with local application of autologous platelet-rich-plasma occurs without any signs of apoptosis prevailing, and it is indicative of stimulation of their functional activity by antigenic or enzymatic mechanisms stimulating their functional activity.Prospects of further studies. The results obtained confi rm and determine further necessity to conduct search innovations in the treatment of diabetic foot syndrome using the factors of physical and biological eff ect directed to the activation of a reparative process in the wound.

Sıçanlarda Mastektomi ve Aksiller Diseksiyon Sonrası Seroma Gelişimi Üzerine Kriyoprezerve İnsan Amniyotik Membran ve Trombositten Zengin Plazmanın Etkileri

Aim: Seroma is one of the most common complications after mastectomy and axillary dissection. It occurs as a result of prolongation of the exudative-inflammatory phase of wound healing. The aim of this study is to evaluate the effects of human amniotic membrane (HAM) and platelet-rich plasma (PRP) on seroma formation. Material and Methods: A total of 24 rats were grouped as control, PRP, and HAM groups. All rats underwent radical mastectomy and axillary lymph node dissection. Saline in the control group, PRP in the second group, and HAM in the third group were applied to the dissection area. The groups were compared in terms of the condition of the surgical field, seroma volume, and histopathological changes. Results: Seroma volume decreased in the PRP group, but not in the HAM group. Lymphocyte, eosinophil, histiocyte, and fibroblast levels were significantly lower both in the PRP and HAM groups compared to the control group. E-cadherin and TGF-β1 immunoreactivities of PRP and HAM groups were higher than in the control group. Conclusion: In this study, it was observed that PRP and cryopreserved HAM increased tissue healing and decreased the inflammatory process. However, although local PRP application significantly reduced seroma formation, it was determined that HAM application did not reduce seroma formation. It was thought that this might be due to the fact that the smooth surface of HAM mechanically prevents the adhesion of the tissues. More beneficial results will be obtained with the modification to be made in the preparation and application of HAM.

Minimally Invasive Treatment of Recurrent Anal Fistulas with Autologous Platelet-Rich Plasma Combined With Internal Orifice Closure.

Minimally invasive procedures for the treatment of anal fistulas are gaining more and more popularity. For this purpose, Platelet-Rich Plasma (PRP) are administered to accelerate the healing process of various difficult wounds or lesions. The aim of this study was to evaluate preliminary results of PRP injection into the tissues adjacent to anal fistulas. A cohort of 42 patients with recurrent anal fistula, who underwent at least one cutting procedure previously, were enrolled into this preliminary and prospective trial. Closure of internal orifice was performed in all investigated patients, however, in 22 patients from group I, that procedure was combined with topical injection of PRP. In the postoperative period, the PRP administration could be repeated in case of incomplete fistula closure. Follow-up consisted of out-patient visits in a fortnight, 1, 2, and 12months. Complete closure of anal fistulas was achieved in 16 (75%) patients from group I and 10 (45,5%) patients from group II. The fistulas were healed in 9 patients from group I after single application of PRP. In the next 9 patients with incomplete fistula closure, the injection was repeated 2 to 4 times every fortnight leading finally to complete recovery in 6 of them. Surgical fistula closure with local PRP application spares the anal sphincter and gives the opportunity to repeat the procedure several times if necessary. Treatment of recurrent anal fistulas with PRP can be considered as last resort therapy.

Available methods to enhance regenerative potential of plastic materials for bone defects replacement in orthopedics. Part 1. Autologous platelet rich plasma

The main method of surgical treatment of patients with post-traumatic disorders of bone regeneration is the use of bone grafting. Until now, the optimal plastic material has been a bone autograft, which use involves additional trauma to the patient. Alternative materials that are used for grafting have only an osteoconductive effect, of varying effectiveness. To optimize the properties of plastic materials, giving them an osteostimulating effect, they can be used in combination with biologically active substances. A source of biologically active substances can be platelet-rich plasma, platelet lysate and red bone marrow. This literature review includes a description of three main methods to stimulate osteogenesis. The first part examines the mechanism of action of platelet-rich plasma, indications and contraindications for its use, describes the results of treatment when platelet-rich plasma is used to stimulate osteogenesis. Platelet-rich plasma is a product of a human native blood obtained by centrifugation. The output is a high concentration of platelets in a small volume of plasma, which contain growth factors and cytokines that have a direct effect on the regeneration process. Local platelet-rich plasma therapy is performed to stimulate osteogenesis. Autologous platelet-rich plasma with growth factors contained in α-granules of platelets is injected into an allogeneic graft or into a fracture zone. The aim of this article is to summarize the results of treatment using platelet-rich plasma to improve bone regenerative potential in orthopaedics.

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.