Platelet-rich Plasma In Management Research Articles

Role of platelet rich plasma in management of early knee osteoarthritis pain: A retrospective observational study

IntroductionKnee joint osteoarthritis is a well-known cause of pain and disability in patients above 40 years of age. It is treated by use of non-steroidal inflammatory drugs, corticosteroids, glucosamine, chondroitin sulfate, physiotherapy with limited success. The platelet rich plasma (PRP) contains a large amount of platelet derived growth factors, cytokines and anti-inflammatory molecules which showed promising results in recent studies to relieve pain of knee joint osteoarthritis. The present study aims to determine the efficacy of intraarticular PRP for pain relief and functional improvement in patients with early knee joint osteoarthritis. MethodsIt is a retrospective observation study involving patients who underwent single intraarticular administration of PRP for knee pain with Kellgren-Lawrence (KL) grades I or II knee joint osteoarthritis. The Visual analogue scale (VAS) score and Oxford knee score (OKS) were recorded pre-procedure and at 1- and 6-month post-procedure. ResultsA total of 31 patients (20 females, 11 males) underwent PRP therapy for knee pain (16 kL grade I, 15 kL grade II). The mean age and duration of symptoms were of 53.9 years (range: 79–42 years) and 5.53 ± 2.35 years respectively. There was a significant reduction (p < 0.05) in VAS scores from pre-procedure (68.06 ± 8.33) to post procedure at 1 month (37.74 ± 11.16) and 6 months (54.52 ± 11.78). There was also significant improvement (p < 0.05) in OKS score from pre-procedure (31.1 ± 3.47) to post-procedure at 1 month (39.06 ± 3.37) and 6 months (34.10 ± 3.75). No adverse effects were reported in patients during the study period. ConclusionThis small retrospective study suggests that a single administration of intraarticular PRP may be safe and effective for pain relief and functional improvement for up to 6 months in patients of early-stage osteoarthritis.

Role of Autologous Platelet Rich Plasma in Management of Chronic Wounds

Role of Autologous Platelet Rich Plasma in Management of Chronic Wounds

Update on the Use of Platelet-Rich Plasma Injections in the Management of Musculoskeletal Injuries: A Systematic Review of Studies From 2014 to 2021.

There has been expanding use of platelet-rich plasma (PRP) in the management of musculoskeletal soft tissue injuries. To determine if there are any recent studies that show any clear benefits regarding the use of PRP in the management of soft tissue injuries. Systematic review. This review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The EMBASE, MEDLINE, PubMed, and Cochrane Bone, Joint and Muscle Group Specialised Register databases were queried for randomized controlled trials comparing PRP with a non-PRP/placebo in participants >18 years of age with musculoskeletal soft tissue injuries. Exclusion criteria were non-soft tissue injuries and research published in journals with an impact factor <3.5. The main outcome measure analyzed across all injury types was the effect of PRP injections on pain and function. Of the 853 studies initially screened, 32 were included in this review. There were 13 studies that investigated the effects of PRP on the management of rotator cuff injuries; 7 studies that investigated PRP in conjunction with arthroscopy found no significant difference between PRP groups and controls, while 5 of 6 studies that investigated nonsurgical management showed positive results for PRP. Eight studies investigated various tendinopathies; of these, 2 studies demonstrated positive results for PRP in Achilles and gluteal tendinopathy management. Six studies examined PRP in acute soft tissue injuries, with 2 of these reporting significant improvements in recovery time for hamstring injuries and 1 study showing positive results for ankle ligament injuries. Two studies looked at acute rupture of soft tissues and found no benefit to PRP use. Two studies investigated PRP injections for chronic plantar fasciitis, and both reported positive results in pain and function with PRP. Finally, 1 study evaluated the effects of PRP on meniscal injuries and reported significant improvement in the healing rate and a decreased need for surgical repair. Currently, there is no research strongly advocating the use of PRP compared with traditional management strategies (rest, ice, corticosteroid injection, rehabilitation program). No long-term physiological benefits were reported to justify the invasive and costly technique of obtaining, producing, and implementing PRP.

FUNCTIONAL OUTCOME OF TENNIS ELBOW (LATERAL EPICONDYLITIS) TREATED BY LOCAL INJECTION OF PLATELET RICH PLASMA

Objective: The aim of the study was to evaluate the efficacy of local injection of platelet rich plasma in management of patients with tennis elbow who failed to respond to conservative management. Methods: This was a prospective and cohort study in which 80 patients with lateral epicondylitis (Tennis elbow) were included on the basis of a predefined inclusion and exclusion criteria. Demographic details were noted. Patients were treated by local injection of autologous platelet rich plasma. Patients were followed up for 6 months. Relief of pain as well as functional improvement was assessed by patient-rated tennis elbow evaluation (PRTEE) score. SSPS 21.0 software was used for statistical analysis and p&lt;0.05 was taken as statistically significant. Results: Out of 80 studied cases, there were 36 (45%) males and 44 (55%) females with a M: F ratio of 1:1.22. The mean age of male (42.77±9.95 years) as well as female (41.06±9.56 years) was found to be comparable. Nineteen (23.75%) patients were involved in plumbing, 16 (20%) patients were involved in activities that required forceful use of screwdrivers such as electric work, 8 (10%) patients were involved in gardening, and 7 (8.75%) patients were involved in production or laying of bricks. Twelve (15%) patients were professional tennis player. The mean PRTEE score was 74.24±9.74 at the time of presentation. There was significant reduction in PRTEE score during follow-up and at the time of last follow-up visit, PRTEE score was found to be 8.32±2.56. Conclusion: Local injection of autologous platelet rich plasma is effective in managing patients of lateral epicondylitis (Tennis elbow) who fail to respond to conservative management.

Platelet-rich Plasma in the Management of Shoulder Disorders: Basic Science and Implications Beyond the Rotator Cuff.

Platelet-rich plasma (PRP) is an autologous mixture produced by centrifugal separation of whole blood. Understanding the clinical efficacy of PRP remains a challenge in the field of sports medicine, including the treatment of various shoulder conditions. Animal studies have examined the biologic actions of PRP on the rotator cuff tendon and shoulder capsule. Human studies have reported the outcomes of PRP in the management of subacromial impingement syndrome, rotator cuff tears, frozen shoulder, and glenohumeral osteoarthritis. These studies highlight the role of PRP in the nonsurgical management of these conditions and its utilization in the perioperative setting to augment tissue healing and optimize the surgical outcomes. The role of PRP as an adjunct therapy in patients undergoing rotator cuff repair has been in the spotlight during the last decade; however, a limited number of studies have examined the role of PRP in the management of non-rotator cuff shoulder conditions. This article aims to provide an overview of the biologic actions of PRP on shoulder tissues and to summarize the outcomes of PRP injection in patients with rotator cuff and non-rotator cuff disease of the shoulder. We sought to organize the existing literature and to provide recommendations on the use of PRP in various shoulder conditions, based on the existing evidence.

The use of platelet-rich plasma in management of musculoskeletal pain: a narrative review.

Musculoskeletal pain is the most common pain reported by patients. Platelet-rich plasma (PRP) is widely used to treat musculoskeletal pain. However, the efficacy of PRP to treat this pain remains controversial. This review highlights the application of PRP in the treatment of musculoskeletal pain. PRP treatment appears to reduce pain and improve function in patients with musculoskeletal pain. However, there are limitations to the currently published studies. These limitations include the PRP preparation methods, type of activators, types of pathology to be treated, methods and times of administration, and association of PRP with other treatments.

Combined microneedling and Platelet-rich plasma in management of post-acne scars: a comparative study

Combined microneedling and Platelet-rich plasma in management of post-acne scars: a comparative study

The Use of Platelet-Rich Plasma in Management of Chronic Tendinopathies

Background: Tendinopathy is a common chronic disorder in athletes and sedentary individuals affecting almost all tendons especially wrist extensors, supraspinatus tendon and Achilles tendon. Objectives: Assessment the usefulness and efficacy of injecting platelet-rich plasma (PRP) as an alternative way of management of chronic tendinopathies not responding to medical or conservative management. Setting: Orthopedic Department, Qena university hospital, south valley university, Qena Egypt. Patients and methods: The study included 60 patients with chronic tendinopathy. 20 patients with rotator cuff tendinopathy, 20 patients with Achilles tendinopathy and 20 patients with lateral epicondylitis. Clinical and radiological assessment were done to the included patients. Follow up was done 1 week, 1 month and 3 months after injection. Results: The mean pain score was 2.1 ±.9 in patients with Achilles tendinopathy 3 months after injection (68% decrease) while mean joint score was 75.4 ±16.2 (21.5% increase). Patients with rotator cuff tendinopathy had mean pain score 4± 1.8 (31% decrease) while mean joint score was 75.7 ± 15.1 (15% increase). Patients with lateral epicondylitis had mean pain score 3.3 ±1.5 (90.9% increase) while mean joint score was 80.3 ± 13.4 (19% increase) There was statistically significant improvement in patients with Achilles and rotator cuff tendinopathies (P value 0.05). Conclusion: PRP injection is a promising method of treatment in cases of Supraspinatus and Achilles tendinopathies and to a lesser extent in cases of lateral epicondylitis.

Role of autologous platelet rich plasma in management of chronic wounds

Role of autologous platelet rich plasma in management of chronic wounds

Platelet rich plasma in management of anosmia

Background: Anosmia is a loss of sense of smell that means inability to perceive odors. Functional anosmia is loss of smell due to nasal obstruction while organic anosmia is due to damage of the peripheral olfactory area causing permanent loss of smell as post-traumatic anosmia. Objectives: A diagnostic approach to detect the effect of platelet-rich plasma (PRP) injection in the olfactory area as a treatment for anosmia. Study design and methodology: A prospective study was done in otorhinolaryngology department, Aswan university hospital from June 2018 to August 2019, 80 patients were fulfilling the inclusion criteria presented with anosmia were enrolled from otorhinolaryngology outpatient to share in this study. Approximately an amount of 1mL of PRP was injected in each nasal cavity in the olfactory area (located on superior turbinate and superior portion of lateral and medial walls of nasal cavity) guided by nasal endoscope. The procedure is done with follow-up of patients after 1 month. Results: Results of our study revealed that 46 out of 80 patients (57.5%) said that “their smell came back” while 34 out of 80 patients (42.5%) showed no improvement, thus these results show no statistical significance between proportion in a group showing improvement and proportion in the group showing no improvement. 5 patients with idiopathic anosmia improved with 100% ratio. Conclusion: Although there is no statistical significance difference between the two groups of patients all patients with idiopathic anosmia were improved.

Platelet-Rich Plasma in Management of Tendinopathy

Platelet-Rich Plasma in Management of Tendinopathy

Role of Platelet Rich Plasma in Management of Diabetic Wound in Ischemic Lower Limb (after revascularization)

Role of Platelet Rich Plasma in Management of Diabetic Wound in Ischemic Lower Limb (after revascularization)

Efficacy and outcome of platelet rich plasma in management of primary osteoarthritis Knee; A prospective study

Introduction: The present management line of osteoarthritis of knee is mostly symptomatic, therefore the need to investigate treatment modality which addresses the disease process in itself. This study was undertaken with an aim to evaluate the efficacy of platelet rich plasma in primary osteoarthritis of knee. Materials and Methods: This prospective study was done on 67 knees in 60 patients of early primary osteoarthritis of the knee. Three injections of platelet rich plasma were given at four weeks interval and the outcome was evaluated using WOMAC and VAS score at pre injection, 3 weeks, 12 weeks and 24 weeks. Ahlback’s grading was done at pre-injection and at 6 months. Results: Most of the cases in our series were in the age group of 51-60 years with female predominance (66.7%), 46 cases had grade 2 disease and the remaining had grade 1 involvement. Improvement in WOMAC score parameters started at 3 weeks with progressive improvement at subsequent follow-ups. WOMAC score parameters (pain, stiffness, physical function and total score) at pre injection were 14.31, 5.01, 36.52 and 55.75 and at 6 months follow up were 6.54, 2.03, 19.07 and 27.66 respectively. Similar improvement was seen in VAS score with pre injection score of 6.45 and final score of 3.76. The average WOMAC score was less for grade 1 as compared to grade 2 (45.52 and 60.41). Improvement was seen in 89.55% of cases though the level varied from good to mild improvement. There was no complication related to the treatment in our series. Conclusion: The initial results conclude that PRP is an effective treatment modality in early grades of primary Osteoarthritis of knee. However, further high evidence studies are required to look for the long-term effects and to confirm the findings of this study. Keywords: Platelet rich plasma, osteoarthritis, intra articular injection, PRP in knee.

Comparative study of the use of arthrocentesis and arthrocentesis in addition with platelet rich plasma in management of temporomandibular joint internal derangement

Background: Disc derangement disorders of the TMJ are a group of intra-articular biomechanical disorders in which there is an abnormal relationship in the functional ‘articular cartilaginous’ condyle-disc complex.Platelet-rich plasma (PRP) is a blood product that allows in a simple, low cost, and minimally invasive way to obtain a concentration of many growth factors when activated.Aim: To compare the use of arthrocentesis alone and arthrocentesis in addition with platelet rich plasma in management of TMJ internal derangement.Materials and Methods: fourteen patients with DDwOR were included in the study diagnosed according to The Research Diagnostic Criteria for Temporomandibular disorders (RDC/TMD) and divided into two groups as follow; seven patients underwent intra-articular injections of 2 ml PRP after arthrocentesis (study group) and the other seven patients were treated by the conventional arthrocentesis using Ringer’s solution (control group). The patients were clinically evaluated preoperatively and postoperatively at the intervals of 1 month and 6 months.Results: The differences between the two groups in all the measured parameters were statistically insignificant throughout the postoperative period.Conclusion: injection is a safe and effective method in the treatment of TMDs.

Platelet rich plasma for the treatment of osteoarthrosis knee

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; New studies focused on modern therapeutic methods which stimulate cartilage healing and repair the damage, including the use of platelet-rich plasma (PRP) as a cocktail of growth factors. This study has the purpose to present the use of PRP in management of knee osteoarthrosis and its outcomes up to 6 month follow up.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 58 patients with 100 knees (32 male, 26 female) with Kellgren Lawrence grade 1, 2,3 and 4, aged between 50 to 65 years between February 2015 to December 2015 treated with 4 ml of intra-articular PRP injections at 4 week interval in each affected knee and evaluated using WOMAC and VAS scores before injection and on follow up at end of the 1&lt;sup&gt;st&lt;/sup&gt;, 3&lt;sup&gt;rd&lt;/sup&gt;, and 6&lt;sup&gt;th&lt;/sup&gt; month.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean age was 58.29 years. Improvement in WOMAC score for KL grade 1 (32.61%), grade 2 (31.12%), grade 3(26.54%) whereas only 13.68% in KL grade 4 at end of 6month follow up. Improvement in VAS score for KL grade 1 (41.30%), grade 2 (38.02%), grade 3 (47.68) whereas only 12.74% in grade 4 at the end of 6 month follow up. Results show statistically higher significant improvement seen in WOMAC and VAS for KL grade 1, 2, and 3 as compared to grade 4 at 6 months follow up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The results of our study illustrated that the treatment with intra articular PRP injections is safe and effective in reducing pain and stiffness as well as improve knee function and quality of life in early stages of knee osteoarthrosis. &lt;/p&gt;

Clinical Evaluation of Combined Porous Hydroxyiapatite and Platelet Rich Plasma in Management of Mandibular Class II Furcation Defects

Clinical Evaluation of Combined Porous Hydroxyiapatite and Platelet Rich Plasma in Management of Mandibular Class II Furcation Defects

Platelet-Rich Plasma Attenuates 30-kDa Fibronectin Fragment–Induced Chemokine and Matrix Metalloproteinase Expression by Meniscocytes and Articular Chondrocytes

Background: Proteolytic fragments of fibronectin have catabolic effects on cartilage and menisci. Platelet-rich plasma (PRP) is increasingly being used to treat a range of joint conditions, but it is unknown whether PRP influences fibronectin fragment (FN-f) procatabolic activity. Hypotheses: The procatabolic activity of FN-f on meniscocytes and articular chondrocytes is attenuated by cotreatment with PRP. Study Design: Controlled laboratory study. Methods: Human meniscocytes were treated with FN-f (30 kDa) with or without PRP coincubation, and gene expression was analyzed by complementary DNA microarray analysis. Validation of altered expression of known and novel chemokine and protease genes was undertaken by real-time polymerase chain reaction (RT-PCR) in articular chondrocytes and meniscocytes. Chemokine release was assayed by enzyme-linked immunosorbent assay, and intracellular pathway signaling was evaluated by Western immunoblotting. Results: Microarray analysis and RT-PCR showed increased expression of matrix metalloproteinase (MMP)1, MMP2, MMP3, MMP9, MMP13, interleukin (IL)–6, IL-8 (CXCL8), CCL5, CCL20, and CXCL10 chemokines in meniscocytes after treatment with FN-f. Upregulation of these genes was significantly attenuated by PRP. Similar results were seen with articular chondrocytes, although no changes in MMP2 or MMP9 levels were identified. PRP-induced suppression of gene expression was associated with activation of Akt and p44/p42. Conclusion: PRP treatment attenuates the 30-kDa FN-f–induced expression of a range of proinflammatory chemokines and MMPs, including IL-8, IL-6, CCL20, CCL5, CXCL10, MMP1, MMP3, and MMP13, by both meniscocytes and articular chondrocytes. Clinical Relevance: These observations provide support for the use and further trials of PRP in management of cartilage and meniscal injuries.

The role of platelet rich plasma in management of fracture neck femur: new insights.

The aim of this study is evaluation of the efficacy of the use of platelet rich plasma (PRP) in management of femoral neck fractures. This is a prospective study that was conducted between February 2010 and March 2013. A total of 60 patients were included in this study, categorized randomly into two groups. Group A included fracture neck femur treated by closed reduction and internal fixation with three cannulated screws and group B by addition of PRP to internal fixation. We planned to compare time of healing, need for revision and incidence of complications between the two groups. Union occurred in 53 patients (88.33%) in both groups, 25 cases (83.3%) in group A and 28 cases (93.3%) in group B, including three cases (5%) with avascular necrosis (AVN): two in group A (6.7%) and one case in group B (3.3%).Revision surgery was done for six cases (20%) in group A and for two cases (6.7%) in group B. In both groups, all united cases had good to excellent clinical outcome as regards Harris hip score (HHS) at the end of the follow up. Despite advances in surgical techniques and medical care, the risk of nonunion and avascular necrosis (AVN) after treatment of femoral neck fractures have not been changed appreciably in the last 50years. Results of this study generally showed that both the median clinical and radiographic healing time were lower in group B compared to group A.

Effect of Platelet-Rich Plasma Intra Articular Injection on Patients with Primary Knee Osteoarthritis

Background: Osteoarthritis (OA) is the most common type of arthritis. It is a degenerative joint disease. OA is usually defined according to radiographic changes. Conventional radiographs (CR) were considered the most relevant outcome measure to assess the progression of OA in clinical trials and epidemiological studies. Many modalities are used in treatment of knee OA. There is a distinct need for new procedures that are cost effective by reducing the need for pharmaceutical and surgical management, while targeting the biochemical process of OA. Platelet-rich plasma (PRP) is one of these new procedures. PRP was found to increase hyaluronic acid (HA) concentration, stabilizing angiogenesis in patients with osteoarthritic knees. Aim of the study: Was to assess the value of intra articular injection of autologous platelet rich plasma in management of knee osteoarthritis. Patients and methods: This study was conducted on 40 patients with primary knee osteoarthritis, divided into 2 groups; study group treated with 3 injections of PRP, and control group treated with single dosed high-molecular weight HA. Clinical assessment and visual analogue scale (VAS) scoring were done pretreatment and 3 months post treatment. Results: Clinical improvement and reduction of VAS in both groups which is significant at the study group. Conclusion: PRP injection could be considered as a simple, safe, effective and non-palliative treatment that may promote cartilage healing in knee osteoarthritis as it improve the clinical condition and the function of the joint. Hence, it may represent a useful addition to the available therapeutic options for knee osteoarthritis.