Single Platelet-rich Plasma Injection Research Articles

Clinical Efficacy of Platelet-Rich Plasma Injection and Its Association With Growth Factors in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized Double-Blind Controlled Clinical Trial As Compared With Hyaluronic Acid

Background: Although platelet-rich plasma (PRP) has potential as a regenerative treatment for knee osteoarthritis, its efficacy varies. Compositional differences among types of PRP could affect clinical outcomes, but the biological characterization of PRP is lacking. Purpose: To assess the efficacy of intra-articular PRP injection in knee osteoarthritis as compared with hyaluronic acid (HA) injection and to determine whether the clinical efficacy of PRP is associated with its biological characteristics. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 110 patients with symptomatic knee osteoarthritis received a single injection of leukocyte-rich PRP (1 commercial kit) or HA. Clinical data were assessed at baseline and at 6 weeks and 3 and 6 months after injection. The primary endpoint was an improvement in the International Knee Documentation Committee (IKDC) subjective score at 6 months, and the secondary endpoints were improvements in scores based on the Patient Global Assessment, the visual analog scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index, and the Samsung Medical Center patellofemoral score. Cell counts and concentrations of growth factors and cytokines in the injected PRP were assessed to determine their association with clinical outcomes. Results: PRP showed significantly improvement in IKDC subjective scores at 6 months (11.5 in the PRP group vs 6.3 in the HA group; P = .029). There were no significant differences between groups in other clinical outcomes. The Patient Global Assessment score at 6 months was better in the PRP group (P = .035). The proportion of patients who scored above the minimal clinically important difference (MCID) for VAS at 6 months was significantly higher in the PRP group (P = .044). Within the PRP group, the concentrations of platelet-derived growth factors were high in patients with a score above the MCID for VAS at 6 months. The incidence of adverse events did not differ between the groups (P > .05). Conclusion: PRP had better clinical efficacy than HA. High concentrations of growth factors were observed in patients who scored above the MCID for clinical outcomes in the PRP group. These findings indicate that concentration of growth factors needs to be taken into consideration for future investigations of PRP in knee osteoarthritis. Registration: NCT02211521 (ClinicalTrials.gov identifier).

Platelet-Rich Plasma for Vocal Fold Scar: A Preliminary Report of Concept

Vocal fold atrophy and scar can lead to loss of normal superficial lamina propria, negatively affecting the vibratory function of the vocal fold. These changes can lead to dysphonia, vocal fatigue, decreased volume, and altered pitch. Treatment options for these conditions are limited. Platelet-rich plasma (PRP) consists of platelets, growth factors, and cytokines derived from the patient's own blood and is believed to activate tissue regeneration. The purpose of this study was to review the technical aspects of collecting PRP and injecting it into the vocal fold injection - based on our initial experience with this procedure. A patient with vocal fold scar was identified and enrolled in an ongoing prospective clinical trial study of a series of 4 monthly subepithelial vocal fold PRP injections, which was temporarily halted due to the COVID-19 pandemic. Patient underwent a single injection of autologous PRP into the left vocal fold. There were no adverse events during the study period. Subjective improvement in voice was noted at 1 month after injection with subsequent return to baseline over the next 4 months. Videostroboscopy performed on postinjection day 1 and day 7 and demonstrated no concerning exam changes. Compared to the preinjection baseline, the patient-reported voice-handicap index-10 (VHI-10) and voice catastrophization index were similar at 4 months following injection (20 to 20 and 4 to 3, respectively). Independent perceptual analysis of voice showed improvement at 4 months postinjection, compared to baseline consensus auditory-perceptual evaluation of voice 60 to 44. This preliminary report was part of a prospective trial investigating the use of PRP to treat vocal fold atrophy and scar. This work highlights the technical considerations for injecting PRP into the vocal fold. Planned prospective enrollment in this study will help to validate the safety and efficacy of PRP injections.

Effectiveness of Single Platelet-rich Plasma Injection and Rehabilitation in the Management of Calcaneocuboid Syndrome: A Case Series

Calcaneocuboid syndrome is a common yet underdiagnosed condition. It has been noted as a FADI scores complication of plantar flexion and inversion ankle injuries which are one of the most common athletic injuries. It is common in ballet dancers and athletes. Presentation of this condition is lateral foot pain which is exaggerated on inversion. To determine the outcomes of a single platelet-rich plasma (PRP) injection combined with rehabilitation for calcaneocuboid syndrome. Six patients (3 non-sportsperson, 2 footballers, 1 basketball player) who presented with complaints of chronic lateral ankle pain were evaluated clinically and radiologically and identified to have calcaneocuboid syndrome. Ultrasound-guided PRP injection was done. Preinjection and one and three months postinjection visual analog scale (VAS) and foot and ankle disability index (FADI) scores were noted. They also underwent a rehabilitation program. One patient was lost to follow-up after 1 month. Five patients showed significant improvement in VAS and FADI at 3 months. The use of PRP has shown proven benefits in the literature. Our study combined PRP along with a rehabilitation program for the subjects. Single PRP injection along with a rehabilitation program has shown to be effective in the management of calcaneocuboid syndrome. Rao V, Anand K, Jaganathan P, et al. Effectiveness of Single Platelet-rich Plasma Injection and Rehabilitation in the Management of Calcaneocuboid Syndrome: A Case Series. J Foot Ankle Surg (Asia Pacific) 2021;8(1):16–18.

Role of Platelet Rich Plasma in Chronic Plantar Fasciitis: A Prospective Study.

Autologous platelet rich plasma (PRP) local injection has been recently proposed as a treatment of plantar fasciitis. The autologous PRP does not have much side effects compared to steroid injections. So far PRP injections have shown promising results in various studies. This study assessed the efficacy of a single local injection of PRP in chronic unilateral plantar fasciitis through a prospective case series. A hospital-based prospective case series of 30 unilateral plantar fasciitis patients with symptom duration of 6months or more were included in the study. All patients included in the study were assessed clinically and by visual analogue score for heel pain, AHS component of AOFAS and FADI scores before injection and at 6 and 12week follow-up. USG measurement of plantar fascia thickness was done at pre-injection and at 12weeks follow-up. All patients were observed for 12weeks. The mean age was 39years (range 20-55years). The pre-injection VAS score for heel pain was 6.5 ± 1.1 which improved to 2.7 ± 0.5 and 1.8 ± 0.8 at 6 and 12week respectively and difference was significant (p < 0.001). The baseline FADI and AHS component of AOFAS scores were 53.1 ± 9.0 and 72.2 ± 5.7 which improved to 65.5 ± 5.3 and 76.1 ± 4.5 at 6weeks and, 77.9 ± 4.4 and 85.7 ± 4.6 at 12weeks respectively which was significant (p < 0.001). The baseline mean plantar fascia thickness was 4.9 ± 0.3mm which was significantly (p < 0.001) reduced to 3.9 ± 0.3mm at 12weeks post PRP injection. All pairwise comparisons by the post-hoc Wilcoxon signed rank test with p-value adjustment were also significant. The short-term results of single dose PRP injections shows clinical and statistically significant improvements in VAS for heel pain, functional outcome scores and plantar fascia thickness measured by USG. This study concludes that local PRP injection is a viable management option for chronic plantar fasciitis.

Evaluation of the Effect of Platelet Rich Plasma on Wound Healing in the Tongue of Normal and Streptozotocin-induced Diabetic Albino Rats: Histological, Immunohistochemical, and Ultrastructural Study

Background: Delayed healing of diabetic wounds has been well-documented. Currently, the use of platelet-rich plasma (PRP) has attracted great attention in many medical fields including wound healing.&#x0D; Aim: Histological, immunohistochemical and ultrastructural evaluation of the effect of PRP on wound healing in the tongue of normal and Streptozotocin-induced diabetic albino rats.&#x0D; Methodology: A total number of 108 adult male albino rats with average weight 200gm, were used in the study. The animals were classified into two main groups: non-diabetic and diabetic groups. Each group was further divided into three subgroups: non- treated wound, PRP-treatment before wound, and PRP-treatment after wound. Tongue specimens were dissected on postoperative days 1, 3, and 7. The specimens were examined histologically by H&amp;E, immunohistochemically by p63 and vimentin, and ultra-structurally by TEM.&#x0D; Results: The most accelerated wound healing was revealed in the subgroups treated with PRP before the wound, whether non-diabetic or diabetic, which occurred very early at the 3rd day postoperative in both cases. While complete wound healing was revealed at the 7th day postoperative in both the non-diabetic and diabetic subgroups treated with PRP after the wound, which was like the non-diabetic control subgroup. Whilst, the diabetic non-treated subgroup only showed partial wound healing at the 7th day postoperative.&#x0D; Conclusion: A single injection of PRP could be used as a prophylactic to prevent expected impaired wound healing in diabetic oral mucosal wounds and to enhance wound healing in non-diabetic wounds. PRP could be used as a therapeutic to enhance wound healing in diabetic and non-diabetic oral mucosal wounds.&#x0D; Key Words: platelet rich plasma, wound healing, diabetes, rat, tongue, p63, vimentin, TEM&#x0D; BACKGROUND: Delayed healing of diabetic wounds has been well-documented. At present, the use of platelet-rich plasma (PRP) has attracted great attention in many medical fields including wound healing.&#x0D; AIM: Histological, immunohistochemical, and ultrastructural evaluation of the effect of PRP on wound healing in the tongue of normal and streptozotocin-induced diabetic albino rats.&#x0D; METHODOLOGY: A total number of 108 adult male albino rats with average weight 200 g were used in the study. The animals were classified into two main groups: Non-diabetic and diabetic groups. Each group was further divided into three subgroups: Non-treated wound, PRP-treatment before wound, and PRP-treatment after wound. Tongue specimens were dissected on post-operative days 1, 3, and 7. The specimens were examined histologically by H&amp;E, immunohistochemically by p63 and vimentin, and ultrastructurally by TEM.&#x0D; RESULTS: The most accelerated wound healing was revealed in the subgroups treated with PRP before the wound, whether non-diabetic or diabetic, which occurred very early at the 3rd day post-operative in both cases. While complete wound healing was revealed at the 7th day post-operative in both the non-diabetic and diabetic subgroups treated with PRP after the wound, which was like the non-diabetic control subgroup. While, the diabetic non-treated subgroup only showed partial wound healing at the 7th day post-operative.&#x0D; CONCLUSION: A single injection of PRP could be used as a prophylactic to prevent expected impaired wound healing in diabetic oral mucosal wounds and to enhance wound healing in non-diabetic wounds. PRP could be used as a therapeutic to enhance wound healing in diabetic and non-diabetic oral mucosal wounds.

Comparison between platelet rich plasma injection, corticosteroid injection and short-wave diathermy in the management of pain and the improvement of functional outcome in the patients suffering from adhesive capsulitis of the shoulder: a randomized controlled trial

Background: Adhesive capsulitis of shoulder is characterized by pain and restricted range of motion and has a wide variety of treatment options without any substantial evidence. Platelet rich plasma (PRP) is one of the newer treatment modalities and its efficacy needs to be compared with other routine treatment modalities.Method: A randomized controlled trial was conducted in the Department of Physical Medicine and Rehabilitation, Regional Institute of Medical Sciences (RIMS), Imphal for a period of 1-year February 2019 to January 2020. One hundred ninety-five patients with adhesive capsulitis recruited and randomized, patients received single PRP injection (2 ml) or corticosteroid (80 mg methyl prednisolone) or shortwave diathermy (10 settings continuous mode using 27.12 MHz).Results: The primary outcome measure was active range of motion of the shoulder and the secondary outcome measures included Visual analogue scale (VAS) for pain and a shortened version of Disabilities of the Arm, Shoulder and Hand (Quick DASH) for function. Patients were evaluated at 0, 3, 6 and 12 weeks. Chi-square test and ANOVA were used to determine significant differences. PRP treatment resulted in statistically significant improvement over corticosteroid at 12 weeks and over short-wave diathermy therapy at 6 weeks.Conclusion: This study demonstrates that single injection of PRP is more effective than corticosteroid or short-wave diathermy in the treatment of adhesive capsulitis of shoulder.

Platelet-rich plasma injection versus surgical and medical treatment of mild-moderate carpal tunnel syndrome

Carpal tunnel syndrome (CTS) accounts for approximately 90% of peripheral entrapment neuropathy cases. Treatments of CTS as splinting, corticosteroid injection, and surgery are not 100% effective, and alternative treatments are worth exploring. Surgery indicated in patients with persistent numbness, pain, and motor dysfunction. Empirical evidence indicates that many patients with CTS respond to anti-inflammatory medications. Recently, major attention has been drawn to platelet-rich plasma (PRP) for its possible effects on axon regeneration and neurological recovery.ObjectivesTo evaluate the therapeutic efficacy of single ultrasound guided PRP injection of CTS versus surgical procedures and medical treatment in patients with mild-moderate CTS regarding pain relief and function improvement.MethodsThirty patients were injected in the carpal tunnel with single ultrasound-guided PRP (1–2 ml) injections; 30 patients went to surgical procedure, and 30 patients received conventional medical treatment and hand support. They were followed by using VAS (visual analogue scale), Boston questionnaire for CTS, and nerve conduction study for clinical improvement.ResultsBoth groups of patients who had received PRP injection and who underwent to surgery showed improvements in their scores of evaluation parameters at 6 months post intervention, while the third group that received medical treatment shows insignificant improvement at 6 months post treatment.ConclusionPRP can be considered as a safe, less invasive, and long-lasting alternative to surgery and effective with one shot session compared to medical treatment in management of mild-moderate CTS.Trial registrationClinical trial.govID: NCT04235426.Unique protocol ID:1472.Verification date: January 2020.

Study protocol for a double-blind, randomised placebo-controlled trial evaluating clinical effects of platelet-rich plasma injection for acute grade-2 hamstring tear among high performance athletes

IntroductionHamstring injury among athletes often results in significant morbidity. Currently, there are controversies regarding the clinical use of platelet-rich plasma (PRP) for the treatment of acute hamstring injury.Methods and analysisThis...

Intra-articular platelet-rich plasma vs corticosteroids in the treatment of moderate knee osteoarthritis: a single-center prospective randomized controlled study with a 1-year follow up

BackgroundOsteoarthritis is the most prevalent type of arthritis, which significantly impacts the patient’s mobility and quality of life. Pharmacological treatments for osteoarthritis, such as corticosteroids, produce an immediate reduction of the patient’s pain as well as an improvement in the patient’s mobility and quality of life, but with a limited long-term efficacy. In this context, platelet-rich plasma (PRP) infiltrations represent a therapeutic tool due to its trophic properties and its ability to control inflammatory processes, especially in musculoskeletal applications. The aim of this study is to evaluate and compare the clinical benefits of PRP when injected intra-articularly vs a commonly used corticosteroid (CS, triamcinolone acetonide, Kenalog®) in patients affected by mild to moderate symptomatic knee osteoarthritis.MethodsForty patients affected by symptomatic radiologically confirmed knee osteoarthritis (Kellgren-Lawrence grades II–III) were enrolled in this randomized study. Patients randomized in the PRP group (n = 20) received an intra-articular injection of PRP (8 mL) while patients randomized in the CS group (n = 20) received an intra-articular injection of triamcinolone acetonide (1 mL of 40 mg/mL) plus lidocaine (5 mL of 2%). The pain and function of the target knee were evaluated by the VAS, IKDC, and KSS scales at the baseline (V1), 1 week (V2), 5 weeks (V3), 15 weeks (V4), 30 weeks (V5), and 1 year (V6) after treatment.ResultsNo serious adverse effects were observed during the follow-up period. A mild synovitis was registered in 15 patients (75%) in the PRP group within the first week after treatment which resolved spontaneously. Both treatments were effective in relieving pain and improving the knee function in the very short-term follow-up visit (1 week). A high improvement of the subjective scores was observed for both groups up to 5 weeks, with no significative differences between the groups for the VAS, IKDC, or KSS. After 15 weeks of follow-up, the PRP group showed significative improvements in all scores when compared to the CS group. Overall, the patients who received PRP treatment had better outcomes in a longer follow-up visit (up to 1 year) than those who received CS.ConclusionsA single PRP or CS intra-articular injection is safe and improves the short-term scores of pain and the knee function in patients affected by mild to moderate symptomatic knee OA (with no significant differences between the groups). PRP demonstrated a statistically significant improvement over CS in a 1-year follow-up. This study was registered at ISRCTN with the ID ISRCTN46024618.

Evaluating the efficacy of platelet rich plasma injection for the treatment of chronic plantar fasciitis

Background: Plantar fasciitis is a common and recurring cause of heel pain in adults. Platelet-rich plasma (PRP) derived from autologous blood contains a high concentration of growth factors necessary for tissue healing and offer potential treatment for plantar fasciitis. Materials and Methods: The study was conducted in Coimbatore medical college hospital as a day care procedure. Between May and September 2017, 100 patients with chronic plantar fasciitis with a mean age of 40 years were included in this prospective study and were treated with single autologous PRP injection. All patients were assessed for the pain on the visual analog scale (VAS) and the American orthopedic foot and ankle score (AOFAS) both preinjection and postsingle injection of PRP. Results: The average pain perception before injection as assessed using VAS was observed to be 9.1. Before PRP injection, 72% of patients had severe limitation of activities and 28% of patients had moderate limitation of activities. Following the administration of PRP, VAS decreased to 1.6. Eighty-eight patients were completely satisfied; eight patients were satisfied with reservation, whereas four patients were unsatisfied with the treatment outcome. AOFAS improved from 52 to 90, thus establishing its therapeutic efficacy both at 8 weeks and 3 months posttreatment. Conclusion: The results of this study support that injection of autologous PRP is safe, does not affect the biomechanical function of the foot and is efficacious in improving plantar fasciitis.

In Adults with Acute Achilles Tendon Rupture, a Single Platelet-Rich Plasma Injection Did Not Improve Muscle-Tendon Function at 24 Weeks.

In Adults with Acute Achilles Tendon Rupture, a Single Platelet-Rich Plasma Injection Did Not Improve Muscle-Tendon Function at 24 Weeks.

CORR Synthesis: What Is the Role of Platelet-rich Plasma Injection in the Treatment of Tendon Disorders?

CORR Synthesis: What Is the Role of Platelet-rich Plasma Injection in the Treatment of Tendon Disorders?

Assessment of a Single Intra-Articular Stifle Injection of Pure Platelet Rich Plasma on Symmetry Indices in Dogs with Unilateral or Bilateral Stifle Osteoarthritis from Long-Term Medically Managed Cranial Cruciate Ligament Disease.

PurposeThe use of platelet-rich plasma (PRP) to treat canine osteoarthritis has gained support within the scientific community. PRP effects on pain control for degenerative joint disease induced by naturally occurring cranial cruciate ligament instability are limited, particularly in a cohort of dogs with chronic instability and osteoarthritis (>12 months), representing a commonly encountered clinical population that often defaults to medical management. The goal of this study was to assess the effects of a single intra-articular PRP injection into an effected stifle in this cohort, to assess response to treatment, quantitative kinetic data as it relates to percent body weight for peak vertical force (PVF) and vertical impulse (VI) were collected, and symmetry indices related to PVF were determined.MethodsTwelve dogs with unilateral or bilateral osteoarthritis with ruptured, non-stabilized cranial cruciate ligaments over 12 months duration were identified. Unilateral injections of 2.5 mL of a PRP preparation into the most severely affected stifle based on kinetic analysis was performed. Repeat pressure-sensitive walkway analysis was conducted monthly for 3 months. Peak vertical force (PVF) and vertical impulse (VI) were normalized to body weight and identified in all four limbs. Previously published symmetry indices regarding PVF were calculated, comparing the treated limb with the contralateral limb, ipsilateral forelimb, and contralateral forelimb.ResultsAfter treatment, hind limb symmetry index (SI) regarding PVF showed improved symmetry, suggesting more weight placement at all-time points after injection of the most affected limb (p < 0.01). Further, PVF asymmetry indices assessing contralateral fore (CFL) and hind limb (CHL) as well as ipsilateral forelimb (IFL) revealing a significant decrease from baseline for CHL at week 4 (p = 0.02), but not weeks 8 and 12. The CFL showed decreased differences in symmetry from baseline at each time point (p = 0.03). There were no statistically significant changes in PVF or VI over time in treated dogs.ConclusionA single injection of PRP improved kinetics for minimally 4 weeks with some data suggesting an effect for up to 12 weeks. Therefore, PRP might be a viable therapeutic option for instability and inflammation associated with chronic osteoarthritis due to cranial cruciate ligament disease in the non-surgical patient.

Factors associated with positive outcomes of platelet-rich plasma therapy in Achilles tendinopathy.

The efficacy of platelet-rich plasma in the treatment for Achilles tendinopathy is debated. Therefore, it is important to know which factors, related to the subjects and/or the disease, are associated with positive or negative outcomes. Aim of this study was to evaluate in a large cohort of patients with Achilles mid-portion tendinopathy which variables were independently associated with a positive outcome after platelet-rich plasma treatment. Eighty-four subjects with Achilles tendinopathy were evaluated by means of VISA-A score and ultrasound and treated with a single platelet-rich plasma injection once a week for 3weeks. Afterward, a rehabilitation program, based on eccentric training, was implemented. At 3 and 6months, the relationship between the mean VISA-A score and the following putative predictors was evaluated: sex, age, physical activity, sport, smoking, metabolic risk factors, BMI, symptoms duration, tendon damage, neovessels, adherence to eccentric training. Finally, the percentage of clinically evident positive outcomes (defined as an increase in VISA-A score ≥ 20 points) related to each variable was computed. At final follow-up, using the General Linear Model for Repeated Measures procedure, male sex (0.02), age ≤ 40 (0.05) and adequate eccentric training (0.02) were found to be independently associated with a significant increase in the mean VISA-A score. Moreover, the clinically evident positive outcomes, as previously defined, were significantly associated with male sex (0.01), age ≤ 40 (0.000), BMI ≤ 25 (0.001), symptoms duration ≤ 12months (0.02) and good adherence to eccentric training (0.004). Younger age, male sex and good adherence to eccentric training can be considered predictors of better results after platelet-rich plasma therapy in Achilles tendinopathy.

The use of platelet-rich plasma in treatment of olfactory dysfunction: A pilot study.

BackgroundOlfactory dysfunction is a prevalent problem with a significant impact on quality of life and increased mortality. Limited effective therapies exist. Platelet‐rich plasma (PRP) is an autologous biologic product with anti‐inflammatory and neuroprotective effects. This novel pilot study evaluated the role of PRP on olfactory neuroregeneration in patients with hyposmia.MethodsSeven patients who had olfactory loss greater than 6 months in duration, no evidence of sinonasal inflammatory disease, and no improvement with olfactory training and budesonide topical rinses were enrolled in this preliminary study. Patients received a single intranasal injection of PRP into the mucosa of the olfactory cleft. The Sniffin' Sticks olfactory test consisting of threshold, discrimination, and identification measurements (TDI) was administered at the beginning of the study and at 1 and 3 months.ResultsAll patients reported a subjective improvement of their smell shortly after injection but then stabilized. At 3‐month post‐treatment, two patients with functional anosmia (TDI < 16) did not improve significantly. Five patients with hyposmia (TDI > 16 but <30) showed an improvement with 60% achieving normosmia (TDI > 30) at 3‐month follow‐up. On average, patients with baseline TDI > 16 improved by 5.85 points with the most significant improvement in the threshold subcomponent. There were no adverse outcomes from intranasal PRP injections.ConclusionPRP appears safe for use in the treatment of olfactory loss, and preliminary data suggest possible efficacy, especially for those with moderate yet persistent loss. Further studies will help determine optimal frequency and duration of use.Level of evidence: 2B

Platelet rich plasma versus placebo for the management of Achilles tendinopathy: protocol for the UK study of Achilles tendinopathy management (ATM) multi-centre randomised trial

IntroductionIn the UK, 150 000 people every year experience mid-substance Achilles tendinopathy. Typically patients are offered a range of treatment options such as exercise, electrotherapy, injections and surgery. With large...

Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 1 Year: A Prospective, Randomized Trial.

Background:Approximately 47 million people in the United States have been diagnosed with arthritis. Autologous platelet-rich plasma (PRP) injections have been documented to alleviate symptoms related to knee osteoarthritis (OA) in randomized controlled trials, systematic reviews, and meta-analyses. Autologous bone marrow aspirate concentrate (BMC) injections have also emerged as a treatment option for knee OA, with a limited clinical evidence base.Purpose:To compare the efficacy of BMC to PRP for the treatment of knee OA regarding pain and function at multiple time points up to 12 months after an injection. We hypothesized that BMC will be more effective in improving outcomes in patients with knee OA.Study Design:Randomized controlled trial; Level of evidence, 2Methods:A total of 90 participants aged between 18 and 80 years with symptomatic knee OA (Kellgren-Lawrence grades 1-3) were randomized into 2 study groups: PRP and BMC. Both groups completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and subjective International Knee Documentation Committee (IKDC) questionnaires before and 1, 3, 6, 9, and 12 months after a single intra-articular injection of leukocyte-rich PRP or BMC.Results:There were no statistically significant differences in baseline IKDC or WOMAC scores between the 2 groups. All IKDC and WOMAC scores for both the PRP and BMC groups significantly improved from baseline to 1 month after the injection (P < .001). These improvements were sustained for 12 months after the injection, with no difference between PRP and BMC at any time point.Conclusion:Both PRP and BMC were effective in improving patient-reported outcomes in patients with mild to moderate knee OA for at least 12 months; neither treatment provided a superior clinical benefit. Autologous PRP and BMC showed promising clinical potential as therapeutic agents for the treatment of OA, and while PRP has strong clinical evidence to support its efficacy, BMC has limited support. This study did not prove BMC to be superior to PRP, providing guidance to clinicians treating OA. It is possible that the results were affected by patients knowing that there was no control group.Registration:NCT03289416 (ClinicalTrials.gov identifier).

Effectiveness of single injection of platelet-rich plasma over corticosteroid in the treatment of plantar fasciitis – A randomized, comparative study

Objectives: Plantar fasciitis (PF) is not an uncommon cause of heel pain whose treatment is not yet standardized. Although platelet-rich plasma (PRP) and corticosteroid (CS) injections are the two commonly used modalities, yet not much importance has been given to the comparison of their roles in sustained functional improvement. We aimed to study the effect of PRP and CS injections in PF and compare their effectiveness with respect to pain relief and improvement of functional and patient satisfaction. Methods: Seventy-three cases were randomized into two groups: 39 patients (Group A) received a single injection of autologous PRP and 34 in Group B received a single injection of CS (40 mg of methylprednisolone) by the random selection. A structured home exercise program was demonstrated to both the groups, as baseline management. The effectiveness was assessed and compared in preinjection and postinjection at 3- and 6-months follow-up. Visual Analog Scale (VAS), Roles and Maudsley (RM), and Foot Function Index (FFI) scoring systems were used as outcome measures. Results: CSs had an early effect, reducing pain to a moderate level in 82.4% of patients compared to PRP (P = 0.000). However, the effect was not sustainable over a long period. On the other hand, PRP was found to have better pain relief over 3 months and 6 months follow-up with a mean VAS score of 2.0 ± 0.9 and 0.8 ± 0.8, respectively (P = 0.000). There was a significant improvement of FFI and RM score as well as at 6 months follow-up (P = 0.000). Conclusion: Injection of CS had an early effect, which is not sustainable, whereas PRP was found to have a prolonged impact on pain relief and better patient satisfaction with treatment outcomes. Therefore, PRP can be advised for sustained and prolonged improvement in PF.

Platelet rich plasma injection versus extracorporeal shock-wave therapy in treatment of plantar fasciitis

Objective The aim of this study was to determine the efficacy of local platelet-rich plasma (PRP) injection compared with extracorporeal shock-wave therapy (ESWT) for treatment of plantar fasciitis. Background Plantar fasciitis is an important cause of heel pain. ESWT and PRP have emerged as new management options, alternative for surgery. Patients and methods This comparative study included 60 patients, comprising 48 female and 12 male patients with plantar fasciitis diagnosed clinically and by ultrasound. The patients were divided into two groups: 30 patients received single local PRP injection and 30 patients received three sessions of ESWT weekly. All patients were assessed using pain visual analog scale (VAS) score, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hind foot scale, and plantar fascia thickness by ultrasound before treatment and at 1 and 3 months after treatment. Results VAS, AOFAS ankle-hind foot score, and plantar fascia thickness improved significantly in both groups. The AOFAS ankle-hind foot scale shows more improvement in the ESWT group at 1 month after treatment (P = 0.009). Significant improvement in plantar fascia thickness was seen clearly in PRP group at 1 and 3 months after treatment (P Conclusion Local PRP injection and ESWT improve pain and function in patients with plantar fasciitis. ESWT showed early improvement if plantar fasciitis is associated with calcaneal spur.

A short-term comparative analysis of the efficacy of platelet-rich plasma therapy and corticosteroid injection in lateral epicondylitis

Background: Tennis Elbow, a common overuse syndrome, is a tendonitis of the extensor muscles of the forearm mainly due to intratendinous degeneration associated with aging, repetitive movement, and vascular compromise. Autologous platelet-rich plasma (PRP) injections represent a new therapeutic option for chronic tendinopathies including tennis elbow. The purpose of the present study was to assess the therapeutic effect, efficacy, and safety of a single injection of PRP and corticosteroid in improving pain and function in patients suffering from lateral epicondylitis over a short term. Materials and Methods: Sixty patients with lateral epicondylitis were randomized into two groups to receive one injection of PRP or corticosteroid and were followed for 3 months. The two groups were compared as regards pain and functional improvement using the visual analogue scale (VAS) and the patient-rated tennis elbow evaluation (PRTEE) Score, by assessing the patients three times postintervention. Results: VAS scale showed that both modalities were effective in pain reduction. PRTEE score represented variably improved symptoms, i.e., decrease in pain and better function along with improvement in daily activity after 3 months in both groups. Conclusion: As the degree of pain relief achieved by the respective modalities was almost similar, the most important difference between the intervention groups was the duration of their effectiveness. PRP is suggested to be superior in the duration of pain relief when compared to corticosteroids. We can propose that PRP can be administered less often and more conveniently as compared to corticosteroid for lateral epicondylitis.