Ml Of Platelet-rich Plasma Research Articles

Facial biostimulation with PRP activated with ozone resound on cellular redox balance, improves lipoatrophy and quality of life in HIV patients

Context: Pathogenic impact of high-grade local and systemic oxidative stress in antiretroviral treated HIV patients are recognized factor influencing in lipodystrophy, which is proposed can be ameliorate with platelet rich plasma (PRP). Aims: To determine the efficacy and safety of ozone and calcium activated PRP application in lipoatrophy- AIDS Cuban individuals. Methods: Thirty HIV individuals enrolled in quasi experimental prospective study showed lipoatrophy grade from 1 to 3. A mean volume interval of 8 to 22.2 mL of PRP was injected in 5 interventions during a year. The clinical, chemical, oxidative stress and progression indexes determinations were performed prior to injections and at 6 and 12 months after. Also, questionnaires based on Short Form 36, Medical Outcomes Study HIV Health Survey were assessed. Different statistical analyses were done comparing baseline respect final values of variables. Results: Beneficial improve of lipoatrophy grade (p<0.05) and stabilization in global indexes of damage and antioxidant status at the end of the study was demonstrated. The comparison revealed a significantly smaller damage and higher antioxidant status compared to baseline values (p<0.05). Non-significant modifications were observed in hematological and chemical indexes (p˃0.05), respect quality of life 75% of three dimensions improved and depressive symptoms decreased. Non-adverse reactions were observed during the study period. Conclusions: These results corroborate that beneficial amelioration of oxidative stress occurs in lipoatrophy AIDS patients during effective and safety PRP-ozone facial bioestimulation. Integral diagnosis would be worthwhile to conduct a more comprehensive study and manage of lipoatrophy.

Evaluation of platelet-rich plasma injection in knee osteoarthritis patients

Objectives The aim of this study was to determine the effect of local injection of platelet-rich plasma (PRP) in patients with mild and moderate knee osteoarthritis (OA) and its effect on pain in comparison to corticosteroid injection. Background OA is one of the most prevalent chronic musculoskeletal diseases worldwide. The use of PRP appeared in the last years for the management of symptoms of knee OA. Patients and methods This study included 50 patients with knee OA. Our patients were divided to two groups: a group of 25 patients who were injected intra-articularly with about 3–4 ml of PRP and another of 25 patients who were injected intra-articularly with triamcinolone acetate for one affected knee. We measure and assess all patients by Western Ontario and McMaster Universities Osteoarthritis Index and visual analog score – pain questionnaires before injection and after 1 and 3 months of injection. Results There was a highly statistically significant difference between preinjection and postinjection after 1 month with more decrease in postinjection (P Conclusion Intra-articular injection PRP is an effective method for the treatment of knee OA. Also, PRP intra-articular injection is more effective than intra-articular injection of corticosteroid.

Injection of Stromal Vascular Fraction Plus Platelet-Rich Plasma in a Non-Healing Decubitus Ulcer

Non-healing decubitus ulcers can be challenging to treat and may often progress to other life-threatening complications. Significant tissue damage is present in stage 3/4 wounds and treatment options can be limited or present additional risks. Applications of regenerative medicine and stem cell therapy are rapidly expanding in particular in the field of non-healing wounds. Adipose tissue is a rich source of autologous stem cells which can be easily isolated in an outpatient visit. The population of cells collected from fat after the adipocytes (fat cells) are removed via centrifugation is called stromal vascular fraction (SVF) and contains mesenchymal/adipose stem cells, fibroblasts, pericytes, endothelial/progenitor cells and more. Adipose tissue is collected under local anesthesia via cannula and SVF is separated via centrifugation after enzyme digestion. In addition, peripheral blood can be centrifuged to collect platelet-rich plasma (PRP) which contains a mixture of cytokines/growth factors. Here we present a first in man case study of a single injection of SVF and PRP into a chronic non-healing stage 3 ulcer in a patient with an incomplete spinal cord injury. After removing approximately 60 mL of fat tissue, the SVF was isolated and resuspended in approximately 5 mL of PRP for local administration in the non-healing wound. The wound was monitored and tracked with imaging and the patient was tracked for quality of life parameters as well as safety (adverse events). No complications or other safety events were reported either during the procedure or in the months following the procedure. The patient reported reduction of pain consistent with wound healing and a willingness to repeat therapies if required. The healing stage 3 pressure injury showed clear re-epithelialization. Based on this case study, a feasible treatment plan to promote healing for stage 3 and 4 decubitus ulcers could be a single injection of SVF plus PRP. J Med Cases. 2018;9(10):323-327 doi: https://doi.org/10.14740/jmc3128w

Comparative Study of Local Injection of Platelet Rich Plasma versus Corticosteroids in the Treatment of Lateral Epicondylitis (Tennis Elbow)

Background: Lateral epicondylitis, also known as 'tennis elbow', is a very common condition affecting mainly middle-aged patients that is associated with local tendon pathology, alteration in pain perception and motor impairment. Several approaches to treatment have been proposed, the most frequently used is PRP. Platelet-rich plasma (PRP) is a growing modality for tissue healing, regeneration and has more pain relief lasting effect. Aim of the work: was to estimate the clinical efficacy of local injection of Platelet Rich Plasma compared to local injection of corticosteroids in cases of lateral epicondylitis. Patients and Methods: This study was a prospective clinical trial study in which 80 patients with lateral epicondylitis of both sexes between 2l - 60 years of age were recruited for the study. The included patients were divided into two groups: 1- Platelet Rich Plasma group (40 patients) were received a two injections of 1 ml of PRP with one month interval between the two injections, with absolute platelet count of 1 million platelets/ mm3 as confirmed by automated cell counter. . PRP were prepared under complete aseptic conditions. 2- Corticosteroids group (40 patients) were received a two injections of corticosteroid (methyl-prednisolone, 40mg in l ml) with one month interval between the two injections. The site of injection and the technique used was same in both the groups. Results: Affected side was higher in right hand than left hand in both studied groups. In PRP group, there were 92.5 % right hand and 7.5 % left handed patients. Whereas, in corticosteroid group, there were 95.0 % right handed and 5.0 % left handed patients; and there was no significant difference between the studied groups. Visual Analog Scale (VAS) was significantly improved at 1 and 3 months in PRP patients compared to only significant improvement at 3 months in corticosteroid group. Both studied groups showed significant improvement of grip strength at 1 and 3 months. qDASH at 1 and 3 months was significantly better in the PRP group, but it statically not reached. On the other hand, significant improvement of US edema was estimated in the corticosteroid group at 3 months when compared with PRP group. In addition, slight improvement of US tears was appeared in both groups after 3 months. Conclusion: It could be concluded that both PRP and corticosteroids showed better improvement of pain, grip strength and qDASH at 3 months. However, PRP is suggested to be an effective treatment for lateral epicondylitis. PRP provides better improvement in all parameters with nearly durable effect when compared to corticosteroids. On the other hand, corticosteroids treatment resulted in better improvement of US detected edema.

Comparative Study of Local Injection of Platelet Rich Plasma versus Corticosteroids in the Treatment of Lateral Epicondylitis (Tennis Elbow)

Background: Lateral epicondylitis, also known as 'tennis elbow', is a very common condition affecting mainly middle-aged patients that is associated with local tendon pathology, alteration in pain perception and motor impairment. Several approaches to treatment have been proposed, the most frequently used is PRP. Platelet-rich plasma (PRP) is a growing modality for tissue healing, regeneration and has more pain relief lasting effect. Aim of the work: was to estimate the clinical efficacy of local injection of Platelet Rich Plasma compared to local injection of corticosteroids in cases of lateral epicondylitis. Patients and Methods: This study was a prospective clinical trial study in which 80 patients with lateral epicondylitis of both sexes between 2l - 60 years of age were recruited for the study. The included patients were divided into two groups: 1- Platelet Rich Plasma group (40 patients) were received a two injections of 1 ml of PRP with one month interval between the two injections, with absolute platelet count of 1 million platelets/ mm3 as confirmed by automated cell counter. . PRP were prepared under complete aseptic conditions. 2- Corticosteroids group (40 patients) were received a two injections of corticosteroid (methyl-prednisolone, 40mg in l ml) with one month interval between the two injections. The site of injection and the technique used was same in both the groups. Results: Affected side was higher in right hand than left hand in both studied groups. In PRP group, there were 92.5 % right hand and 7.5 % left handed patients. Whereas, in corticosteroid group, there were 95.0 % right handed and 5.0 % left handed patients; and there was no significant difference between the studied groups. Visual Analog Scale (VAS) was significantly improved at 1 and 3 months in PRP patients compared to only significant improvement at 3 months in corticosteroid group. Both studied groups showed significant improvement of grip strength at 1 and 3 months. qDASH at 1 and 3 months was significantly better in the PRP group, but it statically not reached. On the other hand, significant improvement of US edema was estimated in the corticosteroid group at 3 months when compared with PRP group. In addition, slight improvement of US tears was appeared in both groups after 3 months. Conclusion: It could be concluded that both PRP and corticosteroids showed better improvement of pain, grip strength and qDASH at 3 months. However, PRP is suggested to be an effective treatment for lateral epicondylitis. PRP provides better improvement in all parameters with nearly durable effect when compared to corticosteroids. On the other hand, corticosteroids treatment resulted in better improvement of US detected edema.

Clinical evaluation of intra-articular platelet-rich plasma injection for the treatment of knee osteoarthritis

Objective The aim of this study was to evaluate results of intra-articular injection of plasma sample rich in platelets for the treatment of knee osteoarthritis (OA). Background OA is a progressive, chronic condition leading to pain and loss of function that reduce patients' quality of life. Materials and methods The study was performed on 30 knees of 30 patients with age 30–65 years. All of the patients presented with knee OA grade I, II, and III and were treated with two intra-articular platelet-rich plasma (PRP) injections with three weeks interval. Preparation was done by centrifugation of 50 ml blood in two separate cycles, finally resulting in 5 ml of PRP then get activated by calcium chloride (CaCl2) at concentration of 50 μl/1 ml PRP, added just before injection. Western Ontario and McMaster universities score was used for clinical evaluation. Complications and adverse events were also recorded. Results Mean age of patients was 52 years. All of them were followed up to 12 months. The clinical results were classified on subjective base and were graded as excellent in 19 (63.3%) patients, good in six (20%) patients, and poor in five (16.7%) patients. No complications were noted. There was significant significance between BMI and clinical success (P = 0.000). The study showed significant association between grade of OA and clinical success (P = 0.008). Conclusion Maximal improvement occurred in a month and continued above basal levels in 12 months follow-up, especially in the young individuals. These findings indicate that treatment with PRP injections can reduce pain and improve knee function and quality of life with short-term efficacy.

BONE GRAFTING ENHANCED BY PLATELET-RICH PLASMA IN TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

Treatment of avascular necrosis of the femoral head is an issue of current interest while it affects young and employable people. So far there is no well-defined strategy of management which would help to postpone hip arthroplasty and further revision procedure. Hip sparing surgical treatment of avascular necrosis of the femoral head by bone grafting prior to head collapse proved to be a viable option not only during early stages of disease but also at advanced stages. Platelet-rich plasma (PRP) addition to treatment plan potentially helps improving bone regeneration in situ.In this article the authors present a case of a 37 years old patient with avascular necrosis of the femoral head at a fragmentation stage (type 4B by ARCO). The authors centrifuged 15 ml of autologous whole blood (1500 RPM) obtained by a special double-contoured syringe. During the surgical stage of treatment PRP and morselized bone graft were mixed to introduce and impact into the debrided zone of avascular necrosis. The authors also introduced 0.3–0.4 ml of PRP into the debrided zone of avascular necrosis after bone grafting. At 6 months follow-up CT images of the studied patient demonstrated signs of bone reorganization and no loss of femoral head sphericity. Preoperative Visual Analogue Scale (VAS), Harris Hip Score (HHS) and Hip disability and Osteoarthritis Outcome Score (HOOS) prior to treatment were 60, 45 and 33 points respectively. Postoperative VAS, HHS and HOOS scores were 10, 78 and 78 respectively. In the authors’ opinion, impaction bone grafting enhanced by PRP helps obtaining good and excellent outcomes not only at early but also at advanced stages of avascular necrosis.

Injection of Stromal Vascular Fraction Plus Platelet-Rich Plasma in a Non-Healing Decubitus Ulcer

Non-healing decubitus ulcers can be challenging to treat and may often progress to other life-threatening complications. Significant tissue damage is present in stage 3/4 wounds and treatment options can be limited or present additional risks. Applications of regenerative medicine and stem cell therapy are rapidly expanding in particular in the field of non-healing wounds. Adipose tissue is a rich source of autologous stem cells which can be easily isolated in an outpatient visit. The population of cells collected from fat after the adipocytes (fat cells) are removed via centrifugation is called stromal vascular fraction (SVF) and contains mesenchymal/adipose stem cells, fibroblasts, pericytes, endothelial/progenitor cells and more. Adipose tissue is collected under local anesthesia via cannula and SVF is separated via centrifugation after enzyme digestion. In addition, peripheral blood can be centrifuged to collect platelet-rich plasma (PRP) which contains a mixture of cytokines/growth factors. Here we present a first in man case study of a single injection of SVF and PRP into a chronic non-healing stage 3 ulcer in a patient with an incomplete spinal cord injury. After removing approximately 60 mL of fat tissue, the SVF was isolated and resuspended in approximately 5 mL of PRP for local administration in the non-healing wound. The wound was monitored and tracked with imaging and the patient was tracked for quality of life parameters as well as safety (adverse events). No complications or other safety events were reported either during the procedure or in the months following the procedure. The patient reported reduction of pain consistent with wound healing and a willingness to repeat therapies if required. The healing stage 3 pressure injury showed clear re-epithelialization. Based on this case study, a feasible treatment plan to promote healing for stage 3 and 4 decubitus ulcers could be a single injection of SVF plus PRP. J Med Cases. 2018;9(10):323-327 doi: https://doi.org/10.14740/jmc3128w

Healing Effect of Platelet-rich Plasma on Decellularized Tracheal Allotransplantation in Rabbits.

The purpose of this study was to explore the effect of platelet-rich plasma (PRP) on enhancing healing of trachea allotransplantation and confirm the effect via parallel histological and tracheoscopic examinations in seven adult New Zealand White rabbits. Harvested trachea was inserted into recipients with end-to-end anastomosis by a simple interrupted suture. PRP-treated rabbits were treated with 0.5 ml of PRP at the trachea grafts, while control rabbit allografts were treated with 0.5 ml of saline. Tracheoscopy of tracheal allografts treated with PRP revealed that the trachea was well healed with no stenosis. The healing effect in the PRP-treated rabbits increased tracheal activity and produced faster trachea regeneration compared to that in control rabbits. There was a good correlation between the subjective symptom of noisy breathing and the objective grading of tracheal stenosis. The tracheal allografts with suture materials appeared slightly pale and looked more like mucosa erosion than normal mucosa at four weeks post-surgery. Contact of trachea-to-transplanted grafts in PRP-treated rabbits was intimate with the surface of the transplanted region and showed high-density epithelialization. After 8 weeks, blood vessels were observed in the transplanted graft in PRP-treated rabbits. Normal epithelium was present in grafts at 8 weeks after allotransplantation. No CD20+ cells were detected in grafts but a few CD3+ cells were observed under the epithelium. The results of this study show that it is possible to perform tracheal reconstruction in rabbits treated with PRP after tracheal transplantation.

Effectiveness of Intra Articular Injection of Platelet-Rich Plasma in Patients with Anterior Disc Displacement with Reduction

Background: Anterior disc displacement with reduction (ADDWR) is the most common form of the internal derangement (ID) of temporomandibular joint (TMJ). It is a painful progressive dysfunction and clinically characterized by reciprocal clicking due to shift in the disc anteriorly in relation to the condyle and fossa during mandible elevation. Minimally invasive therapy such as intra-articular injection of platelet-rich plasma (PRP) has been used. PRP is a natural autologous product with a high platelet concentration obtained by centrifugation process to enhance tissue healing through several growth factors (GFs), which are released after endogenous activation. The aim of this study is to assess this technique which is increasingly used today as a safe, simple modality. Materials and Methods: sixty patients with ADDWR were participated (Females 41, males 19; age 20-39 years). Patients were divided into two groups; PRP was used as study group and conservative therapy was used as control group. 1 ml of PRP was obtained by a single step centrifugation. Pain, joint sounds and maximum mouth opening were clinically evaluated before and two months after therapy. Results: There was statistically significant improvement in pain score, clicking and maximum mouth opening in patients treated with PRP. No complications were recorded immediately and two months after therapy. Conclusion: This study support the effectiveness of PRP injection in treatment of ADDWR as a safe modality in reducing pain, clicking and increase mouth opening.

The Contribution of Adipose Tissue-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma to the Treatment of Chronic Equine Laminitis: A Proof of Concept

Laminitis, a highly debilitating disease of the foot in ungulates, is characterized by pathological changes of the complex lamellar structures that maintain the appendicular skeleton within the hoof. Laminitis is a multifactorial disease that involves perturbation of the vascular, hematological, and inflammatory homeostasis of the foot. Interestingly, the pathogenesis of the disease resembles what is observed in metabolic syndromes and sepsis-induced organ failure in humans and animals. We hypothesized that local administration of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) might contribute to establishing an anti-inflammatory and pro-angiogenic environment, and could stimulate the injured tissue in order to restore its functional integrity. According to this assumption, an experimental protocol based on the local intravenous administration of adipose tissue-derived MSCs (aMSCs) in combination with PRP was developed for the treatment of horses affected by chronic laminitis. Nine horses with severely compromised venograms (showing grade III and IV laminitis) that had been unsuccessfully treated with conventional therapies were enrolled. aMSCs and PRP (15 × 106 cells resuspended in 15 mL of PRP) were injected into the lateral or medial digital vein three times, at one-month intervals. The first administration was performed with allogeneic aMSCs, while for the following administrations, autologous aMSCs were used. There was no adverse short-term reaction to the intravenous injection of aMSCs. In the long term, venograms outlined, in all subjects, a progressive amelioration of the vascularization of the foot. An improvement in the structure and function of the hoof was also observed. No adverse events were reported during the follow-up, and the horses returned to a comfortable quality of life. Although the number of animals enrolled in the study is limited, both clinical observations and venography demonstrated an enhancement in the condition of all horses, suggesting that the regenerative therapies in chronic laminitis could be useful, and are worthy of further investigation.

Uterine clinical findings, fertility rate, leucocyte migration, and COX-2 protein levels in the endometrial tissue of susceptible mares treated with platelet-rich plasma before and after AI

Persistent mating-induced endometritis (PMIE) results in decreased fertility in horses, thereby causing a significant impact in the horse market. Platelet-rich plasma (PRP), a modulator of the inflammatory response, has been largely used in veterinary medicine. Here, we investigated the effects of PRP on uterine inflammation, conception rate, endometrial polymorphonuclear neutrophil (PMN) migration, and COX-2 protein levels in the endometrial tissue. Thirteen PMIE-susceptible mares were used for artificial insemination (AI). The mares were inseminated with fresh semen in three consecutive cycles in a cross-over study design. The following cycle classifications were used: control cycle, no pharmacological interference; pre-AI, 20 mL of PRP was infused 24 h before AI; and post-AI, 20 mL of PRP was infused four h after AI. Follicular dynamics were monitored daily by transrectal ultrasound. When a follicle larger than 35 mm was detected, ovulation was induced with deslorelin acetate (1 mg, im). AI was performed 24 h after ovulation induction. Intrauterine fluid (FLU) was evaluated by ultrasonography before and 24 h after AI. PMNs in uterine cytology (CYT) and biopsy (HIS) were also observed before and 24 h after AI. Pregnancy was determined within 14 days after ovulation. Number of COX-2 positive cells was evaluated by immunohistochemistry. Both PRP treatments resulted in a decrease of PMNs in the CYT after breeding when compared to controls. FLU did not differ between cycles; however, the conception rates were significantly higher in the PRP mares. Mares positive for endometritis decreased in both treatment groups, and a more intense positive COX-2 labeling was observed in the control group when compared to the two treatment groups. In conclusion, PRP beneficially reduces inflammatory response in PMIE mares independent of when treatments were administered, thus increasing chances of successful pregnancy.

Platelet Rich Plasma for Chronic Synovitis Treatment in Patients with Haemophilia.

Haemophilic synovitis is caused by chronic accumulation of blood in the joint. Conservative treatment is insufficient to solve this pathology. Platelet-rich plasma (PRP) has a high concentration of growth factors (GFs) that play a key role in regulation and stimulation of healing processes. The aim of this study was to describe the effect of PRP injection in chronic synovitis of the joints in patients with haemophilia (PWH). Nineteen patients with 28 joints were treated at our centre in Buenos Aires, Argentina between December 2014 and December 2015. Eighteen were Haemophilia type A (17 severe, one mild) and one was type B severe. Mean age was 26 years old. Chronic synovitis was present in two ankles, seven elbows and 19 knee joints. All affected joints were evaluated for range of motion (ROM), perimeter, Haemophilia Joint Health Score (HJHS), number of bleedings episodes and Visual Analogue Scale (VAS). Evaluations were before treatment and 3 and 6 months after treatment. A mean volume of 4 mL of PRP was injected into the joint cavity. The statistical analysis before and after treatments revealed a statistically significant (P < 0.001) decrease in the HJHS score. Decrease in joint bleeding episodes was also statistically significant (P < 0.001). All patients reported pain relief and VAS scores were statistically significant (P < 0.001). Joint perimeter also showed a statistically significant difference (P < 0.001). No complications were observed in any of the patients, either during blood collection or during PRP injection, even for inhibitor patients. Platelet-rich plasma is a useful, safe, and inexpensive treatment for chronic haemophilic synovitis.

Six-month efficacy of platelet-rich plasma for carpal tunnel syndrome: A prospective randomized, single-blind controlled trial

Recently, a few small reports with short follow-up period have shown clinical benefits of platelet-rich plasma (PRP) for peripheral neuropathy including one pilot study and one small, non-randomized trial in patients with carpal tunnel syndrome (CTS). Therefore, we conducted a randomized, single-blind, controlled trial to assess the 6-month effect of PRP in patients with CTS. Sixty patients with unilateral mild-to-moderate CTS were randomized into two groups of 30, namely the PRP and control groups. In the PRP group, patients were injected with one dose of 3 mL of PRP using ultrasound guidance and the control group received a night splint through the study period. The primary outcome measure was the visual analog scale (VAS) and secondary outcome measures included the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score, the cross-sectional area (CSA) of the median nerve (MN), electrophysiological findings of the MN, and finger pinch strength. The evaluation was performed before treatment and at 1, 3, and 6 months post-injection. The PRP group exhibited a significant reduction in the VAS score, BCTQ score, and CSA of MN compared to the those of control group 6 months post-treatment (p < 0.05). Our study demonstrates that PRP is a safe modality that effectively relieves pain and improves disability in the patients with CTS.

Effects of Autologous Platelet-Rich Plasma on Regeneration of Damaged Endometrium in Female Rats.

PurposeTo investigate whether autologous platelet-rich plasma (PRP) treatment can improve regeneration of the endometrium in an experimental model of ethanol-induced damage.Materials and MethodsSixty female Sprague-Dawley rats were randomly assigned into three groups: control group, ethanol group, and PRP-treated group (administration of 0.25 mL of PRP into both uterine cavities 72 hours after ethanol injection). After 15 days of endometrial damage, all the animals were sacrificed during the estrous cycle, and samples were taken from the mid-uterine horn. Functional and structural recovery of the endometrium was analyzed by hematoxylin-eosin (H&E) and Masson trichrome (MT) staining, real-time polymerase chain reaction (PCR) assay, and immuno-histochemical (IHC) analyses.ResultsH&E and MT staining confirmed significantly decreased fibrosis and increased cellular proliferation in the PRP-treated group, compared to the ethanol group. The endometrial areas in the ethanol and PRP-treated groups were 212.83±15.84 µm2 and 262.34±12.33 µm2 (p=0.065). Significantly stronger IHC expression of cytokeratin, homeobox A10 (HOXA10), vascular endothelial growth factor (VEGF), and Ki-67 was found in the PRP-treated group, compared to the ethanol group. In real-time PCR analyses, interleukin-1β mRNA was down-regulated, while c-Kit mRNA was up-regulated, in the PRP-treated group, compared to the ethanol group.ConclusionIntrauterine administration of autologous PRP stimulated and accelerated regeneration of the endometrium and also decreased fibrosis in a murine model of damaged endometrium.

Adding Intra-Articular Growth Hormone to Platelet Rich Plasma under Ultrasound Guidance in Knee Osteoarthritis: A Comparative Double-Blind Clinical Trial.

IntroductionIntra-articular injections of platelet rich plasma (PRP) for the treatment of knee osteoarthritis have been shown to reduce pain and improve joint function. The aim of this study is to examine the joint function by adding intra-articular growth hormone to platelet rich plasma. This study was performed on the individuals with knee osteoarthritis and under ultrasound guidance.MethodsFifty four patients who were scheduled for ultra-sound guided intra-articular injection were enrolled in the study. The patients were randomly allocated to groups P (platelet rich plasma) and PS (platelet rich plasma and Somatropin). Group P and PS were injected with 5 mL of platelet rich plasma, and 4 IU growth hormone (Somatropin) added to platelet rich plasma, respectively. Intra-articular injection was performed in two steps; the onset of study and one month after. Knee joint function based on Western Ontario and McMaster osteoarthritis index (WOMAC) score at the baseline, 1 and 2 month later, and complications were evaluated.ResultsWOMAC score in both groups has been significantly reduced after injections (P = 0.030). WOMAC score reduction in group PS in first month was significantly higher than group P, but in second month 2, the difference between two groups was not significant (P = 0.235). No complication was observed.ConclusionsThese results showed that adding growth hormone to platelet rich plasma for intra-articular injection improved function of the osteoarthritic knee joint in short period of time.

Effects of autologous platelet-rich plasma on implantation and pregnancy in repeated implantation failure: A pilot study

Repeated implantation failure (RIF) is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on the most effective one. This study was conducted to evaluate the effectiveness of platelet-rich plasma in improvement of pregnancy rate in RIF patients. Twenty women with a history of RIF who were candidates for frozen-thawed embryo transfer were recruited in this study. Intrauterine infusion of 0.5 ml of platelet-rich plasma that contained platelet 4-5 times more than peripheral blood sample was performed 48 hrs before blastocyst transfer. Eighteen participants were pregnant with one early miscarriage and one molar pregnancy. Sixteen clinical pregnancies were recorded and their pregnancies are ongoing. According to this study, it seems that platelet-rich plasma is effective in improvement of pregnancy outcome in RIF patients.

Comparison between Corticosteroid, Platelet Rich Plasma (PRP) and Xylocaine Infiltration for Lateral Epicondylosis (Tennis Elbow): A Prospective Randomized Study

Background: Platelet rich plasma and corticosteroid injection have both been suggested to treat chronic lateral epicondylosis. The aim of this study was to compare the safety and effectiveness of corticosteroid, PRP and xylocaine infiltration for lateral epicondylosis. Materials and Methods: 150 patients with chronic lateral epicondylosis were randomly divided into three groups. Group A was treated with a single injection of 2 ml of corticosteroid mixed with 1 ml of xylocaine, Group B with 2 ml of PRP mixed with 1 ml of xylocaine and Group C with 3 ml of 2% xylocaine through peppering needle technique. Pain and functional improvements were assessed using visual analogue scale (VAS) and Nirschl’s staging at 0,2,6,12,26 and 52 weeks. Results: Baseline evaluation showed no difference between the three groups (p>0.05). Analysis at 2 weeks showed no difference in Nirschl staging but showed significant decrease in VAS score in favour of corticosteroid group. No statistically significant difference was noted between groups at 6 weeks (p>0.05). At 12 weeks VAS score was comparable but Nirschl stage was significantly low in corticosteroid group. Evaluation at 26 and 52 weeks demonstrated a statistically significant difference between groups favouring PRP group (p<0.05). Conclusion: PRP, Corticosteroid and Xylocaine are safe and effective in treatment of lateral epicondylosis. Both steroid and xylocaine are effective on a short term period. However, on long term follow-up, PRP seems to be the more effective treatment with more persistent efficacy than corticosteroid and xylocaine in relieving pain.

Platelet-Rich Plasma Injection as an Effective Treatment for Temporomandibular Joint Osteoarthritis

Emerging evidence has suggested that platelet-rich plasma (PRP) might be of assistance in the treatment of degenerative conditions of the joints. The aim of the present study was to compare the use of PRP and hyaluronic acid (HA) in the treatment of temporomandibular joint (TMJ) osteoarthritis (OA) with long-term follow-up data. Patients meeting the Research Diagnostic Criteria for TMJ-OA were randomly assigned to 1 of 2 study groups that received either PRP or HA. The outcome variables were maximum nonassisted (voluntary) mouth opening (MVMO), joint sounds, and pain index scores. Other variables, including patient age and gender, were evaluated in relation to the outcomes. Descriptive and bivariate statistics were computed, and the P value was set at .05. A total of 50 patients with TMJ-OA were enrolled in the study (29 women and 21 men, age range 31 to 49 years, mean age 38.6). In group I, 25 patients received 3 injections of 1 mL of PRP. In group II, 25 patients received 3 injections of 1 mL of low-molecular-weight HA. Between-group comparisons of the outcome variables over time revealed significant improvements in group II at 1 and 3 months. At 6 and 12 months, the PRP group exhibited better performance compared with the HA group in terms of the recurrence of pain and joint sounds. The improvements obtained with the PRP injections in group I were maintained during the follow-up period. At the end of the follow-up period, the median MVMO in group I was 41.0 mm. In group II, the median MVMO was 39.0 mm. PRP performed better than HA acid in the treatment of TMJ-OA during long-term follow-up in terms of pain reduction and increased interincisal distance. Future studies will focus on the synergistic actions of HA and PRP in the treatment of TMJ-OA.

Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome.

Both in vitro and in vivo experiments have confirmed that platelet-rich plasma has therapeutic effects on many neuropathies, but its effects on carpal tunnel syndrome remain poorly understood. We aimed to investigate whether single injection of platelet-rich plasma can improve the clinical symptoms of carpal tunnel syndrome. Fourteen patients presenting with median nerve injury who had suffered from mild carpal tunnel syndrome for over 3 months were included in this study. Under ultrasound guidance, 1–2 mL of platelet-rich plasma was injected into the region around the median nerve at the proximal edge of the carpal tunnel. At 1 month after single injection of platelet-rich plasma, Visual Analogue Scale results showed that pain almost disappeared in eight patients and it was obviously alleviated in three patients. Simultaneously, the disabilities of the arm, shoulder and hand questionnaire showed that upper limb function was obviously improved. In addition, no ultrasonographic manifestation of the carpal tunnel syndrome was found in five patients during ultrasonographic measurement of the width of the median nerve. During 3-month follow-up, the pain was not greatly alleviated in three patients. These findings show very encouraging mid-term outcomes regarding use of platelet-rich plasma for the treatment of carpal tunnel syndrome.