Platelet-rich Plasma Group Research Articles

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

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

Aspirin Does Not Inhibit Platelet-Rich Plasma Releasate Efficacy in a Murine Model of Rotator Cuff Tendinopathy

Background: Platelet-rich plasma (PRP) has been shown to be a promising treatment for subacromial impingement, and although its interaction with aspirin (ASA) is controversial, many providers ask patients to stop non–steroidal anti-inflammatory drug use before PRP administration. Purpose: This studied aimed to identify the effect of PRP in a murine model of subacromial impingement and to explore the effect of ASA on PRP treatment. Methods: A murine model of subacromial impingement was used, incorporating 48 wild-type C57BL/6 mice. After impingement surgery, mice received either human PRP activated via calcium chloride or saline injected into the subacromial space. The mice received either drinking water with ASA or standard drinking water, creating 4 groups: saline injection, saline injection + ASA, PRP injection, and PRP injection + ASA. All injections occurred at 3 weeks after impingement surgery, and mice were evaluated at 6 weeks. Each mouse underwent gait analysis, biomechanical analysis (N = 10 shoulders), histological analysis (N = 6), and gene expression analysis (N = 8). Results: Biomechanical testing showed increased load to failure in the PRP group compared to the ASA group, and increased stiffness in PRP vs saline, PRP vs ASA, and PRP vs ASA + PRP. Gene expression analysis identified 17 downregulated genes between the ASA + PRP and saline groups. Eight of these differentially expressed genes contribute to collagen biosynthesis and modification, 4 to extracellular matrix (ECM) synthesis, and 4 to ECM degradation. Conclusions: In this preliminary analysis, PRP injections in a murine model of subacromial impingement demonstrated mixed effects on tendon quality and pain, and ASA did not have a consistent effect on the response to PRP.

Relationship of Body Mass Index on Patient-Reported Outcomes After Platelet-Rich Plasma Versus Microfragmented Adipose Tissue for Knee Osteoarthritis: A Secondary Analysis of a Randomized Controlled Trial.

Body mass index is known to contribute to outcomes for patients with knee osteoarthritis. Furthermore, body mass index influences the protein expression of orthobiologic treatments like platelet-rich plasma and microfragmented adipose tissue. We performed a secondary analysis of the association of body mass index with patient-reported outcomes for patients with knee osteoarthritis who received either platelet-rich plasma or microfragmented adipose tissue injections. Seventy-one patients with knee osteoarthritis were randomized to receive a single ultrasound-guided injection of platelet-rich plasma or microfragmented adipose tissue. Platelet-rich plasma was created from 180 cc of anticoagulated blood and processed using a double-spin, buffy-coat concentration system. Microfragmented adipose tissue was created using autologous lipoaspirate that was processed according to minimal manipulation guidelines. Patient-reported outcomes and osteoarthritis outcome scores (Knee Osteoarthritis and injury Outcome Score) were tracked for 12 mos. Forty-nine patients (platelet-rich plasma = 23, microfragmented adipose tissue = 26) completed 12-mo follow-up. Knee Osteoarthritis and injury Outcome Score quality of life and activity of daily living subscores were inversely correlated (both P < 0.05) with body mass index in the microfragmented adipose tissue but not platelet-rich plasmagroup. Knee Osteoarthritis and injury Outcome Score pain and sport subscores showed a trend toward inverse correlation with body mass index in the microfragmented adipose tissue group ( P = 0.07 and P = 0.06, respectively), but not platelet-rich plasma. Body mass index was negatively associated with patient-reported outcomes in patients who received microfragmented adipose tissue injections for knee osteoarthritis, but not for patients receiving platelet-rich plasma.

Effects of submucoperichondrial application of platelet-rich plasma on nasal mucosal healing after septoplasty

Objective(s)Our aim is to investigate the effects of the submucoperichondrial application of Platelet Rich Plasma (PRP) on nasal mucosal healing after septoplasty surgery. Method(s)This prospective randomized observational study was conducted between July 2019 and February 2021, with 40 patients aged 18–60 years who underwent closed the only septoplasty operation for similar septal deviations. Patient divided into two group; 21 patients were placed in PRP group to which PRP was applied on all mucosal surface and submucoperichondrial area of septum and 19 patients were placed in control group to which saline solution was applied on same regions. Nasal obstruction score, mucociliary clearance time, presence of nasal crusting, and bleeding time were evaluated on 5th, 10th, 15th day after surgery and compared between groups. ResultsIntranasal crusting on day 10 was found to be lower in the PRP group (n:13 68.4 %) than control group (n:7 33.3 %) with a statistically significant difference (p = 0.028). The nasal obstruction score on day 10 and 15 were found to be lower in the PRP group (3,33 ± 2,75, 2,07 ± 2,20) (than the control group (5,44 ± 2,26, 3,37 ± 1,92) with a statistically significant difference (p = 0,003,p = 0,009). The mucociliary clearance rate was found to be higher and the bleeding time was found to be lower in the PRP group, but a statistically significant difference was not observed. ConclusionsApplication of submucoperichondrial PRP could have beneficial effects on nasal mucosal repair, nasal crusting, and congestion after septoplasty surgery.

Effect of Platelet-Rich Plasma Dosing for Healing after Arthroscopic Cuff Repair Compared with Surgery Alone: A Systematic Review and Meta-Analysis.

Platelet-rich plasma (PRP) has been used for arthroscopic rotator cuff repairs (aRCR), but no studies have addressed the impact of platelet concentration. The primary aim was to evaluate whether the PRP cell concentration has an effect on tendon healing after aRCR compared with surgery alone. The secondary aim was to assess the functional and pain outcomes. A systematic review was performed with searches in the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane (Central) databases according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Metanalytic procedures were performed for randomized controlled trials (RCTs), and a subgroup analysis was used for studies with target (approximately 10 6 cells·μL -1 ) or below-target PRP cellular concentrations (app. 5 × 10 5 cells·μL -1 ) regarding the primary outcome of tendon healing. This review included 10 studies (8 RCTs) with 342 patients in the aRCR + PRP group and 344 patients with isolated aRCR. The risk of bias was low to intermediate (6/4, respectively). Meta-analysis of the RCT revealed that the aRCR + high-concentration PRP group had an approximately 3.9-fold higher chance of healing than the non-PRP group (odds ratio, 3.89; 95% confidence interval, 1.78-8.44; P = 0.0007). No significant difference in healing was found between the aRCR + low-concentration PRP and non-PRP groups (odds ratio, 2.21; 95% confidence interval, 0.66-7.45; P = 0.2). The Constant-Murley score and University of California Los Angeles scores were significantly improved in the aRCR + PRP groups with more than 12 months of follow-up, and no significant differences were found consistently for the American Shoulder and Elbow Society and visual analog scale scores. This study highlights that a PRP cell concentration close to the target (10 6 cells·μL -1 ) of patients with aRCR may improve their healing and functional outcomes and that dosing may be potentially useful in therapy.

Efficacy and safety of platelet-rich plasma for acute nonarteritic anterior ischemic optic neuropathy: a prospective cohort study.

As the most common acute optic neuropathy in older patients, nonarteritic anterior ischemic optic neuropathy (NAION) presents with varying degrees of visual acuity loss and visual field defect. However, there is no generally accepted treatment for NAION. To evaluate the efficacy and safety of platelet-rich plasma (PRP) for patients with acute NAION within 2 months. A prospective, nonrandomized controlled trial. Twenty-five eyes of 25 patients were enrolled. Of them, 13 received anisodine hydrobromide and butylphthalide-sodium chloride injection continuously for 10 days as basic treatment in the control group, and 12 received two tenon capsule injections of PRP on a 10 days interval as an additional treatment in the PRP group. We compared the best-corrected visual acuity (BCVA) and capillary perfusion density (CPD) of radial peripapillary capillaries and the moth-eaten eara of the peripapillary superficial capillary plexus and deep capillary plexus at 1 day (D1) before the first PRP treatment and 7 days (D7), 14 days (D14), and 30 days (D30) after the first PRP injection. Ocular and systemic adverse effects were assessed. In the PRP group, a better BCVA occurred at D30 (adjusted p = 0.005, compared with D1, recovered from 0.67 ± 0.59 to 0.43 ± 0.59), and a significant improvement in CPD was observed at D30 (adjusted p < 0.001, p = 0.027, p = 0.027, compared with D1, D7, D14, in sequence, the value was 35.97 ± 4.65, 38.73 ± 4.61, 39.05 ± 5.26, 42.71 ± 4.72, respectively). CPD at D7 in the PRP group was better than that in the control group (p = 0.043). However, neither BCVA nor the moth-eaten area index were significantly different (all p > 0.5) between the two groups. The main adverse effect was local discomfort resolved within 1 week, and no other systemic adverse events occurred. Tenon capsule injection of PRP was a safe treatment for AION and could improve capillary perfusion of the optic nerve head and might be helpful in increasing short-term vision in patients with acute NAION.

(028) Intracavernosal Injection of Platelet-Rich Plasma for the Treatment of Erectile Dysfunction: A Meta-Analysis of Randomized Placebo-Controlled Trials

Abstract Introduction Erectile dysfunction (ED) affects 3 to 76.5% of men globally. Appropriate treatments for ED patients are vital to ensure their quality of life. However, the present conservative ED treatments cannot reverse the underlying pathology and often lead to discontinuation due to the lack of efficacy. Regenerative therapies, including platelet-rich plasma (PRP), have been gaining increasing interest for the last few years. Preclinical studies suggest that growth factors in PRP may be beneficial in ED. With the increasing evidence of PRP, a meta-analysis has yet to be conducted to determine its efficacy and safety compared to a placebo. Objective To systematically evaluate PRP's efficacy and safety for treating ED based on randomized placebo-controlled trials (RCTs) results. Methods A comprehensive search on PubMed, Scopus, and EMBASE databases was conducted on June 2023 to find relevant articles following Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. RCTs in English evaluating PRP's efficacy and safety in treating ED were included. The primary outcomes were the International Index of Erectile Function-Erectile Function (IIEF-EF) score at 1-, 3-, and 6-months post-treatment. The secondary analysis includes the proportion of patients who met the minimal clinically important difference (MCID) of IIEF-EF score, IIEF score for sexual satisfaction and overall satisfaction, peak systolic velocity (PSV) in the cavernousal artery, and the complication rate after treatment. Quality of included studies was assessed using JADAD Score and Cochrane RoB2 tools. Meta-analysis with a random or fixed effects model based on the heterogeneity was performed using Revman 5.4. Results From 183 articles in initial research, three RCTs with low risk of bias were reviewed. We included 103 patients in the PRP group and 106 in the placebo group. The baseline of the evaluated score from both groups was comparable despite variable PRP protocol being used. The pooled analysis showed that PRP is associated with higher IIEF-EF scores at 1, 3, and 6 months follow up compared to placebo with a mean difference (MD) of 2.85 (95% CI, 1.68 – 4.03, p: &amp;lt;0.00001), 2.81 (95% CI, 1.57 – 4.05, p: &amp;lt;0.00001), 3.11 (95% CI, 1.96 – 4.27, p: &amp;lt;0.00001). Similarly, the proportion of patients who met MCID and PSV at follow-up also favoured the PRP group. On contrary, the IIEF score for sexual satisfaction and overall satisfaction domain, as well as VAS score post-injection were comparable between groups. No significant adverse event was reported in any study during follow-up. Conclusions The present meta-analysis suggests that PRP is effective and tolerable as a restorative therapy for managing ED patients compared to a placebo. Nevertheless, additional RCTs with more robust data from larger sample sizes and longer-term follow-ups are required to corroborate the findings. Disclosure No.

Revolutionizing Back Pain Management: Is Epidural Platelet-Rich Plasma the Superior Choice Over Steroids?

Background and objective Low back discomfort is one of the main factors that restrict physical activity, and it is becoming more and more common. Surgery is the best option when all other conservative treatment methods have failed, but it is not a panacea. While local anesthetic-free and combined epidural steroid injections have been used for many years, their usefulness is limited to shorter periods. In the field of orthopedics, platelet-rich plasma (PRP) has gained widespread recognition as an adjuvant component. PRPhas been applied to improve tissue repair, both soft and hard.This comparative study aimed to evaluate the potential of PRP as atherapy for low back pain (LBP). Methods We included 64 adult individuals with complaints ofLBP. They were classified into two groups: group A underwent a single injection in the afflicted lumbar intervertebral disc (IVD) level with 1.5 ml of methylprednisolone, 1.5 ml 2% lidocaine, and 0.5 ml of saline under rigorous aseptic precautions; in contrast, group B was administered a single injection of 3 milliliters of autologous PRP. Patients' scores on the visual analog scale (VAS), the Modified Oswestry Disability Questionnaire (MODQ), and the Straight Leg Raising Test (SLRT) were assessed before and during therapy. Results The datagathered were subjected to statistical analysis. Statistically significant differences were found in the VAS scores between group A (methylprednisolone group) and group B (PRP group) post-one hour (6.0 ±0.74 vs. 6.92 ±0.57) and after three months (5.2 ±0.65 vs. 3.26 ±0.79). Conclusions Our study revealed gradual progressive improvement in the symptoms of patients in the PRP group as indicated by scores onSLRT, VAS, and MODQ. The results were comparable to those who received methylprednisolone injections. There was a statistically significant difference in VAS scores between the two groups, with the PRP group reporting a higher degree of pain reduction, showing that PRP is an effective alternative to epidural steroid infiltration in managing chronic LBP.

Microfragmented Adipose Tissue Is Equivalent to Platelet-Rich Plasma for Knee Osteoarthritis at 12 Months Posttreatment: A Randomized Controlled Trial.

Platelet-rich plasma (PRP) is an effective treatment for knee osteoarthritis (OA). Microfragmented adipose tissue (MFAT) is another orthobiologic that holds promise, but data supporting its use are limited. Previous studies showed that MFAT created using the Lipogems device was equivalent to PRP created via noncommercial laboratory-based processes. To perform a comparison of commercially available MFAT and PRP systems for treatment of knee OA. Randomized controlled trial; Level of evidence, 2. A total of 71 patients with symptomatic knee OA (Kellgren-Lawrence grades 1-4) were randomized to receive a single injection of either leukocyte-rich PRP (Angel; Arthrex) or MFAT (Lipogems) under ultrasound guidance. Patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], visual analog scale for pain with activities of daily living [VAS pain], and Tegner activity level) were recorded at baseline and at 1, 3, 6, and 12 months after injection. The primary outcome was the KOOS-Pain subscale score at 12 months after injection. Overall, 49 patients completed their 12-month follow-up (PRP group, n = 23; MFAT group, n = 26). All demographic features were similar between groups, except that more men were randomized to the PRP group and more women to the MFAT group. At 12 months posttreatment, KOOS-Pain scores improved in both groups, with no significant group difference (PRP, 78 ± 17.9 vs MFAT, 77.8 ± 19.3; P = .69). Similarly, other KOOS subscales, VAS pain scores, and Tegner scores improved at 12 months, with no differences between treatment groups. Both PRP and MFAT injections for knee OA resulted in improved patient-reported outcomes at 12 months posttreatment, with no differences found between treatments. NCT04351087 (ClinicalTrials.gov identifier).

A comparison of intra-articular hyaluronic acid and platelet-rich plasma for knee osteoarthritis: a systematic review.

Knee osteoarthritis (KOA), the most common chronic degenerative condition in an older population, accounts for many disabilities around the world. One of the most popular treatments is intra-articular injection of hyaluronic acid (HA) and platelet-rich plasma (PRP). Prior studies have found that both HA and PRP had a therapeutic effect on KOA. This study aims to perform a systematic review regarding whether PRP is superior to HA for KOA. We conducted a comprehensive literature search using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines for prospective randomized control trials (pRCTs) in three international databases PubMed, Google Scholar, and ScienceDirect from 2019-2022. Two researchers independently searched the reviews, extracted, and cross-checked the data. The disparity when choosing the literature was resolved by discussion. The modified Jadad was scale used to assess the quality of the included studies. Cochrane risk of bias 2 tool (RoB-2) was used for determininzg risk of bias. Twenty three studies were eligible for inclusion. Four pRCT with the highest Jadad score were selected as best evidence. Risk of bias assesment concluded two studies having a low risk of bias, one is high risk of bias, and the other possesses some concerns.. Three studies found no difference in patient-reported outcomes between PRP and HA group and one study concluded that PRP is more effective than HA in treating KOA. Intra-articular injections of PRP and HA are effective interventions for KOA. However, there is not enough evidence of PRP superiority over HA.

Lumbar Transforaminal Injection of Steroids versus Platelet-Rich Plasma for Prolapse Lumbar Intervertebral Disc with Radiculopathy: A Randomized Double-Blind Controlled Pilot Study.

Double-blind randomized controlled pilot study. The purpose of this study was to compare outcomes of steroids with autologous platelet-rich plasma (PRP) administered by lumbar transforaminal injection (LTI) in patients with lumbar radiculopathy. Degenerative disc disease of the lumbar spine is one of the most common conditions managed by spine surgeons in routine practice. Once conservative management fails, LTI is diagnostic and often therapeutic. Steroids are the gold standard drug used for LTI but have limitations and side effects. In this single-center double-blind randomized controlled pilot study, 46 patients were recruited and randomized by the lottery method. The Visual Analog Scale (VAS) for leg pain, modified Oswestry Disability Index (mODI), and Short-Form 12 (SF-12) were assessed at 1 week, 3 weeks, 6 weeks, 6 months, and 1 year. Both groups were comparable in terms of demographics, preprocedure VAS scores, mODI, and SF-12 scores (p=0.52). At the 1-week follow-up, the steroid group had significantly better improvement than the PRP group (p=0.0001). At the 3-week follow-up, both groups showed comparable outcomes; however, the PRP group had better symptom improvement. At 6 weeks and 6 months, the PRP group had better outcomes (VAS, p<0.0001; ODI, p=0.02; SF-12, p=0.002). Moreover, 17 and 16 patients in the steroid and PRP groups underwent repeat LTI with steroids or surgery because of pain recurrence during follow-up. At 1 year, no difference in outcomes was observed. PRP may be a useful alternative to steroids for LTI in lumbar radiculopathy. Although improvement was delayed and 1-year outcomes were comparable, the 6-week and 6-month outcomes were better with PRP than with LTI. Multiple PRP injections may be beneficial because of its autologous nature. However, further studies with a larger number of participants, longer follow-up, and repeat LTIs are warranted to draw definite conclusions.

Effect of platelet rich plasma versus melatonin on testicular injury induced by Busulfan in adult albino rats: a histological and immunohistochemical study

ABSTRACT This study was done to estimate the testicular histological alterations induced by Busulfan (BUS) and compare the possible protective effects of melatonin (MT) and platelet rich plasma (PRP) in a rat model. Sixty-four male rats were dispersed into: control group, BUS group, melatonin group, and PRP group. Blood samples were processed for biochemical analysis. Tissue specimens were managed for light and electron microscopic studies. Immunohistochemical expression of vimentin and proliferating cell nuclear antigen (PCNA) was performed. Busulfan induced severe testicular damage in all studied methodologies. It showed a statistically significant decrease in serum testosterone and elevation of MDA when compared to the control group. Abnormal testicular cytostructures suggesting defective spermatogenesis were observed: distorted seminiferous tubules, deformed spermatogenic cells, low germinal epithelium height, few mature spermatozoa, and also deformed barrier. Vimentin and PCNA expressions were reduced. Ultrastructurally, Sertoli cells and the blood testis barrier were deformed, spermatogenic cells were affected, and mature spermatozoa were few and showed abnormal structure. Both melatonin and PRP induced improvement in all the previous parameters and restoration of spermatogenesis as confirmed by improvement of Johnsen’s score from 2.6 ± .74 to 7.6 ± .92. In conclusion, melatonin and PRP have equal potential to ameliorate the testicular toxicity of BUS. Melatonin can provide a better noninvasive way to combat BUS induced testicular injury.

Effects of Leukocyte-rich platelet-rich plasma and Leukocyte-poor platelet-rich plasma on cartilage in a rabbit osteoarthritis model.

Osteoarthritis is a prevalent chronic disease. One of its primary pathological processes involves the degeneration of articular cartilage. Platelet-rich plasma (PRP) contains cytokines and growth factors that can stimulate the repair and regeneration of articular cartilage tissues. PRP may also slow the progression of osteoarthritis. The purpose of this experiment is to compare the efficacy of Leukocyte poor (LP) - PRP and Leukocyte rich (LR) - PRP in treating rabbit osteoarthritis and to investigate their mechanisms of action. Analyzing the impact of leukocytes on PRP therapeutic effectiveness will provide a valuable clinical reference for the choice of which PRP is better for the treatment of osteoarthritis. A rabbit osteoarthritis model was established by injecting papain into the knee joint cavity, and LP-PRP and LR-PRP were prepared through different centrifugation methods for injection into the knee joint cavity. Eight weeks after injection, rabbit knee cartilage specimens were observed for gross changes, HE staining, senna O-solid green staining, and immunohistochemistry of type II collagen and were quantitatively compared using Pelletier's score, Mankin's pathology score, and ImageJ image processing software. Injection of papain into the knee joint cavity successfully established a rabbit model of osteoarthritis. All three evaluation indexes differed significantly from those of the blank group (P<0.05). LP-PRP and LR-PRP exhibited therapeutic effects when compared with the model group. The two PRP groups had similar gross tissue appearance and pathology (P>0.05). The LR-PRP group had higher collagen type-II expression (P < 0.05) than the LP-PRP group. Both LP-PRP and LR-PRP proved therapeutic for the rabbit papain osteoarthritis model. The difference in leukocyte content between the two groups did not yield different cartilage morphology or other factors by 8 weeks posttreatment. LR-PRP displayed the ability to release more factors relevant to the metabolism of type II collagen than LP-PRP, enabling the preservation of into cartilage collagen content of type II collagen and delaying osteoarthritis progression.

Platelet-Rich Plasma vs Extracorporeal Shock Wave Therapy in the Treatment of Plantar Fasciitis at 3-6 Months: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Plantar fasciitis (PF) is a common foot disorder with variability in treatment strategy. Two effective management techniques include platelet-rich plasma (PRP) injections and extracorporeal shock wave therapy (ESWT). The purpose of this meta-analysis is to compare the effectiveness of PRP vs ESWT in the management of PF. A systematic search was performed of PubMed, Cochrane, and Google Scholar for randomized controlled trials comparing PRP to ESWT. Studies met inclusion criteria if mean and SDs for visual analog scale (VAS) pain scores and plantar fascia thickness (PFT) were reported. Mean differences were used to compare VAS pain score and PFT between PRP and ESWT. Six randomized controlled trials, comparing a total of 214 subjects in the PRP group and 218 subjects in the ESWT group, were analyzed. A significantly greater statistical improvement was seen in the PRP group in VAS pain (mean difference = -0.67 [95% CI -1.16, -0.18], P = .007) and plantar fascia thickness (PFT) (mean difference = -0.56 [95% CI -0.77, -0.35], P < .001). PRP had a statistically higher pain reduction than ESWT, but the difference does not reach clinical significance in this meta-analysis.

Platelet-rich Plasma Superiority over Hyaluronic Acid as a Conservative Treatment for Early Knee Osteoarthritis: A Systematic Review

AIM:This study aimed to perform a systematic review (SR) of SR to elucidate prior findings regarding favorable outcomes between platelet-rich plasma (PRP) and hyaluronic acid (HA) injections for early knee osteoarthritis (KOA). MATERIALS AND METHODS: We conducted a thorough literature search adhering to the Preferred Reporting Items for SR and Meta-analyses only for SRs from PubMed, ScienceDirect, and Google Scholar from 2020 to 2023. The inclusion and exclusion criteria were determined using the population, intervention, comparison, outcome, and study design model. A measurement tool to assess SR-2 was used to grade the included SRs. Two researchers independently searched, extracted, and assessed the risk of bias in the included studies. Cohen’s kappa coefficient was used to calculate the inter-observer disparities in study eligibility and risk of bias. The corrected covered area (CCA) metric addressed the overlap issue with the original studies. RESULTS: One SR yielded high methodological quality whereas three SRs yielded moderate methodological quality. The overall CCA among the four SRs was 30.77%, and all SRs used the Western Ontario and McMaster Universities Osteoarthritis Index score as a patient-reported outcome (PRO) and revealed that the PRP group improved more than the HA group. One SR used the Tegner score as a PRO and found no distinction between the PRP and HA groups. The incidence of substantial pain was lower in the PRP group than in the HA group. One SR reported considerably lower local pain post-injection in the HA groups. Overall, three SRs showed that PRP yielded better outcomes than the HA, and one showed that PRP showed advantages over HA injections for knee pain at 6 and 12 months; however, the clinical outcomes were not different. CONCLUSION: Our findings supported the superiority of PRP over HA as a long-term alternative therapy for early-stage KOA.

Intrauterine autologous platelet-rich plasma treatment in women with at least two implantation failures: A retrospective cohort study.

Finding the most effective way to improve implantation rate in women who are receiving assisted reproductive technology treatment is still a challenge. This study aimed to assess the pregnancy outcomes of intrauterine platelet-rich plasma (PRP) therapy in women with a history of at least 2 implantation failures. In this retrospective cohort study, data of 852 women who were candidates for frozen-thawed embryo transfer was extracted from their medical records from April 2017 to September 2021 at Yazd Reproductive Sciences Institute, Yazd, Iran. Of these, 432 received intrauterine PRP treatment 48 hr before transfer (PRP group), and the results of the pregnancy outcomes compared with 420 of the control group who did not receive the treatment before transfer. Pregnancy outcomes, including chemical, clinical, ongoing pregnancy, and live birth rate were statistically significant in the PRP group (p 0.001). However, when categorized according to the implantation history, this significant improvement in all 4 was only seen in women with at least 2 prior implantation failures. In women with a history of only one implantation failure, PRP therapy significantly improved the ongoing pregnancy and live birth rate (19.5%, p = 0.04). Also, in women who received donor eggs and had repeated implantation failure, PRP improved pregnancy outcomes clinically but not statistically (p = 0.15). PRP seems to be effective in improving the pregnancy rate in women with a history of 2 or more implantation failures and also shows an increase in the live birth rate in women with only one implantation failure.

Mesenchymal stem cells in PRP and PRF containing poly(3-caprolactone)/gelatin Scaffold: a comparative in-vitro study.

Scaffold design is one of the three most essential parts of tissue engineering. Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) have been used in clinics and regenerative medicine for years. However, the temporal release of their growth factors limits their efficacy in tissue engineering. In the present study, we planned to synthesize nanofibrous scaffolds with the incorporation of PRP and PRF by electrospinning method to evaluate the effect of the release of PRP and PRF growth factors on osteogenic gene expression, calcification, proliferation, and cell adhesion of human bone marrow mesenchymal stem cell (h-BMSC) as they are part of scaffold structures. Therefore, we combined PRP/PRF, derived from the centrifugation of whole blood, with gelatin and Polycaprolactone (PCL) and produced nanofibrous electrospun PCL/Gel/PRP and PCL/Gel/PRF scaffolds. Three groups of scaffolds were fabricated, and h-BMSCs were seeded on them: (1) PCL/Gel; (2) PCL/Gel/PRP; (3) PCL/Gel/PRF. MTS assay was performed to assess cell proliferation and adhesion, and alizarin red staining confirmed the formation of bone minerals during the experiment. The result indicated that PCL/Gel did not have any better outcomes than the PRP and PRF group in any study variants after the first day of the experiment. PCL/gelatin/PRF was more successful regarding cell proliferation and adhesion. Although PCL/gelatin/PRP showed more promising results on the last day of the experiment in mineralization and osteogenic gene expression, except RUNX2, in which the difference with PCL/gelatin/PRF group was not significant.

An animal study on the effectiveness of platelet-rich plasma as a direct pulp capping agent

Direct pulp capping (DPC) is a conservative approach for preserving tooth vitality without requiring more invasive procedures by enhancing pulp healing and mineralized tissue barrier formation. We investigated the effectiveness of Platelet Rich Plasma (PRP) vs. Mineral Trioxide Aggregate (MTA) as a DPC agent. Forty-two teeth from three mongrel dogs were divided into two equal groups. After three months, the animals were sacrificed to evaluate teeth radiographically using cone-beam computerized tomography, histopathologically, and real-time PCR for dentin sialophosphoprotein (DSPP), matrix extracellular phosphoglycoprotein (MEPE), and nestin (NES) mRNA expression. Radiographically, hard tissue formation was evident in both groups without significant differences (p = 0.440). Histopathologic findings confirmed the dentin bridge formation in both groups; however, such mineralized tissues were homogenous without cellular inclusions in the PRP group, while was osteodentin type in the MTA group. There was no significant difference in dentin bridge thickness between the PRP-capped and MTA-capped teeth (p = 0.732). The PRP group had significantly higher DSPP, MEPE, and NES mRNA gene expression than the MTA group (p < 0.05). In conclusion, PRP enables mineralized tissue formation following DPC similar to MTA, and could generate better cellular dentinogenic responses and restore dentin with homogenous architecture than MTA, making PRP a promising alternative DPC agent.

Comparison of fluoroscopy guided inter-laminar epidural platelet-rich plasma versus steroid injection in patients with lumbar radicular pain

Background: Radicular back pain is one of the prevalent causes for low back pain. Objective: The aim of work is to compare the efficacies of fluoroscopic guided inter-laminar epidural injection of platelet-rich plasma (PRP) and epidural steroids in improving lumbar radicular pain. Settings and Design: This study was a prospective randomized controlled clinical trial. Methods: Forty-eight patients were enrolled in this study and divided into two groups. Steroid group (S); A 24 patient, that received fluoroscopic guided inter-laminar epidural injection of 1ml methylprednisolone (40mg/ml) + 4 ml normal saline and platelet rich Plasma group (p); A 24 patients, that received fluoroscopic guided inter-laminar epidural injection of 4.5 ml PRP + 0.5 ml PRP activator (calcium gluconate). Patients were followed up at one week, 4 weeks, and 3 months after the procedure. Results: No differences between study groups as regard pain scores at pretreatment, after 1 and 4 weeks and 3 months of treatment and disability scores at pretreatment, after 4 weeks and 3 months of treatment.

The impact of submucosal PRP injection on wound healing after endoscopic sinus surgery: a randomized clinical trial

PurposeChronic rhinosinusitis (CRS) is a prevalent chronic disease observed on a global scale. The utilization of endoscopic sinus surgery (ESS) has gained significant recognition as an effective intervention for individuals with CRS and nasal polyps who have not responded to conventional treatments. The need (or not) for revision surgery frequently relies on the promotion of optimal wound healing. The impact of platelet-rich plasma (PRP) on tissue healing has been extensively examined in various surgical fields.MethodsThe present prospective study involved 30 patients suffering with nasal polyposis who underwent endoscopic sinus surgery. 15 patients were assigned to the PRP group, and 15 patients to the control group. The clinical follow-up of the patients took place at specific intervals, at weeks 1, 2, 3, 4, 8, and 12 after the surgical procedure. The evaluator identified the existence of adhesions, crusting, bleeding, granulation and infection using a visual analogue scale score. The patients also completed the SNOT 22 questionnaire prior to surgery and at each postoperative visit.ResultsThe present study observed a lower incidence of adhesion, infection, hemorrhage and granulation in the PRP group. Furthermore, a statistically significant difference was detected between the groups.ConclusionBased on the findings of the present investigation, it seems that platelet-rich plasma (PRP) is beneficial on wound healing during the early stages following the surgical procedure. The technique is characterized by its limited invasiveness, which contributes to its low risk profile and the achievement of clinically good outcomes.