PRP Injection Research Articles

Retrospective Evaluation of Ultrasound Guided Percutaneous Plantar Fasciotomy With and Without Platelet Rich Plasma

Plantar fasciitis is one of the most common foot conditions presenting to a foot and ankle specialist. Surgical treatment outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and significant improvements in symptoms. This study evaluates patient reported pain scores collected pre- and post-op for patients who underwent percutaneous ultrasonic microtenotomy (PUT) plantar fasciotomy with PRP injection vs without the use of PRP. We compared pain visual analog scale (VAS) scores, for patients treated surgically by Orthopedic Surgery department of foot and ankle faculty members between December 2007 and December 2022. A total of 30 patients were identified that met inclusion and exclusion criteria. Our results showed that there was a significant decrease in pain VAS scores from pre-op visit (at least 1 month prior to operation) to post-op visit (at least 1 month following operation) for both groups, with a paired t test (p value <.0001). However, patients who received PRP had a statistically significant decrease in pain level compared to the group who did not receive PRP. Statistical analysis completed with a 2-sample t test (p-value <.0325). Our results found the mean time between the initial pre-op visit and last post-op follow-up visit was 19 months. The mean for time following surgical intervention was 10 months. The findings of our study suggest that the dual use of PUT and PRP to treat plantar fasciitis, could potentially lead to an improvement in pain reduction and longevity of pain relief.

Platelet-Rich Plasma Dressing for Chronic Wound Recovery: A Systematic Review and Meta-Analysis

Chronic wounds are wounds whose healing phase does not match the physiological phase of wound healing. Chronic wounds, characterized by wounds that do not undergo a regular, regular, and timely repair process, remain a significant clinical challenge for healthcare professionals worldwide. As PRP treatments gain momentum in clinical settings, this meta-analysis seeks to offer an evidence-based perspective on their role in chronic wound management, paving the way for informed clinical practice and future research directions. This study aimed to systematically identify the effectiveness of platelet-rich plasma clothing in accelerating chronic wound healing. The studies predominantly employed Randomized Control Trials (RCTs) to evaluate treatments for various wound etiologies, including diabetic, venous, arterial, and mixed. Key outcomes gauged encompassed wound closure rate, size reduction, and other related parameters. While most studies showcased PRP's effectiveness, particularly in dressing form, there was a noticeable heterogeneity among the results. In a side exploration, PRP dressing was juxtaposed against PRP injection, revealing both methods' merits in wound management. In conclusion, while PRP treatments, be it in dressing or injectable form, offer potential benefits for chronic wound healing, the variability in study outcomes highlights the need for more standardized research methodologies.

Autologous Platelet-Rich Plasma (PRP) in Infertility-Infusion versus Injectable PRP.

(1) Background: During IVF (in vitro fertilization) procedures, endometrial thickness has a significant role in the success of pregnancy outcomes for embryo transfers. Endometrial thickness, a crucial component of endometrial receptivity, is a contentious issue. The regenerative properties of PRP have been shown in recent research to have positive effects on the endometrium. PRP increases the pregnancy rate in IVF patients with thin endometrium and recurrent implantation failure. In order to demonstrate the efficacy of PRP therapies, this work compares the administration of injectable and infusible PRP during endometrial preparation. (2) Methods: This prospective single-arm control study was conducted at an IVF center in Oradea, Romania. This study included 50 patients; 27 were included in the group with Injectable PRP and 23 in the group with Infusible PRP. The outcome was compared between the two groups, with the primary outcome being the endometrial thickness after the PRP infusion or injection and the secondary outcome being the pregnancy rate in both groups. (3) Results: Patients who were treated with Injectable PRP had a higher pregnancy rate. An improvement in the quality of the endometrium, in terms of thickness, was also observed in the patients who were injected with PRP. (4) Conclusions: Compared to PRP infusions inside the uterus, sub-endometrial PRP injections in frozen embryo transfer methods have a greater pregnancy rate.

Ultrasound-guided platelet-rich plasma injection versus steroids injection for pain relief in partial rotator cuff tears

ABSTRACT Background Platelet-rich plasma injection has become an effective treatment for partial rotator cuff tears. This study evaluates the efficacy of PRP versus steroids injection in pain relief for partial rotator cuff tears. Study design Prospective clinical trial. Setting Alexandria Main University Hospital. Patients and methods Sixty patients with symptomatic partial RCTs undergoing US-guided subacromial injection were randomly allocated into two equal groups: either steroids or PRP. Pain score, shoulder function, failure rate after injection, and complications were recorded. Results VAS score was significantly lower in the steroid group at week 2 follow-up than the PRP group (p 0.001). However, it was shorter, extended for 8 weeks in steroid in comparison to 4 months in PRP group. There was an insignificant difference among groups in the simple shoulder test at 2 and 4 weeks follow-up, and the test was significantly higher in PRP group at 6, 8, 12 weeks, and 4 month follow-up (P = 0.049, 0.001, 0.001, 0.001). Pain did not improve in six patients in steroid group and one patient in PRP group. Pain on injection was reported by six patients in the steroid group and 13 patients in PRP group (p = 0.052). Elevated blood sugar was significantly higher in the steroid group after the injection (p 0.001). Conclusion Subacromial PRP injection may have a prolonged analgesic effect and superior shoulder functional improvement than steroids in patients with partial RCTs.

Assessment of clinical and functional outcomes after single dose injection of autologous platelet rich plasma in patients with chronic lateral epicondylitis: a prospective and brief follow up study

Background: Lateral epicondylitis is a chronic, painful, and debilitating elbow condition. The introduction of platelet-rich plasma as an adjunct to the conservative and operative treatment has revolutionized the research in this topic. PRP is considered to be the ideal autologous biological blood-derived product which helps in regenerating the degenerated tissue rather than just repairing it and helps in relieving pain and improving function. Methods: This is a prospective study where 40 patients diagnosed with tennis elbow, failing other conservative treatment modalities were enrolled; and treated with single dose injection of autologous PRP; and were evaluated for clinical and functional outcomes using the visual analogue scale and disabilities of arm, shoulder, and hand scores on the follow-ups. Results: Out of the 40 patients enrolled, there were 15 males and 25 females. The mean age of the population was 45.88±8.87 years. All the patients had improved statistically significant differences in mean VAS and DASH scores (p value&lt;0.001) on each follow-up as compared to the baseline score with VAS score and DASH score improvement being more than 77% and 65% respectively at final follow up. Conclusion: Our study concludes that a single local injection of autologous PRP appears to be the promising and safe modality of treatment in lateral epicondylitis, helping to improve the pain as well as the clinical and functional outcomes.

Botulinum toxin A versus platelet rich plasma ultrasound-guided injection in the treatment of plantar fasciitis: A randomised controlled trial

BackgroundPlatelet-rich plasma (PRP) and botulinum toxin type A (BTX-A) injections have proven effective in clinical trials for plantar fasciitis treatment but have not been directly compared. We aimed to compare clinical outcomes in patients undergoing PRP or BTX-A injections. MethodsWe performed a randomised controlled trial (59 patients; 1-year follow-up) to assess efficacy, using pain and functional scales (VAS, AOFAS Hindfoot-scale and FAAM questionnaire) and fascia thickness reduction, in control and single ultrasound-guided BTX-A or PRP injection groups. ResultsThe BTX-A group showed better results at 1-month after treatment. Conversely, the PRP injection was more effective in the long-term, with significant pain reduction and functional improvement. Plantar fascia thickness significantly reduced from months 1 and 3 in the PRP and BTX-A groups, respectively. ConclusionPRP and BTX-A injections are effective in patients with plantar fasciitis with BTX-A achieving better short-term pain reduction and PRP better long-term results. Level of EvidenceLevel I; Randomised Controlled Trial

Salivary Interleukin-6 Level in Iraqi Patients with Oral Lichen Planus receiving Platelet-Rich Plasma Injections

Background: Interleukin-6 (IL-6) is a cytokine that has several functions, including stimulating growth and inhibiting cell death. It has the potential to operate as a biomarker for the accurate prediction of disease severity and activity, platelets-rich plasma was used in the treatment of oral lichen planus and can change the salivary IL-6 level. Objectives: To study the clinical outcome of intralesional platelets-rich plasma in patients with oral lichen planus and to measure salivary IL-6 levels before and after the treatment with platelets-rich plasma were the aims of this study. Subjects and Methods: In this clinical trial, for each patient a standardized case sheet was filled including demography, social, medical, and medication history. Before receiving, each patient was examined for phenotype, color, size, and site of oral lichen planus lesions. Patient's salivary samples were taken between 8 and 11 a.m. Three to four milliliters of saliva was obtained from each patient. The ELISA kit for IL-6 using sandwich-ELISA technique, to measure salivary IL-6 before and after PRP injections. Results: Thirteen oral lichen planus patients were took part in this study, six males (46.2%) and seven females (53.8%). The patients were between 32 and 91 years of age, with a mean age of 60.2(±13.9) years. All symptomatic and most of the hyperemic ones showed improvement after PRP injections, while the size of the lesions was resistant to change. Mean salivary IL-6 was 44.27 pg/mL (±43.24) before PRP injections and (69.74±59.86 pg/mL) after PRP injections. No significant difference was found, however IL-6 was higher after PRP injections. In relation to color changes after PRP, there was a significant changes in IL-6 level compared with that before PRP injections. Similarly, a significant relation was found between IL-6 level and signs and symptoms; pain and burning sensation. No association was found in salivary IL-6 level in relation to lesion phenotype, size, and location. Conclusion: All symptomatic OLP lesions that were treated with intralesional PRP responded very well, similarly almost all hyperemic lesions turned into normal mucosal color after completing the course of treatment. The majority of OLP lesions showed an increased salivary IL-6 levels after PRP treatment.

Poster 148: Preoperative Platelet Rich Plasma Injections Decreases Inflammatory and Chondrodegenerative Biomarkers in Patients with Acute Anterior Cruciate Ligament Tears and Reconstruction: A Pilot Study

Objectives: Post-traumatic osteoarthritis occurs at an alarming rate after ACL injury and surgery. The purpose of this study was to compare the effect of two, pre-operative PRP injections upon the progression of inflammatory and chondrodegenerative biomarkers to the natural progression before ACL reconstruction surgery. Our hypothesis was that pre-operative PRP injections would decrease the chondrotoxicity of the presurgery knee fluid. Methods: Participants were randomized to either a control or intervention group. Both groups received joint aspirations within the first 10 days following ACL injury (Time 1). In addition to joint aspiration at Time 1, the PRP group received a PRP injection at Time 1 and an additional PRP injection at a second visit 5-12 days after the initial visit. Synovial fluid samples were harvested in both groups at the time of ACL reconstruction (Time 2). ELISA was performed on all samples to detect cytokine levels of IL-1B, IL-10, IL-6, GM-CSF, IL-5, IFN-γ, TNF-⍺, IL-2, IL-4, and IL-8 Results: A total 24 participants were enrolled, final analysis was completed on 8 participants in the control group and 9 participants in the intervention group. The control group demonstrated a change in concentration (Δ1à2) between time 1 and time 2 that was not statistically significant for any cytokines p&gt;0.05, except for a statistically significant decrease in IL-8 (p=0.005). The intervention group demonstrated a decrease in all cytokine concentrations that was statistically significant for all cytokines p&lt;0.05, except for IL-8 (p=0.074). When comparing the control group to the intervention group at time 1, no significant difference was seen between cytokine concentrations (p&gt;0.05). Likewise, comparing the control group to the intervention group at time 2, no significant difference was seen between cytokine concentrations (p&gt;0.05). The magnitude of decrease was larger in the intervention group than the control group, but with comparison of means between groups there was not a statistically significant difference. The natural history for these biomarkers is a decrease but at a variable rate/amount. Preoperative intervention with PRP has the potential to consistently alter the concentration of chondrodestructive proteins. Conclusions: Intervention with aspiration and 2 injection series of PRP in the acute ACL injured knee resulted in greater reduction in effusion inflammatory markers than control. This may suggest a treatment modality to improve perioperative pain, function and possibly alter the course of post trauma arthritis in these patients, without the deleterious effect of steroid injection. Long term study and follow up is required to determine if intervention alters the natural history of post traumatic arthritis. [Table: see text][Table: see text]

Poster 378: The Availability and Price of Orthobiologic Injections in the Chicagoland Area: A Market Assessment Study

Objectives: Orthobiologic therapies have recently gained popularity in orthopaedic surgery as potential treatment options that can be used to manage the symptoms of musculoskeletal conditions. However, the market for these products remains unregulated by the Food and Drug Administration (FDA), giving rise to a wide range of available yet untested products. There are growing concerns related to patient safety and product efficacy, but also in regard to the amount of money being charged by providers for these treatments Thus, the purpose of this study was to investigate the current market for orthobiologic injections for knee osteoarthritis in a large, metropolitan city and determine 1) the willingness of providers to disclose the cost of an injection prior to an appointment; 2) the cost of injections if disclosed; 3) the cellular source of injections being advertised as “stem cell” products; and 4) whether there are differences in the market for orthobiologics within and outside of orthopaedic sports medicine practices. Methods: Orthopaedic sports medicine providers in the Chicagoland area were identified through the American Orthopaedic Society for Sports Medicine (AOSSM) and Arthroscopy Association of North America (AANA) registries of sports medicine physicians seeing patients in at least one location within the Chicagoland area. Non orthopaedic clinics (including chiropractors, pain management physicians, and self-advertised “regenerative medicine” clinics) offering orthobiologic injections were compiled using Yelp! and Google search for listings and reviews containing the following key words: “PRP” or “platelet-rich plasma” or “platelet rich plasma,” “SCT” or “stem cells” or “amniotic tissue injections” or “adipose stem cell injections,” and “BMAC” or “bone marrow aspirate concentrate.” A single author [BLINDED] contacted every clinic via a common telephone script, which was modified from an existing study. Data was collected for each site on the types of injections offered, whether price was disclosed over the phone, the price of injections offered, and the source of alternative “stem cell” injections if they were provided. Prices were explicitly specified as being for one injection of one joint. Results: A total of 25 orthopaedic sports medicine practices (comprising 80 AOSSM/AANA surgeons) and 40 non orthopaedic clinics offered at least one of either PRP, “stem cell,” and/or BMAC injections over the phone (Table 1). There was no difference in the likelihood of providing PRP injections (p = 0.698) or BMAC injections (p = 0.340). However, non orthopaedic clinics were significantly more likely to offer “stem cell” injections (p &lt; 0.001). There was no difference in the willingness to disclose the price of PRP without an appointment (p = 0.269), willingness to disclose the price of “stem cell” injections (p = 0.302), willingness to disclose price of BMAC (p = 0.528), or willingness to disclose the source of what each clinic advertised as “stem cell” injections (p = 0.302). While the average price of a BMAC injection was not different between provider types (p = 0.238), the average price of a single PRP injection was significantly higher (p = 0.011) and significantly more variable (F statistic = 0.139; p &lt; 0.001) at non orthopaedic clinics (Figure 1). Similarly, the average price of a single “stem cell” injection was significantly higher (p &lt; 0.001) and significantly more variable (F statistic = 0.080; p = 0.025) at non orthopaedic clinics. Most commonly, alternative “stem cell” products included amniotic-based injections, which are currently discouraged for distribution or use based upon the most recent FDA guidance document. Conclusions: When compared to orthopaedic sports medicine providers, non orthopaedic clinics providing orthobiologic treatments in the Chicagoland area are more likely to offer alternative “stem cell” injections and charge a significantly greater and more variable amount per PRP and “stem cell” injection. Unfortunately, there was liberal use of the terms “regenerative medicine” and “stem cell” therapies in the face of increased scrutiny related to the FDA’s current position on cell-based therapies. Future studies should examine these trends on a national scale to assess compliance with FDA regulations on orthobiologics, as well as establish standards of price for these treatments. [Table: see text]

P-798 Comprehensive evaluation of autologous Platelet-Rich Plasma infusion in ovarian rejuvenation

Abstract Study question This study aimed to the evaluation of PRP injection in women with ovarian dysfunction (with POR, POI, perimenopause and menopause) to promote the ovarian rejuvenation. Summary answer Intraovarian infusion of autologous PRP exhibited remarkable evidence and promising results to restore ovarian insufficiency. What is known already Ovarian dysfunctions, such as premature ovarian insufficiency (POI) and poor ovarian response (POR) are conditions, characterized by the collapse of ovarian function and are considered currently as a global public health issue. Primary factors that are associated with female infertility include endocrine dysfunction, failure of embryo implantation, endometriosis, and other related pathologies such as polycystic ovary syndrome (PCOS), various environmental factors and inflammatory disease. For this purpose, the rejuvenation of the ovaries using the intraovarian PRP injections may result in increased release of follicles from the available reservoir, and can potentially increase the possibility of a successful pregnancy. Study design, size, duration This study was designed as a randomized prospective observational pilot study. A number of 582 participants were interested to participate. The whole study was performed between May 2018 and December 2021. The patients were subdivided into 5 groups, followeeed by autologous blood collection, PRP preparation and intraovarian injection. The follow-up of the patients lasted for 2 months. Participants/materials, setting, methods The classification of the participants was performed into the following groups: Group A (22-38 years), Group B (39-44 years), Group C (45-57 years), Group D (48-50 years) and Group E (51-56 years). 60 ml of autologous blood was collected from each patient, followed by the preparation of PRP. Intraovarian PRP injection was performed and monitoring of the ovarian function including the quantification of FSH, LH, AMH and E2 for two constitutive menstrual cycles, was performed. Main results and the role of chance For group A, decrease of more than 50% was detected for the FSH and LH whereas, the levels of E2 and AMH were elevated by more than 44% and 31%, respectively in all participants Moreover, statistically significant differences regarding the levels of FSH (p = 0.001), LH (p = 0.046) , E2 (p = 0.035) and AMH (p = 0.012), were observed after the 1st and 2nd month of follow-up. In group B, a statistically significant decrease in FSH (p &amp;lt; 0.001) and LH (p = 0.001) levels were observed in all participants. In parallel, the elevation of E2 and AMH levels was observed. Moreover, 28% of the participants with diagnosed POI, after the PRP infusion, achieved successful pregnancies and live births. In group C, after the PRP infusion, a reduction in FSH and LH levels with a parallel increase of E2 and AMH levels was detected. In group D, the levels of FSH and LH slightly declined after the PRP infusion. Also, the levels of E2 and AMH were increased. In group E, the levels of FSH and LH declin Limitations, reasons for caution No classifications between responders and no responders after the PRP administration were performed. Additionally, no presence of control groups in each category nor the determination of the growth factor content of the produced PRP was performed. The relatively limited time for the follow-up can also be considered a further limitation. Wider implications of the findings The administration of autologous PRP can be considered a safe and tolerable alternative approach to the classical ones for ovarian rejuvenation. This in turn could result to better conceiving rates, thus may beneficially improve the social impact of women with ovarian dysfunction. Trial registration number 10/10/19

IMPROVING FUNCTION IN KNEE OSTEOARTHRITIS WITH PLATELET-RICH PLASMA THERAPY: A FUNCTIONAL OUTCOME EVALUATION

Objective: Osteoarthritis is a chronic and degenerative disease that commonly affects the knee joint. The effectiveness of using PRP injections in the knee joint for managing osteoarthritis symptoms, which include pain, disability, deformity, and reduced quality of life, is being studied. Methods: This is a two-year prospective study conducted between January 2019 and December 2020 at the Government General Hospital in Kurnool. The study focused on the management of osteoarthritis knee in 60 patients who received 3 ml autologous intra-articular platelet-rich plasma injections, with their pain, joint stiffness, and joint mobility being evaluated using the WOMAC score. The majority of participants were middle-aged women with grade KL 2 and 3 osteoarthritis knee. Results: The study included 60 cases with KL grade II (28 cases) and grade III (32 cases) of knee osteoarthritis. The pretreatment WOMAC score for KL grade II was 56.11±6.36, which showed significant improvement to 50.76±7.6 (p=0.000) at 2 w, 50.76±7.6 (p=0.001) at one month, 26.97±3.47 (p=0.001) at 3 mo, and 22.11±2.99 (p=0.001) at 6-month follow-up. Similarly, for KL grade III, the pretreatment WOMAC score was 59.21±5.63, which improved significantly to55.76±7.6 (p=0.000) at 2 w, 48.79±5.42 (p=0.001) at one month, 36.46±4.36 (p=0.001) at 3 mo, and 32.12±2.66 (p=0.001) at 6-month follow-up. Conclusion: PRP injection is a safe and cost-effective alternative for treating knee osteoarthritis, leading to pain relief and an enhanced quality of life, especially in the initial stages. Not only does PRP provide immediate relief, but it also results in gradual improvements over time. Overall, PRP is a viable option for individuals seeking alternative treatments for knee osteoarthritis.

The conservative management for improving Visual Analog Scale (VAS) pain scoring in greater trochanteric pain syndrome: a Bayesian analysis

BackgroundGreater trochanteric pain syndrome (GTPS) possesses a harmful influence on quality of life. Numerous conservative management modalities with varying success have been proposed for patients with GTPS. However, it is not clear which treatment is more effective for reducing pain. The purpose of this Bayesian analysis was to assess the current evidence for the effectiveness of conservative treatments on improving Visual Analog Scale (VAS) pain scoring of GTPS and to determine the most effective treatment protocol.MethodsA comprehensive study search was performed from inception until July 18, 2022, via the electronic databases PubMed, the Cochrane Library, and Web of Science for potential research. The risk of bias assessment for the included studies was independently performed based on the Cochrane Collaboration Risk of Bias Tool. Bayesian analysis was conducted by using ADDIS software (v1.16.5). The DerSimonian-Laird random effects model was used to perform the traditional pairwise meta-analysis.ResultsEight full-text articles with a total of 596 patients with GTPS were included in the analysis. In comparing ultrasound-guided platelet-rich plasma application (PRP-U) to ultrasound-guided corticosteroid injection (CSI-U), patients who received PRP therapy experienced reduced pain as the VAS decreased significantly (MD, -5.21; 95% CI, -6.24 to -3.64). VAS score in group of extracorporeal shockwave treatment (ESWT) was significant improved than that in exercise (EX) group (MD, -3.17; 95% CI, -4.13 to -2.15). There were no statistically significantly different VAS scores between the CSI-U group and the CSI under landmark (CSI-B) group. The treatment efficacy rankings of the different treatments on improving VAS scores showed that the most likely efficacious treatment was PRP-U (99%) followed by ESWT (81%), CIS-U (58%), usual care (48%), CIS-B (54%), and EX (84%).ConclusionBayesian analysis revealed that PRP injection and ESWT are relatively safe and effective in the treatment of GTPS. More multicenter high-quality randomized clinical trials with large sample sizes are still needed in the future to provide further evidence.

A comparative study to analyze the efficacy of platelet rich plasma versus corticosteroids in treatment of chronic plantar fasciitis

Plantar Fasciitis is responsible for 15% of all foot problems. Over ten percent of the population will be affected at some point in their lives. It is caused by inflammation of a broad band of tissue that links your heel bone to your toes and runs across the bottom of your foot (plantar fascia). Plantar fasciitis is a type of plantar fasciitis that causes stabbing pain when you take your first steps in the morning. The discomfort usually goes away as you get up and move around, but it may come back after long periods of standing or when you stand up after sitting. Runners are more likely to get plantar fasciitis. The plantar fascia is made up of of white-coloured fibers that run longitudinally from the calcaneum to the toes. The attachments include the following: Proximal- Affixed to the calcaneum's medial tubercle. The fascia fanning out into five slips against the metatarsophalangeal joints and attaches to the base of the appropriate toes' proximal phalanges. Chronic heel pain is a difficult condition to treat and takes a long time to resolve. This study outlines both PRP and steroid are effective and safe modalities in the treatment of plantar fasciitis. But statistical data suggest that steroid injection is effective for immediate pain relief. And PRP injection is better for long term pain relief in plantar fasciitis with no side effects.

Efficacy Differences of Platelet Rich Plasma for Treatment of Androgenetic Alopecia between Men and Women

Background: Almost 50% males face a health issue called androgenic alopecia and even almost 21 million women are affected too. Aim: To determine the efficacy difference of platelet rich plasma for treatment of androgenic alopecia among patients. Study design: Quasi experimental method. Methodology: In order to collect the data, the purposive sampling technique was used. Enrolled patients (n=102) were divided into two groups. Each group received PRP infections after every 1 month for 3 months. Follow up was done at 3 and 6 months. Results were assessed by standard photographs and Hamilton Norwood scale for men and Ludwig scale for women. SPSS v 23 evaluated data. Chi-square test was used to compare the efficacy of Platelet Rich Plasma for treatment of androgenic alopecia between genders. Results: Mean age of the study participants was 27.1±4.5 years. Independent sample t test revealed that the mean age of the female participants was significantly higher than male participants (p &lt; 0.001). There was 100% response rate of PRP treatment for androgenic alopecia in both genders. Practical Implication: This study helped researchers in exploring the efficacy of PRP as a remedy for hair re-growth as it is cheap and safe. Secondly, it added to local literature regarding androgenic alopecia. Conclusion: It was concluded that sub-dermal PRP injections were effective among both genders with androgenic alopecia. Keywords: Efficacy, Androgenic alopecia, Response Rate, Treatment Options and Plasma Rich Proteins.

Comparative evaluation of autologous platelet rich plasma and triamcinolone acetonide injection in the management of erosive lichen planus and oral submucous fibrosis: a clinical study

Background: It is need of an hour to establish an effective and efficient treatment modality for OLP and OSMF with lesser or no adverse effects. Platelet rich plasma can be used in mucosal lesions as it has a high concentration of various growth factors and anti-inflammatory properties. It could be a better novel substitute to the corticosteroid without any side effects. The present study is an effort to evaluate the therapeutic effects of intralesional injection of PRP in oral erosive lichen planus and OSMF compared to intralesional corticosteroids in the same patient. Methods: It was a randomized controlled clinical study consisting of 40 patients between the age groups of 18-60 years visiting dental OPD diagnosed clinically with either erosive lichen planus or OSMF. Triamcinolone 40 mg(1mg/ml) mixed with 2% (1:80,000) lignocaine hydrochloride was injected into the lesion on one side in case of erosive lichen planus and into the submucosal plane and fibrous bands in case of OSMF patients. Autologous PRP was prepared and injected on the other side in same patients. At every visit, all the patients were evaluated for pain and burning sensations, size, and severity of the lesion, and interincisal mouth opening (mm). The parameters were measured and recorded during the patient’s every visit. All the results were obtained and statically analyzed. Results: Intralesional injections of triamcinolone acetonide and PRP are effective in reducing pain and burning sensation in OSMF, but PRP is less effective in improving cheek flexibility as compared to triamcinolone acetonide. In OLP, both triamcinolone acetonide and PRP are almost equally effective in reducing the size of the lesion. However, PRP shows slightly better results in reducing the severity of the lesion and in pain and burning sensation in the patients of OLP as compared to intralesional triamcinolone acetonide. Conclusions: Thus, PRP is an effective modality in treating both OSMF and oral erosive lichen planus with no adverse effects.

The Effect of Ultrasound-Guided Treatment of Symptomatic Partial Rotator Cuff Injury Under the Background of Deep Learning

Deep learning is one of the most powerful machine learning algorithms at present. The convolutional neural network model has the ability to automatically learn features, and has a greater performance advantage than other deep learning models in the field of image processing. Based on deep learning, the effects of platelet-rich plasma injection of betamethasone on shoulder pain and function in patients with partial rotator cuff injury were investigated. Eighty patients with tendinosis or a partial tear (<1.0 cm) were recruited between 2021 and 2022. Mixed injection of 1 mL betamethasone and 5 mL lidocaine, following 5 mL PRP injected in 7-day intervals, were infiltrated directly into the lesion of supraspinatus interstitial RCT under ultrasound control. The patients were assessed by the SPADI, CMS and ASES before and 1, 3, 6, 9 months after injection. MRI was also performed before and 6 months after injection. All patients had significant better ASES, SST, CMS score and improvement of motion and pain relief after PRP injection, compared with the baseline before injection (p < 0.05). In the MRI data, statistical pre- and post-comparisons revealed significant differences between location of partial rupture and grade of tendinopathy. There were no mortality and major complications observed during follow-up. Under the background of deep learning, ultrasound-guided injection of PRP with betamethasone can progressively relieve shoulder joint pain and improve motor function in patients with partial rotator cuff injury. Ultrasound-guided injection of PRP with betamethasone is safe and useful for rotator cuff disease.

Comparative efficacy of platelet-rich plasma and dextrose prolotherapy for stifle joint arthritis in a rabbit model

This study aimed to investigate the efficacy of PRP and dextrose PRL in stifle joint arthritis in rabbits.Sixteen healthy adult male rabbits were allocated into groups A (n=8) and B (n=8). After induction of arthritis in all experimental animals, the animals of group A were treated with intra-articular injection of PRP, while the animals of group B were treated with dextrose PRL. Pain scoring was evaluated by the Simple Descriptive Pain scale at 0d, 6d, 13d, and 19d, while radiographic scoring was examined by Kellgren and Lawrence grading system at pre-induction, post-induction, and post-treatment. The hematological parameters, including PLT, HB, WBC, PCV, RBC, monocytes, and lymphocytes, were assessed in blood samples at 0d, 6d, 13d, and 19d. We observed that Pain scoring showed a significantly lower (P<0.05) value in group A than in group B at 13d and 19d. Radiographic scoring was significantly lower (P<0.05) in group A than the group B during post-treatment. However, during the pre- and post-monoiodoacetate (MIA) induction, there was no significant difference (P>0.05) in radiographic scoring between both groups. The PLT concentration was increased, and monocyte was decreased in the group A animals than the group B animals at 13d and 19d (P<0.05), while WBC, RBC, PCV, HB, and lymphocyte concentration showed no significant difference (P>0.05) between both groups. In conclusion, the application of PRP is an effective method for treating stifle joint arthritis compared to the dextrose PRL in the rabbit model.

Subacromial Platelet-Rich Plasma Injections Produce Significantly Worse Improvement in Functional Outcomes in Patients With Partial Supraspinatus Tears Than in Patients With Isolated Tendinopathy

The purpose of this study was to compare the effect of subacromial leukocyte-rich PRP injections in patients with isolated rotator cuff tendinopathy (RCT) and those with partial thickness rotator cuff tears (PTRCTs) based on functional outcomes, pain improvement, sleep disturbances, and return to sports. Between November 2019 and March 2021, 150 patients underwent PRP injections at our institution for refractory rotator cuff tendinopathy and partial rotator cuff tears (105 RCTs and 45 PTRCTs). The American Shoulder and Elbow Surgeons (ASES) score, the visual analog scale (VAS) for pain, the Single Assessment Numeric Evaluation (SANE) and The Pittsburgh Sleep Quality Index were evaluated at 2, 6 and 12 month follow up. Return to sports was also evaluated. An ultrasound examination was performed to evaluate structural outcomes 12 months after the injection. The mean age was 36.6 years (±9.08). Overall, the ASES, VAS, SANE and Pittsburgh scores showed statistical improvement after the injection (P < .01). Specifically, the improvement in the ASES score which was the primary outcome measure was significantly greater in the group without tears than in the group with PTRCTs at all follow-up times. Moreover, 94% of the patients in the isolated RCT group and 49% in the PTRCTs group achieved a substantial clinical benefit at 12 months follow up. Ten out of the 50 patients (20%) who received PRP injections due to a partial RC tear underwent surgery due to lack of clinical improvement. Subacromial PRP injections produced a significant improvement in shoulder function, pain and sleep disturbances in most patients with RCT refractory to conservative treatment that was maintained up to 12-month follow-up. Moreover, most patients returned to sports at the same level they had previous to the injury. However, improvement in symptoms and functional outcomes were significantly worse in patients who had a PTRCT compared with patients who had an isolated tendinopathy.

The effectiveness of Ozone activated Platelet Rich Plasma intra articular injection in pain management of anterior cruciate ligament tear

Objectives: The anterior cruciate ligament (ACL) is one of the most common injured knee ligaments and it is one of the most frequent injuries seen in orthopedic practice&#x0D; Methods: This is a retrospective study of 20 patients (14 female and 6 male) with ACL tear managed by intra articular activated PRP injection in the first author private clinic in Kirkuk over 2 years period (August 1, 2017–July 31, 2019). A detailed history was taken according to a questionnaire and a complete physical and radiological (MRI) examination was done. A sample of patient’s own blood was used to prepare PRP by a process of two repeated centrifugation. Longevity resources EXT50 Ozone Generator with oxygen tank and CGA870 Oxygen Regulator were used for activation of PRP. The clinical notes were reviewed to ascertain the clinical presentations and response of patients to PRP therapy.&#x0D; Results: The mean age was 55±10.38years. The age groups affected with ACL were 50-59 and 60-69 years (n: 7, 35%) for each, while (n:5,25%) from age group 40-49 years and (n: 1, 5%) was from age group 20-29. Although 19 patient (95%) have at least one co-morbid condition, all the patient (n:20, 100%) show good response.7 patient (35%) received three doses of PRP and 13 patient (65%) received four doses to get good response.&#x0D; Conclusion: Even though PRP and Ozone are not expensive therapies, they seem to be safe and effective in pain management of ACL tear.

Use of Activated Platelet Rich Plasma (A-PRP) on Alopecia: A Systematic Review and Meta-analyses.

Alopecia reduces perceptions of age, beauty, success, and adaptability. Hair loss can be caused by genetic, physiological, environmental, and immunologic factors. The current treatment for alopecia is varied. This systematic review and meta-analysis evaluates activated platelet rich plasma (A-PRP) for alopecia treatment. The objective of this review was to assess the clinical efficacy and safety of autologous activated PRP (A-PRP) injections in alopecia patients. We compare the safety, limitations, and outcomes of A-PRP use with those of prior research on alopecia. We searched PubMed, EMBASE, the Cochrane Database, and Google Scholar for relevant articles. We included all primary clinical studies involving patients that evaluated A-PRP. Twenty-nine articles met the eligibility criteria, which included 864 patients, and were analyzed for qualitative review. Our review found that 27 studies indicated that A-PRP is significantly effective in treating alopecia, especially for improving hair density before and after therapy (n = 184, MD = 46.5, I2 = 88%, 95% CL 29.63-63.37, P 0.00001) as well as when comparison is made between treatment and control group (n = 88, MD = 31.61, I2 = 80%, 95% CI: 6.99-56.22, P = 0.01); terminal hair density between treatment and control group (n = 55, MD = 26.03, I2 = 25%, 95% CI 8.08-43.98, P = 0.004); hair counts after therapy (n = 85, MD = 12.79, I2 = 83%, 95% CI -5.53, 31.12, P = 0.0006); promoting hair regrowth; folliculogenesis; reducing hair loss; combining with FUs surgery; and initiating the hair cycle. Two studies did not report significant results. This is the first systematic review and meta-analysis of A-PRP as a treatment option for alopecia. A-PRP appears to be a promising and safe method for treating alopecia.