Platelet-rich Plasma Injections In Patients Research Articles

Short-Term Voice Improvement after Repeated Office-Based Platelet-Rich Plasma PRP Injection in Patients with Vocal Fold Scar, Sulcus, and Atrophy

Improving the voice of patients with vocal atrophy, scar, and sulcus vocalis remains challenging. Platelet-rich plasma (PRP) is an autologous biological suitable for regenerative medicine. Office-based injections of PRP may serve as a source of improved wound healing. Thirty two office based injections of PRP were performed in 14 patients with scar, sulcus, and vocal atrophy (12 scars, 1 sulcus, and 1 atrophy). PRP was prepared using 20 cc blood draw and double centrifugation method. Injection laryngoplasty was performed using trans cervical or indirect trans oral technique (10 trans cervical, 22 trans-oral). Volume of PRP use was 0.5-0.7 cc per side. Injections varied from 1 to 3 injections at monthly intervals. Videostroboscopy, Voice Handicap Index (VHI-10), and an objective analysis of the voice using Cepstral Peak Prominence (Cepstral Spectral Index of Dysphonia) were recorded. An expert rater speech pathologist rated the audio and stroboscopy results. Median follow-up was 15 months. No patients were made worse. The mean VHI-10 before the injection was 23. VHI-10 after the injection was 12.5 (P < 0.01). The mean Cepstral Spectral Index of Dysphonia score for CAPE-V sentence was 42.5 before the injection and 23.5 (P < 0.01) after the injection. The expert rater thought the post treatment was better (9/14 acoustic, 10/14 stroboscopy). Eleven of the 14 patients thought the intervention was worthwhile to repeat. The other 3 patients thought the improvement was transient. Office PRP injection into the vocal fold of patients with scar, sulcus, and atrophy may result in short term voice improvements. It is a biological worth considering.

Platelet-Rich Plasma Injection in Patients with Atrophic Rhinitis

Objective: To investigate the effect of platelet-rich plasma (PRP) injection in patients with atrophic rhinitis. Methods: Prepared PRP was injected into the inferior turbinate bilaterally, and nasal bacterial cultures were conducted. Improvement of symptoms was assessed with the Nasal Obstruction Symptom Evaluation (NOSE) and the Sino-Nasal Outcome Test-22 (SNOT-22). Nasal mucociliary clearance was assessed using the saccharin transit time (STT). Results: In the PRP-injected group (group A), NOSE (throughout the study) and SNOT-22 (1 month after injection) scores were significantly decreased during the study. However, the saline spray group (group B) showed no significant nasal symptom improvement during the study period. In group A, the STT was improved until 3 months after the injection. In contrast, group B showed STT improvement after 2 months that was maintained throughout the study. Conclusion: PRP injections can improve nasal symptoms and nasal mucociliary function in patients with atrophic rhinitis.

Efficacy of platelet-rich plasma injections in patients with adhesive capsulitis of the shoulder.

The goal of this study is to investigate whether platelet-rich plasma (PRP) injections are effective in the management of adhesive capsulitis of the shoulder (AC). A triple-blind, randomized controlled trial was designed and conducted in a medical school hospital. 32 adult patients with adhesive capsulitis (21 female, 11 male with a mean age of 57, ranging from 23 to 70) were included in this study. Patients had to have shoulder pain and restrictions in movements (at least 25% when compared to the other side, and at least in two directions) for threemonths minimum and ninemonths maximum. Patients were randomized to two groups, and one group took PRP injections for three times every two weeks, while the other group took saline injections in same frequency and volume. A standardized exercise program was also applied to all patients. Patients were evaluated with Shoulder Pain and Disability Index (SPADI), Visual Analogue Scales for pain and disability, ranges of movements, and use of analgesics in before, after, and third month after the initiation of the therapy. Baseline comparisons between groups showed no differences. SPADI and ranges of motion in all directions showed significant improvements with therapy, and the group which took PRP injections showed better improvements when compared to the control group (p < 0.05). Visual Analogue Scale was found to be better for the PRP group after therapy and third month, and not for the control group (0.4± 1.06 and 0.17± 0.72 vs. 2.5± 2.6 and 2 ± 2.2, respectively, p < 0.05). Use of analgesics was not found to be significant for both groups (p > 0.05). PRP injections were found to be effective in both pain and disability, and showed improvements in a restricted shoulder due to adhesive capsulitis. These findings might point out PRP as a therapeutic option in the management of adhesive capsulitis.

Functional outcome of intra articular platelet rich plasma injections in early osteoarthrosis knee

Functional outcome of intra articular platelet rich plasma injections in early osteoarthrosis knee - IJOS- Print ISSN No: - 2395-1354 Online ISSN No:- 2395-1362 Article DOI No:- 10.18231/j.ijos.2020.042, Indian Journal of Orthopaedics Surgery-Indian J Orthop Surg

Comparison of the Efficacy of Botulinum Toxin, Local Anesthesia, and Platelet-Rich Plasma Injections in Patients With Myofascial Trigger Points in the Masseter Muscle

Masticatory myofascial trigger points (TrP) are one of the major causes of nondental pain in the orofacial region. Intramuscular injections are considered the first-line treatment for myofascial TrPs. The objectives of this study were to evaluate and compare the effectiveness of local anesthesia (LA), botulinum toxin (BTX), and platelet-rich plasma (PRP) injections for the treatment of myofascial TrPs in the masseter muscle. In this retrospective study, the sample was composed of patients with myofascial TrPs in masseter muscle who were treated between 2016 and 2019. Patients were divided into 3 groups according to treatment methods: group I (LA injection), group II (BTX injection), and group III (PRP injection). Primary outcome variable was the average pain level at rest and while chewing, and pressure pain intensity (PPI), Jaw Functional Limitation Scale (JFLS) value, and quality-of-life (measured using Oral Health Impact Profile-14 (OHIP-14)) were secondary outcomes. The outcome variables were assessed at diagnosis, and 1, 3, and 6months post-treatment. The study consisted of 82 patients (group I, 27; group II, 26; group III, 29). At 1 and 3months, improvement in all parameters was recorded in all groups. Groups I and II showed superior improvement in all parameters compared with group III at 3months. Improvements in VAS pain, JFLS, and OHIP-14 values were significantly better in group II than group I at 3months (P=.009; P=.004; P=.002). At 6months, significant improvement in VAS pain, JFLS, and OHIP-14 (P=.008; P<.001; P<.01) values was recorded only in group II. All procedures successfully improved the symptoms of TrPs in the masseter muscle at 1 and 3months. However, BTX injection seemed superior at the 3-month follow-up and remained effective up to 6months.

Functional outcome of intraarticular platelet rich plasma in early osteoarthritis of knee joint: A prospective study

Aims: The effectiveness of Platelet rich plasma (PRP) is still controversial in osteoarthritis. We investigated the effect of PRP injection in patients with knee osteoarthritis based on improving function and decreasing pain. Our aim and objective is to assess the functional outcome of PRP in patients with early osteoarthritis, Kellgren-Lawrence Grade-1, 2 and to evaluate PRP as a treatment option for early osteoarthritis of knee joint. Materials and Methods: This is a prospective study included 50 cases of osteoarthritis of knee of either sex fitting inclusion criteria which was conducted between November 2017 to June 2019. Patients underwent detailed history, clinical and radiological evaluation on first visit and were later followed up for a minimum period of 6 months. Autologous PRP extract prepared in Haematalogy lab and Intraarticular injections injected at 3 weeks interval at 3 sittings each. The outcome was assessed using International Knee Documentation Committee (IKDC) and Visual Analogue Scale (VAS) scores recorded prior to injections and at 2 and 6 months after the injection course. Results: The mean age in our study is 52.48.The mean IKDC score increased from baseline of 38.63 to 59.68 at 6 month follow up, which is statistically significant (p value < 0.0001). The mean VAS score increased from 7.20 to 3.72 which is statistically significant (p value = 0.0001). After 2 month of follow up, there was significant improvement of VAS and IKDC score. The VAS and IKDC score showed improvement in all four age groups. Minor complications were reported. Conclusion: Autologous PRP injections based on current evidence have effective pain reduction than other preparations with additional significant functional improvement in early osteoarthritis. More large studies with longer follow up are needed to confirm these early results and to test PRP injection as a part of management in osteoarthritis of knee.

Prospective Clinical Research of the Efficacy of Platelet-rich Plasma in the Outpatient-based Treatment of Rotator Cuff Tendinopathy.

BackgroundThe purpose of this study is to compare the clinical outcomes of the control group and platelet-rich plasma (PRP) group among the patients who failed to respond to conservative treatment as outpatient-based therapy for rotator cuff tendinopathy, and to compare the clinical results of leukocyte-poor (LP) PRP and leukocyte-rich (LR) PRP.MethodsInclusion criteria are (1) over 18-year-old, (2) patients with rotator cuff tendinopathy, no rotator cuff tear by radiologic diagnosis (ultrasonography or magnetic resonance imaging) within the last 3 months, and (3) not effective to conservative treatment for more than 1 month. Of the final 60 subjects, 33 patients in the exercise treatment group and 27 patients in the PRP injection group (LP-PRP, 13; LR-PRP, 14) were included. Clinical evaluation was carried out by assessing the outcomes of treatment using the Numeric Rating Scale pain score, the American Shoulder and Elbow Society (ASES) score, and the Constant score at baseline and at 3 and 6 months after the procedure.ResultsThere was a statistically significant difference in ΔASES3months (ASES3months-ASESfirst) score between the control and PRP groups (p=0.006). However, there was no statistical significance between LP-PRP and LR-PRP groups (p>0.05).ConclusionsThis study showed that PRP injection was more effective than exercise therapy for the first 3 months. However, there was no difference between the LP-PRP group and the LR-PRP group. Regardless of the type of PRP, clinical application of PRP injection in patients with rotator cuff tendinopathy seems to be effective in early treatment.

Clinical and Radiological Comparison of Effects of Platelet-Rich Plasma, Hyaluronic Acid, and Corticosteroid Injections on Temporomandibular Joint Osteoarthritis.

There are few studies in the literature that comparatively evaluate the use of intra-articular orticosteroids (CS), hyaluronic acid (HA), and platelet-rich plasma (PRP). In this study, the authors aimed to compare the clinical results of intra-articular CS, HA, and PRP injections in patients who presented to the authors' clinic with temporomandibular joint (TMJ) pain and clinically diagnosed with TMJ-osteoarthritis. Patients were evaluated in 2 groups as those patients who felt pain on lateral (n = 31), and posterior (n = 43) palpation. Patients who were evaluated in the study were randomly assigned to 3 different treatment groups as Group 1 (PRP), Group 2 (HA), and Group 3 (CS). Pain felt on the TMJ on lateral and posterior palpation was assessed before treatment and every month for 3 months using a 5-point pain scale. Presence of crepitation, loss of function, and loss of strength were assessed before treatment and every month for 3 months. Significant changes were observed in the PRP and HA groups when the patients were evaluated according to the VAS scores evaluated at different follow-up times for TMJ pain on lateral palpation. Significant changes were observed in the PRP, HA, and CS groups when VAS scores were evaluated according to the patients' follow-up times for TMJ pain on lateral palpation. In conclusion, the findings of this study have shown that intra-articular PRP injections decreased TMJ palpation pain more effectively compared with the HA and CS groups.

The efficacy of intra-articular PRP, Ozone and Ozone+PRP injections in patients with osteoarthritis.

Osteoarthritis (OA) is the most common form of arthritis and some joints are effected more than others. The prevalence of OA increases with age and it represents the major problem for functional impairment in older patients. Non-surgical treatment with oral drugs is not suitable for many patients suffering from gastric disorders, high blood pressure or different heart diseases. Intra-articular injections are a promising solution in these cases.&#x0D; This study was performed to compare the efficacy and safety of ozone injections, PRP (platelet rich plasma) injections and combined ozone plus PRP injections in patients with symptomatic knee OA. &#x0D; 120 patients were diagnosed of OA according to the criteria of the American College of Rheumatology and included into this study. Patients were randomly divided into three equal groups (40 patients each group). We include patients whose VAS score was 5 or above. Patients with inflammatory, endocrine and metabolic disturbances, and patients who had meniscectomy within the past 10 years, extra articular surgery within the last year, arthrocentesis in last 6 months or any drug given intra-articular were not included. We did not include either patients with misalignment.&#x0D; Patients in the first group were treated with intra-articular injections of ozone/oxygen gas mixture 2 times/week, at 10 µg/mL concentration and a volume of 5 mL for a total of 12 injections.&#x0D; Patients in the second group were treated only with PRP injections once a week for a total of 3 times.&#x0D; Patients in the third group were treated with intra-articular injections of Ozone+PRP (10 µg/ml concentration, 5 ml volume) once a week for a total of 3 times.&#x0D; The pain levels of patients were measured with Visual Analog Scale (VAS). Side effects were collected using an open list record.&#x0D; All the groups improved their baseline VAS in a significant way, although the group with the best results was group 3 with the combination of ozone and PRP in the same injection.&#x0D; We are planning further studies including systemic ozone in order to improve more the pain in our patients.

Nonsurgical treatment of partial ACL tears: intraarticular injection of Platelet-rich plasma did not change the progression rate to knee instability

ObjectiveDiagnosis and treatment of partial tears of the ACL remains controversial. Patients that present a hard end positive Lachman and negative pivot shift in the context of a partial tear in the magnetic resonance imaging (MRI) have a healing potential that could avoid surgery. Platelet-Rich-Plasma (PRP) provides certain growth factors that could improve healing and therefore, clinical outcomes after partial ACL tears. The aim of this study was to report the results of autologous intraarticular PRP injection in patients with partial ACL tears.MethodsProspective cohort of patients between 2015 and 2017 with acute ACL partial tear, treated either with autologous PRP therapy combined with a rehabilitation protocol (group 1) or rehabilitation alone (group 2). The primary outcome was to evaluate return to sports and recurrent knee instability requiring surgery. We performed pre and postoperative subjective evaluation using Tegner, IKDC and Lysholm scores and an objective evaluation using KT1000 arthrometer. and return-to-sports were performed. An MRI was performed at 6 months. Platelets and leukocyte concentration in PRP preparation was analyzedResultsA total of 40 patients were included in this study, 21 in group 1 and 19 in group 2. Median age was 26 yeas (IQR 22-35), 85% (n=34) were men with a median follow up of 12 months (IQR 8–15). Eighteen patients (85%) in group 1 and 15 (79%) patients in group 2 were Tegner 7 or above.All patients returned to sports at a mean of 3.8 months in group 1 and 4.2 months in group 2. Five (23,8%) patients in group 1 (1 proximal and 4 mid-third lesions) and four (21%) in group 2 (3 proximal and 1 mid-third lesion) failed and had an ACL reconstruction because of knee instability (p 0.99). All after a new sport trauma.Lysholm score improved from 62 (SD 20) to 70 (SD 24) in group one and from 67 (SD 14) to 74 (SD 16) in group 2. IKDC score improved from 51 (SD 11) to 68 (SD 19) in group 1 and from 55 (SD 17) to 69 (SD 9) in group 2. Side-to-side difference in arthrometric KT1000 evaluation was less than 3 mm in 80% of patients that did not fail. In MRI studies, twenty-two (55%) had a proximal ACL lesion and eighteen (45%) a mid-substance ACL lesion. Fifteen (71%) patients in group 1 and twelve (63%) in group 2 presented an improvement in signal intensity at 6 months.The platelet concentration was 478% and the leukocyte concentration was 9% in relation to the patient´s baseline serum concentration.ConclusionReturn to sports after a partial ACL tear was similar in both groups. Almost 25% of patients progressed to knee instability, without significant differences between those treated or not with an intra-articular PRP injection. Longer follow-up is required before any conclusions.

Allogenic Pure Platelet-Rich Plasma Therapy for Rotator Cuff Disease: A Bench and Bed Study

Background: Although platelet-rich plasma (PRP) is a popular option for rotator cuff disease, the underlying mechanism of PRP and its clinical indications are unclear. Further, some kinds of PRP might be detrimental to patients. Allogenic PRP prepared through a standardized process and fully characterized could eliminate variations in PRP as well as uncertainties regarding its use in each patient, which could provide clues about its mechanism of action and indications for its use. Purpose: To assess the effects of pure PRP on tenocytes with or without inflammation in an in vitro study and to evaluate the safety and efficacy of a fully characterized pure PRP injection in patients with rotator cuff disease in a clinical study. Study Design: Controlled laboratory study and cohort study; Level of evidence, 3. Methods: For the in vitro study, tenocytes were enzymatically isolated and cultured from patients with rotator cuff tear and treated with or without interleukin 1β (IL-1β) and PRP. Gene expression and protein synthesis of pro- and anti-inflammatory cytokines, enzymes and their inhibitors, matrix synthesis, and cell viability were evaluated. For the clinical study, a total of 17 patients with rotator cuff disease received ultrasonography-guided subacromial PRP injection and were followed for 6 months. Pain, range of motion, muscle strength, shoulder function, and overall satisfaction in patients were compared with the results in a propensity score–matched control group who received corticosteroid (triamcinolone acetonide 40 mg). Results: PRP induced inflammation in the absence of inflammation and ameliorated inflammation in IL-1β-induced tendinopathic conditions by regulation of cytokines such as IL-1β, cyclooxygenase 2, microsomal prostaglandin E synthase 1, vasoactive intestinal peptide, and downstream matrix metalloproteinases. No general or local adverse events were noted with regard to allogenic PRP injection. Whereas steroid injection showed earlier improvement in some kinds of pain and functional scores, PRP generally showed comparable effects with steroid injection in all clinical outcomes at 6 months. Conclusion: This study showed that allogenic pure PRP had pleiotropic effects on tenocytes depending on inflammation and that it did not cause adverse events but rather decreased pain and improved shoulder function to a degree comparable with steroid injection in patients with rotator cuff disease. Clinical Relevance: Allogenic PRP could be a treatment option for rotator cuff disease.

Safety and Efficacy of Intra-articular Injection of Platelet-Rich Plasma in Patients With Ankle Osteoarthritis.

An intra-articular injection of platelet-rich plasma (PRP) may be an effective treatment for osteoarthritis (OA). However, its efficacy in ankle OA has not been investigated yet. The purpose of this study was to assess the safety and efficacy of an intra-articular injection of PRP in patients with ankle OA during a 24-week period. Twenty ankles of 20 patients with varus-type ankle OA who received intra-articular injections of PRP were evaluated. PRP was extracted from whole blood by using the double-spin technique. Three injections of 2-mL PRP were administered to the ankle at an interval of 2 weeks under ultrasonographic guidance. Adverse events and efficacy were assessed at 4, 12, and 24 weeks after the last injection. Clinical outcomes were assessed by using the visual analog scale (VAS) for pain, the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). No serious adverse effects were observed during the follow-up period. The VAS and JSSF scale scores significantly decreased from baseline to 4, 12, and 24 weeks after treatment ( P < .001). The mean score in the pain-related subscale of the SAFE-Q significantly improved from baseline to 12 weeks after treatment ( P = .04). Overall, the amount of pain reduction was maximal at 12 weeks after the last injection, and the effect was reduced at 24 weeks. The patients with late-stage OA had worse scores in all outcomes than those with early-stage OA. Intra-articular injections of PRP resulted in no serious adverse effects and significantly reduced pain in the patients with ankle OA. PRP treatment can be safe and effective and may be an option in the treatment of ankle OA. Level IV, case series.

Timing of Platelet Rich Plasma Injections During Antithrombotic Therapy

The use of platelet rich plasma (PRP) spans across many fields owing to its role in healing and as a natural alternative to surgery. PRP continues to grow however much of the literature is anecdotal or case report based and there is a lack of controlled trials to evaluate standards for PRP. The International Cellular Medical Society (ICMS) has developed guidelines to help with the safe advancement of PRP; however there remains a gap in literature concerning the timing of PRP injections in patients who are on antithrombotic therapy. The importance of an intact platelet surface membrane allows for the appropriate release of the healing bioproteins and growth factors granting PRP therapy its efficacy. This along with the proliferation of differentiated cells, enhancement of collagen synthesis, early angiogenesis and revascularization help promote the benefits of regeneration. The intrinsic and extrinsic pathways of the coagulation cascade are valuable in that disruption of this mechanism or prematurely activated platelets may result in limited efficacy. Anticoagulants and antiplatelet drugs are commonly used in patients who are candidates for PRP. As antithrombotic agents affect platelet stability, they will have an effect on PRP efficacy and must be discontinued at an appropriate time frame prior to injection therapy. Understanding the pharmacokinetics and platelet effects can help guide discussion on the proper timing of discontinuation and resumption of a particular antithrombotic agent. With future research, the establishment of clinical practice guidelines concerning PRP and antithrombotic therapy can help structure safe and efficacious means in which to promote healing and regeneration in a growing patient population. Key words: Platelet rich plasma, antithrombotic therapy, coagulation, platelet activation, regenerative medicine, growth factors

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies.

To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects. Systematic literature reviews were conducted in PubMed/MEDLINE and Cochrane electronic databases till May 2015, using the keywords "platelet-rich plasma OR PRP OR autologous conditioned plasma OR ACP AND cartilage OR chondrocyte OR chondrogenesis OR osteoarthritis (OA) OR arthritis." The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs-one for knee and one for hip-did not report significant superiority of PRP compared to the control group (HA). Nine out of 11 HA controlled studies showed significant better results in the PRP groups. A trend toward better results for PRP injections in patients with early knee OA and young age was observed; however, lack of uniformity was evident in terms of indications, inclusion criteria, and pathology definitions in the different studies. Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.

PLATELET RICH PLASMA FOR CHRONIC TENDINOPATHY

IntroductionThe aetiology, pathogenesis, and pain generators in chronic tendinopathy remain to be elucidated. Biologic therapies, such autologous blood (AB) and platelet rich plasma (PRP) injections, aimed at stimulating healing of...

Treatment of Chronic Patellar Tendinitis with Platelet Rich Plasma Injection

The aim of this study was to evaluate the efficacy of platelet rich plasma (PRP) injections on the healing of chronic patellar tendinitis. We treated 44 patients affected by chronic patellar tendinitis. Lysholm, International Knee Documentation Committee, visual analogue scale score were used for clinical evaluation before, at the end of the treatment. A statistically significant improvement in all scores was observed at the end of the PRP injections in patients with chronic patellar tendinitis. The clinical results are encouraging, indicating that PRP injections have the potential to promote the achievement of a satisfactory clinical outcome to chronic patellar tendinitis.

A New Innovative Therapy for Sports Related Soft Tissue Injuries: Platelet-Rich Plasma (PRP)

Introduction: Platelet-rich plasma (PRP) is the cellular component of plasma that settles after centrifugation, and contains numerous growth factors. There is increasing interest in the sports medicine about providing endogenous growth factors directly to the injury site, using autologous blood products such as PRP, to potentially facilitate healing and earlier return to. Despite this interest, and apparent widespread use, there is a lack of high-level evidence trials assessing the efficacy of PRP. Systematic review: We performed a systematic review of the literature and included clinical studies on PRP injections for ligament, muscle or tendon injuries. A few randomized controlled clinical trials have assessed the efficacy of PRP injections and none have demonstrated scientific evidence of efficacy. Scientific studies should be performed to assess clinical indications, efficacy, and safety of PRP, and this will require appropriately powered randomized controlled trials with adequate and validated clinical and functional outcome measures and sound statistical analysis. Original research: Our group recently studied the effects of a platelet-rich plasma injection in patients with chronic midportion Achilles tendinopathy at 1-year follow-up in a randomized controlled trial; Fifty-four patients, aged 18 to 70 years, with chronic tendinopathy were randomized to receive either a blinded injection containing platelet-rich plasma or saline (placebo group) in addition to an eccentric training program. The validated mean Victorian Institute of Sports Assessment-Achilles score improved in both the platelet-rich plasma group and the placebo group after 1 year. There was no significant difference in increase between both groups (adjusted between-group difference, 5.5; 95% confidence interval, −4.9 to 15.8, P = .292). This randomized controlled trial showed no clinical and ultrasonographic superiority of platelet-rich plasma injection over a placebo injection. Overall conclusion: Based on the systematic review and original research, the potential risks involved with PRP are fortunately very low. PRP got the potentiality to facilitate healing and earlier return to sport after musculoskeletal injury, but benefits remain unproven to date and there is a need for high quality studies with a randomized design. Aspetar is currently performing a level I evidence research project into the benefits of PRP in muscle injuries.

One-Year Follow-up of Platelet-Rich Plasma Treatment in Chronic Achilles Tendinopathy

Background Achilles tendinopathy is a common disease among both athletes and in the general population in which the use of platelet-rich plasma has recently been increasing. Good evidence for the use of this autologous product in tendinopathy is limited, and data on longer-term results are lacking. Purpose To study the effects of a platelet-rich plasma injection in patients with chronic midportion Achilles tendinopathy at 1-year follow-up. Study Design Randomized controlled trial; Level of evidence, 1. Methods Fifty-four patients, aged 18 to 70 years, with chronic tendinopathy 2 to 7 cm proximal to the Achilles tendon insertion were randomized to receive either a blinded injection containing platelet-rich plasma or saline (placebo group) in addition to an eccentric training program. The main outcome was the validated Victorian Institute of Sports Assessment–Achilles score. Patient satisfaction was recorded and ultrasound examination performed at baseline and follow-up. Results The mean Victorian Institute of Sports Assessment–Achilles score improved in both the platelet-rich plasma group and the placebo group after 1 year. There was no significant difference in increase between both groups (adjusted between-group difference, 5.5; 95% confidence interval, –4.9 to 15.8, P = .292). In both groups, 59% of the patients were satisfied with the received treatment. Ultrasonographic tendon structure improved significantly in both groups but was not significantly different between groups (adjusted between-group difference, 1.2%; 95% confidence interval, –4.1 to 6.6, P = .647). Conclusion This randomized controlled trial showed no clinical and ultrasonographic superiority of platelet-rich plasma injection over a placebo injection in chronic Achilles tendinopathy at 1 year combined with an eccentric training program.

Platelet-rich plasma for chronic achilles tendinopathy: a double-blind randomised controlled trial with one year follow-up

IntroductionChronic Achilles tendinopathy occurs frequently and is very hard to treat. The disease involves local degeneration of tendon tissue, of which regeneration may be improved by injecting platelet-rich plasma (PRP),...

Use of platelet-rich plasma for the treatment of refractory jumper’s knee

The aim of this study was to evaluate the efficacy of multiple platelet-rich plasma (PRP) injections on the healing of chronic refractory patellar tendinopathy after previous classical treatments have failed. We treated 15 patients affected by chronic jumper's knee, who had failed previous nonsurgical or surgical treatments, with multiple PRP injections and physiotherapy. We also compared the clinical outcome with a homogeneous group of 16 patients primarily treated exclusively with the physiotherapy approach. Multiple PRP injections were performed on three occasions two weeks apart into the site of patellar tendinopathy. Tegner, EQ VAS and pain level were used for clinical evaluation before, at the end of the treatment and at six months follow-up. Complications, functional recovery and patient satisfaction were also recorded. A statistically significant improvement in all scores was observed at the end of the PRP injections in patients with chronic refractory patellar tendinopathy and a further improvement was noted at six months, after physiotherapy was added. Moreover, comparable results were obtained with respect to the less severe cases in the EQ VAS score and pain level evaluation, as in time to recover and patient satisfaction, with an even higher improvement in the sport activity level achieved in the PRP group. The clinical results are encouraging, indicating that PRP injections have the potential to promote the achievement of a satisfactory clinical outcome, even in difficult cases with chronic refractory tendinopathy after previous classical treatments have failed.