Platelet-rich Plasma Treatment Research Articles

Evaluating the Efficacy of Combined Platelet-Rich Plasma and Microneedling for Aesthetic Rejuvenation of the Periorbital Area: A Randomized, Blinded Cohort Study.

Microneedling, a technique involving controlled dermal microwounding, and platelet-rich plasma (PRP) injections are both employed for skin rejuvenation. While both treatments individually show promise, limited research has explored their combined efficacy. This study aimed to evaluate the effectiveness of combining PRP injections with microneedling for aesthetic concerns around the eyes under standardized conditions. This single-center, longitudinal cohort study was conducted from October 2017 to October 2020. Thirteen adult participants (mean age 35, 92.3% female) with aesthetic concerns in the periorbital area underwent combined PRP and microneedling treatment. Standardized photographs were taken preprocedure, at 1 week, and 3 months. Photographs were evaluated by three blinded dermatologists using validated photonumeric scales. Participants completed a self-assessment questionnaire at the 1-week follow-up regarding skin homogeneity, texture, pigmentation, and wrinkles. Self-reported outcomes indicated perceived improvements in skin homogeneity (72.7% reporting mild or significant improvement) and texture (81.8% reporting mild, moderate, or significant improvement). Improvements in pigmentation and wrinkles were less pronounced. Dermatologists' assessments revealed no significant differences in skin attributes before and after treatment. Despite subjective reports of improvement, objective evaluations by independent dermatologists did not demonstrate significant changes. Variability in outcomes might be attributed to differences in study design, treatment protocols, and assessment methods. Further research with larger sample sizes and multiple treatment sessions is needed to better understand the benefits of combining PRP with microneedling for periorbital rejuvenation.

Posterior iliac crest vs. proximal tibia: distinct sources of anti-inflammatory and regenerative cells with comparable 6-month clinical outcomes in treatment of osteoarthritis

BackgroundHuman bone marrow is a source of mesenchymal stem cells (MSCs), other progenitor cells, and factors with anti-inflammatory and regenerative capacity. Though the fraction of MSCs out of the nucleated cells is very small, bone marrow aspirate (BMA) for osteoarthritis (OA) has noteworthy effects. BMA is usually collected from the posterior or anterior iliac crest, and rarely from the proximal tibia. We investigated the clinically beneficial concentration of ex vivo MSCs, derived from BM harvested from the posterior iliac crest and proximal tibia by Marrow Cellution™ Aspiration System, and their phenotypic differences, in comparison to autologous Platelet-Rich Plasma (PRP) treatment prepared with a manual, closed system.MethodsA single-center, parallel, randomized controlled study was designed to investigate the efficacy of BMA from the posterior iliac crest compared to BMA from the proximal tibia, against a control group treated with PRP, in knee OA. Thirty patients with knee OA grade I-IV, according to Kellgren-Lawrence (KL), were distributed into each group. Visual Analog Scale (VAS) and Western Ontario & McMaster Universities Arthritis Index (WOMAC) score were used for clinical outcome evaluation.ResultsData from an intermediate analysis of 6-months follow-up, involving 15 patients in each arm, showed that the posterior iliac crest was significantly more densely populated with mononuclear cells, than the proximal tibia (p = 0.005). Flow cytometric analysis on ex vivo BMA showed a significantly greater number of MSCs in the BM-derived from the posterior iliac crest when compared with the proximal tibia (p < 0.001), together with a significantly higher number of platelets (PLTs) (p < 0.001). Surprisingly, despite these differences in cells number, the improvement in early pain and function scores, after each treatment, were statistically significant within each of the three arms. BM from the proximal tibia showed the highest ΔWOMAC, while BM from the posterior iliac crest showed the highest ΔVAS; however, these differences were not statistically significant across the three arms (p > 0.05). A better outcome, in terms of ΔVAS, was observed in patients classified as KL I-II, when treated with BMA from crest (p < 0.001) and PRP (p = 0.004). Moreover, the effect of BMA treatment on ΔVAS depends on MSCs % only in the Tibia Arm (r = -0.59, p = 0.021), where we also found a correlation between ΔWOMAC and monocytes (r = 0.75, p = 0.016).ConclusionThe results indicate that the iliac crest yields a higher concentration of MSCs compared to the proximal tibia, however both BM, independently of the MSCs concentration, show a beneficial clinical outcome in the treatment of knee OA. Furthermore, BMA is not superior to PRP treatment.

Effects of Nanofat and PRP on Type I Collagen Production in Striae Distensae: Preliminary Findings from a Prospective, Randomized Single-Blind Study.

Striae distensae (SD) appear clinically as parallel striae, lying perpendicular to the tension lines of the skin. SD evolve into two clinical phases, an initial inflammatory phase in which they are called "striae rubrae" (SR) and a chronic phase in which they are called striae albae (SA). This study investigates the synergistic effect of nanofat and platelet-rich plasma (PRP) injections on collagen production in fibroblasts derived from SA (SAF). A prospective, randomized single-blind study was conducted in fifty women presenting with SA in the abdominal region who had voluntarily sought a conventional abdominoplasty procedure and accepted to test an autologous treatment for their SDs. SA were treated using: PrP 10ml; PrP 2ml (20%) + nanofat 8ml (80%); nanofat 10ml. Following the abdominal dermolipectomy, biopsies from treated and untreated SDs were taken and analyzed for type I collagen quantification. Results were processed through statistical analysis models using the Student's t test. Collagen concentration in untreated SA biopsies was significantly lower than in healthy skin. Both PRP and nanofat treatments significantly increased collagen biosynthesis compared to controls, with the combined PRP-nanofat treatment showing the highest increase in collagen levels (p < 0.0001). A superior clinical improvement was observed in the areas that received the combined treatment of PRP and nanofat (p = 0.001). Our findings indicate that both PRP and nanofat treatments effectively enhance collagen production in SA, with the combined PRP-nanofat treatment showing a synergistic effect. This combined therapy holds promise for effectively treating SA, providing a new potential treatment avenue for SMs and similar skin conditions. Further studies are needed to validate these results and explore clinical applications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Full-thickness burn scar treatment using a combination of microneedling and platelet-rich plasma in animal model

Microneedling (MA) and platelet-rich plasma (PRP) therapies have shown potential for enhancing scar repair through collagen production and growth factor release, yet their effects on full-thickness burn scars remain underexplored. This study evaluated the impact of MA, PRP, and combined MA + PRP treatments on scar healing in a rat model of full-thickness burns. Fifty adult rats were divided into four groups: control, MA, PRP, and MA + PRP. Treatments were administered 21 days post-burn, and animals were evaluated at 14- and 21-days post-treatment. Macroscopic, histopathological, and morphometric analyses were performed to assess epithelialization, extracellular matrix (ECM) organization, and collagen deposition. The combination of MA + PRP demonstrated superior outcomes, showing enhanced ECM organization, significant collagen deposition, increased angiogenesis, and an improved inflammatory profile with mononuclear cell infiltration. Morphometric analysis confirmed a substantial increase in collagen content, particularly in the MA + PRP group, supporting improved tissue remodeling and scar maturation. These findings suggest that combined MA + PRP therapy may be a promising approach for promoting effective and accelerated burn scar healing. Further research is warranted to optimize protocols for clinical application.

Safety and efficacy evaluation of intracavernosal injection of platelets rich plasma in treatment of vasculogenic erectile dysfunction

ABSTRACT Objectives The study’s objective is to compare platelet-rich plasma (PRP) injections to placebo in terms of effectiveness and safety for patients with vasculogenic erectile dysfunction (ED). Methods This randomized placebo-controlled clinical trial was done on 50 male patients with organic vasculogenic ED and sexually active in a stable heterosexual relationship for a period of over three months. The patients were randomized into two main groups: Group (A) (n = 25) underwent PRP treatment. Group (B) (n = 25) control underwent placebo treatment. Results The two groups under study differed in a statistically significant way regarding the achievement of minimal clinically important differences (MCID) at 3 months and 24 months. Statistically significant variations existed between the mild subgroup and placebo regarding achieving MCID after 3 months and 24 months. The level of satisfaction was statistically significantly higher in the PRP group. A statistically significant variation was present between the mild subgroup and placebo at 3 months and 24 months in terms of changes from baseline in the erectile function domain of the International Index of Erectile Function (IIEF-EF) questionnaire score in each subgroup. Conclusions PRP is an effective alternative modality of treatment in cases of ED, and they offer an intermediate stage between pharmaceutical therapy and surgical interventions at least in mild and mild to moderate cases where unsatisfactory results or unpleasant side effects compel the patients to abandon all hope on medical treatment.

Improvement in the Youthfulness of Facial Skin after a Single Treatment with Platelet Rich Plasma

Objective: Platelet rich plasma (PRP) is an autologous substance widely used to stimulate dermal collagen synthesis. This study aimed to investigate the efficacy of a single PRP treatment for facial rejuvenation. Materials and Methods: This study was conducted at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand from August 2020 to March 2021. Enrolled patients underwent a single intradermal injection treatment of 0.1 mL PRP at 30 locations on the face. Outcomes were assessed at 1, 2, and 4 weeks post-intervention using the patient-perceived age visual analog scale (VAS), FACE-Q assessment, and elasticity index (EI) with a Cutometer. Results: Forty Thai patients with an average age of 36.4 years, Fitzpatrick skin type 3-4 were enrolled. The mean Patient-perceived Age VAS significantly decreased one month after treatment (-2.71±2.42, p&lt;0.001). FACE-Q satisfaction with facial skin was 74.29±14.49, and satisfaction with the outcome was 73.41±16.26 (scale 0-100). The PRP significantly affected skin EI, with the peak improvement observed at 1-2 weeks post-injection, predominantly at the cheek, crow’s feet, and perioral area (all p&lt;0.05). All patients had an overall improvement in satisfaction scores throughout the study. Conclusion: A single treatment of PRP injection resulted in overall satisfaction in facial skin rejuvenation as measured by patient-perceived age VAS and FACE-Q assessment. The PRP showed positive outcomes in EI with peak performance at 1-2 weeks post-treatment.

Evaluation of Storage Parameters of Platelet-Rich Plasma in Functional Assay of Epithelial Gap Repair

Platelet-rich plasma (PRP), produced from autologous blood and containing growth factors, has shown promise in treating various conditions, including diabetic wounds. However, as expected, patient compliance is low in the context of repeated treatments as required for hard-to-heal wounds. This study investigates the efficacy of PRP stored under refrigeration for up to 2 weeks in promoting in-vitro human epithelial cell gap closure. PRP was prepared from six healthy individuals and immediately split into sterile test tubes for storage at 4°C; the impact of fresh PRP on epithelial gap closure was compared to paired PRP samples stored for one and two weeks. According to gap closure analysis, 5 out of 6 individuals depicted accelerated epithelial gap closure compared to control conditions. There was no significant difference between fresh and refrigerated samples. An overall benefit was observed for using 1-week old samples over 2-week-old samples. Interestingly, according to a 6-hr epithelial gap analysis, significantly accelerated cell migration was obtained by 1-week-old refrigerated samples compared to their corresponding fresh PRP samples. The current study provides data in support of increasing the accessibility of PRP treatment for patients with hard-to-heal wounds. Patients can potentially self-treat between wound clinic appointments by using refrigerated sterile aliquots of their fresh PRP. Notably, by the end of two weeks, refrigerated PRP will not act as fresh PRP. More research is needed to fully investigate the effect of refrigeration on PRP sample efficacy, including larger cohorts, clinical wounds, and an evaluation of the molecular fingerprint of refrigerated PRP samples.

Menstrual blood-derived mesenchymal stem cells combining with platelet-rich plasma infusion in endometrium repair.

Thin endometrium caused by various factors affects the conception rate of females worldwide; however, current medications are still insufficient. Therefore, a novel approach is needed. We previously reported the effect of menstrual blood-derived mesenchymal stem cells (MenSCs) in ameliorating ethanol-induced endometrial injuries. In the present study, we aimed to investigate whether the effect of MenSCs is enhanced by a combination of platelet-rich plasma (PRP) infusion. An endometrial injury mouse model was established by infiltrating 95% ethanol for 15 s into the uterus, followed by MenSCs, PRP, or MenSCs + PRP treatment. Pathological changes were observed by HE staining. The expression of CK18, vimentin, ItgαVβ3, and VEGF was determined using IHC staining and WB blotting. Compared with the model, MenSCs, PRP, and MenSCs + PRP treatments significantly improved endometrial damage and thickness, with the combined therapy displaying the most pronounced efficacy. The density of CK18-, vimentin-, and ItgαVβ3 positive cells increased most significantly in the MenSCs + PRP group of mice. In addition, the protein expression of CK18, vimentin, and VEGF was significantly upregulated after MenSCs + PRP, MenSCs, and PRP treatment, with MenSCs + PRP therapy showing the best efficacy. MenSCs + PRP therapy is more beneficial for ameliorating ethanol-induced endometrial damage than MenSCs or PRP alone, providing a basis for the investigation of novel approaches for treating thin endometria.

Triple combination of fractional carbon dioxide laser, 308-nm excimer lamp, and platelet-rich plasma in refractory vitiligo: A randomized split-body comparative study

Objectives: Vitiligo significantly impacts patients’ quality of life. Current evidence indicates that combination therapy results in faster improvement, enhancing patient adherence to treatment and leading to higher satisfaction among patients. In this study, we compare the efficacy of combined fractional carbon dioxide (FCO2) laser and excimer lamp with platelet-rich plasma (PRP) or topical tacrolimus in patients with refractory vitiligo. Material and Methods: This is a prospective, single-blind, randomized split-body clinical trial involving 41 patients with resistant focal patches of vitiligo vulgaris. Each patient had two similar lesions randomly assigned to receive either a combination of FCO2 laser, excimer lamp, and intradermal PRP injections or a combination of FCO2 laser, excimer lamp, and topical 0.1% tacrolimus (applied twice daily for 12 weeks). The FCO2 laser and PRP treatments were administered in three monthly sessions, and the excimer lamp was used twice a week over 12 weeks. The efficacy of treatment was assessed based on the physician’s assessment and patient’s satisfaction Results: Despite significant improvement in both treatment groups during the course of treatment, the PRP group showed significantly superior efficacy (more than 50% improvement) compared to the tacrolimus group (56.1% and 26.8%, respectively). Furthermore, the PRP group exhibited greater improvement in resistant acral areas compared to the tacrolimus group (51.2% and 19.5%, respectively). Conclusion: The combination of FCO2, an excimer lamp, and PRP demonstrates superior efficacy, particularly in resistant acral areas. As a result, this combination can be recommended in difficult-to-treat areas in patients with vitiligo.

Efficacy of Autologous Platelet Rich Plasma For Treatment of Diabetic Foot Ulcer

Background: Diabetic foot ulcer (DFU) is a common complication of long standing uncontrolled diabetes mellitus. There are different types of treatment commonly practiced among the clinicians to treat DFU. Among them, autologous platelet rich plasma (PRP) application is getting popularity day by day throughout the western world. Methodology: It was a prospective, randomized, controlled study that was carried out among 40 DFU patients in the Department of Surgery, Dhaka Medical College Hospital. Among them, 20 patients were treated by autologous PRP and another 20 patients were treated by conventional method. They were followed up for 12 weeks period. Data collected from the participants were analyzed to compare the healing rate among two groups. Result: In PRP treated ulcers, healing rate was significantly faster and better in comparison to conventionally treated ulcers. After 10th weeks follow up, in PRP group 14 ulcers were completely healed whereas in control group,4 ulcers were completely healed. On the contrary, 3 ulcers in control group showed further deterioration. At the end of 12th weeks follow up, 19 ulcers in PRP group were completely healed whereas 13 ulcers in control group were completely healed. In PRP group no patient showed any complication during treatment, whereas in control group 7 patients experienced local complications. Conclusion: Treatment of diabetic foot ulcer with autologous platelet rich plasma results in faster and better ulcer healing in comparison to conventional treatment. PRP accelerates the healing rate and keep the ulcer area safe from external pathogens. Hence, autologous PRP is a better selection for DFU treatment. J Dhaka Med Coll. 2023; 32(1) : 38-42

Bibliometric Analysis of Platelet-Rich Plasma Treatment for Hair Restoration, Facial Rejuvenation, Dental Procedures, and Gynecological Rejuvenation

Introduction: Autologous platelet-rich plasma (PRP) technologies offer an attractive treatment option for various medical fields. Owing to its high concentration of growth factors, PRP has been posited to induce proliferation, differentiation, and angiogenesis at the cellular level, as well as wound-healing and remodeling at the tissue level. The goal of the present bibliometric analysis was to characterize the growing body of literature concerning PRP use in various medical applications. Methods: A comprehensive literature search was performed on June 28, 2024, using Web of Science and SCOPUS databases, covering all available publications in selected categories from 2001 to present. Results: PRP use for hair restoration had both the greatest number of total publications among the investigated applications, whereas PRP use in dental procedures had the longest-standing history of publications. PRP use in hair restoration and facial rejuvenation had the greatest number of placebo-controlled and double-blinded randomized controlled trials; however, the impact of results may suffer from a lack of consistency in PRP preparation and outcome measurement between different studies. Conclusion: To effectively validate the utility of PRP across various medical interventions, careful consideration of methodology should be undertaken for future studies to ensure validity of results.

The role of fibrinogen combined with platelet-rich plasma in enhancing microfracture for cartilage damage: a retrospective study of 113 patients with knee osteoarthritis

ObjectiveKnee osteoarthritis is the most common osteoarthritis and imposes a significant burden on patients’ lives. Several treatment methods can promote cartilage repair to varying extents, but there are limited studies on the combined application of different treatments. The purpose of this study is to evaluate the clinical efficacy of microfracture combined with fibrinogen and platelet-rich plasma (PRP) under arthroscopic in treating knee osteoarthritis, so as to provide a basis for clinical treatment decisions.MethodA total of 113 patients with knee osteoarthritis who received orthopedic treatment from January 2021 to June 2022 were selected. They were divided into two groups according to whether they received fibrinogen and PRP treatment in addition to microfracture treatment. The two groups were analyzed to compare the differences in knee joint function and quality of life at different points.ResultsThe study compared changes in knee joint function scores and quality of life between the two groups after treatment and found that the quality of life of patients in the combined treatment group was significantly better than that of patients who received microfracture only (at 12-month follow-up, EuroQol-VAS scores were 64.32 ± 5.63 for the microfracture group (MFx) and 75.65 ± 8.57 for the fibrinogen combined with platelet-rich plasma-assisted microfracture group (FPRPA MFx); P = 0.015; at 24-month follow-up, EuroQol-VAS scores were 66.47 ± 5.18 for the MFx group and 79.40 ± 7.43 for the FPRPA MFx group, P = 0.022). There was also a strong correlation between patients’ quality of life and knee joint function score index (IKDC score correlation coefficient r=-0.375, Lysholm score correlation coefficient r = 0.497, MOCART score correlation coefficient r = 0.579, VAS score correlation coefficient r = 0.242, T2 value correlation coefficient r=-0.293, P < 0.001). Age-stratified analysis of the patients in the microfracture combined with fibrinogen platelet-rich plasma treatment group showed that the effect of the combined treatment was more pronounced in elderly patients.ConclusionsThe results of the study showed that compared with microfracture alone, microfracture combined with fibrinogen platelet-rich plasma therapy can further improve patients’ knee joint-related function and their quality of life after treatment. The improvement was more obvious in elderly patients.

Is platelet-rich plasma effective in treating uterine inflammation in jennies inseminated with cryopreserved donkey semen?

Despite frozen donkey semen demonstrating high quality after thawing and achieving suitable pregnancy rates in mares, it yields unsatisfactory results in jennies, likely due to a stronger uterine inflammatory response. This study assessed the effects of platelet-rich plasma (PRP) on uterine inflammation and pregnancy rates in jennies inseminated with frozen donkey semen. Estrous cycles from 11 jennies were assigned to three groups: Control (CTR, n = 22) with no treatment; Single PRP infusion (S-PRP, n = 22) administered 30 h after ovulation induction, prior to artificial insemination (AI); and Double PRP infusion (D-PRP, n = 21) with the first infusion at 30 h after ovulation induction and the second 4 h after AI. Insemination was performed with frozen donkey semen (1 billion sperm) deposited deeply in the uterine horn immediately after ovulation. Endometrial edema, intrauterine fluid (IUF), uterine vascularization, and endometrial cytology were evaluated pre-AI (TCt) and post-AI (6, 24, and 48 h). Uterine biopsies were taken at T48 for histopathological and collagen evaluation. Peripheral blood samples were collected on D5 for serum progesterone measurement, and pregnancy was evaluated via ultrasonography on D14. Data were analyzed using GLMMs, ANOVA, Friedman, and Kruskal-Wallis tests in SAS and GraphPad Prism, with significance set at p < 0.05. The S-PRP group showed less IUF accumulation than the CTR group at T6. Other parameters showed no significant differences among the groups. Cytology revealed a high percentage of inflammatory cells at T6 in all groups, which decreased in subsequent evaluations. In the CTR group, neutrophil percentages were similar to TCt at T24, while treated groups reached this similarity only by T48. Eosinophil percentages increased over time only in the treated groups. Pregnancy rates showed no differences among the groups (CTR: 0 %, S-PRP: 0 %, D-PRP: 10 %). Results indicate that PRP treatments were ineffective in modulating uterine inflammation and did not enhance pregnancy rates in jennies inseminated with frozen donkey semen.

Impact of Platelet-Rich Plasma on Sciatic Nerve Injury in Rats: HSP 70 Expression and Histological Changes in the Anterior Horn of the Spinal Cord

Peripheral nerve injuries are a significant and growing cause of disability worldwide, as reported by the World Health Organization (WHO). These injuries initiate complex cellular and molecular responses, including the activation of protective pathways that upregulate proteins such as Heat Shock Protein 70 (HSP 70), which plays a crucial role in neuroprotection and the inhibition of neuronal apoptosis. This study investigates the effects of Platelet-Rich Plasma (PRP) on peripheral nerve regeneration, focusing on neuron density, Nissl body presence, and HSP 70 expression as key indicators of recovery. The study utilized 36 rat spinal cord samples, divided into two main groups based on the evaluation time points, day 7 and day 42 post-injury. Each time point group was further subdivided into three: control, sciatica injury, and sciatica injury treated with PRP. Results demonstrated that PRP treatment significantly enhances peripheral nerve regeneration. This was evidenced by increased neuron density, improved Nissl body formation, and a modulation of HSP 70 expression levels, leading to accelerated recovery of motor function, particularly noticeable by day 7 post-injury. These findings suggest that PRP could be a promising therapeutic option for enhancing nerve regeneration and functional recovery after peripheral nerve injuries.

Repeated intravesical injections of platelet-rich plasma are safe and effective in the treatment of interstitial cystitis/bladder pain syndrome

ABSTRACT Objectives: Interstitial cystitis/bladder pain syndrome (IC/BPS) is a challenging chronic inflammatory condition affecting the urinary bladder, with limited treatment options. This study aims to assess the clinical efficacy of repeated intravesical platelet-rich plasma (PRP) injections for promoting urothelial regeneration and reducing inflammation in patients with IC/BPS and investigate its correlation with subjective and objective treatment-related outcomes. Materials and Methods: Four monthly intravesical PRP injections were given to 98 patients with non-Hunner-type IC/BPS. Treatment outcomes were assessed using a global response assessment (GRA) score 3 months posttreatment. In addition, clinical symptom scores, pain severity, voiding diary data, uroflowmetry parameters, and GRA scores were compared before and after treatment and between different treatment outcome groups (satisfactory: GRA≥2 unsatisfactory: GRA&lt;2). Baseline urine biomarkers were analyzed to identify potential treatment outcome predictors. Results: After four PRP injections, 54 (55.1%) patients reported satisfactory outcomes. Lower urinary tract symptoms, bladder pain, urinary frequency, anxiety, and flow rate significantly improved from baseline (P &lt; 0.05) in all patients, regardless of the treatment outcome. All patients experienced improved treatment outcomes and increased maximum bladder capacity with successive PRP treatments, and no major complications were reported. Urine biomarkers indicated elevated inflammation and oxidative stress biomarkers in patients with IC/BPS compared to controls. Conclusion: Repeated PRP injections are safe and effective for reducing symptoms and bladder pain and improving bladder capacity in a majority of IC/BPS patients, with better outcomes observed in patients with a mild form of bladder inflammation. These results support PRP as a promising novel bladder therapy for IC/BPS.

Effects of addition of hyaluronic acid on platelet rich plasma in treatment of chronic osteoarthritis of knee joints

Effects of addition of hyaluronic acid on platelet rich plasma in treatment of chronic osteoarthritis of knee joints

A Comparative Study of the Efficacy of Platelet-Rich Plasma (PRP) vs. Other Conservative Treatments for Lateral Epicondylitis.

Background Lateral epicondylitis, also known as tennis elbow, is a degenerative condition that affects a significant portion of the adult population, particularly those between the ages of 35 and 55. Conventional treatments, including analgesics, physiotherapy, and bracing, often lead to a high recurrence rate. Platelet-rich plasma (PRP) therapy has emerged as a promising alternative, offering regenerative benefits that may enhance tissue healing. This study evaluates the effectiveness of PRP injections compared to traditional conservative therapies in alleviating pain and improving function in individuals with chronic lateral epicondylitis. Methods This prospective observational study was conducted at Father Muller Medical College Hospital from April 2018 to August 2019. A total of 44 patients aged 18-60 years with chronic lateral epicondylitis were randomly assigned to two groups: PRP (n = 22) and conservative treatment (n = 22). The conservative group received a combination of physiotherapy, analgesics, and a counterforce brace. The primary outcome was measured using the Patient-Rated Tennis Elbow Evaluation (PRTEE) score, assessed at baseline, four weeks, eight weeks, three months, and six months. The PRTEE score includes pain and function subscales. Data was analyzed using appropriate statistical methods, and significance was considered at p < 0.05. Results Both groups significantly improved pain and function during the first eight weeks. However, the PRP group demonstrated superior long-term outcomes. At three and six months, the PRP group had significantly lower pain scores (26.00 ± 3.55 and 19.55 ± 3.33, respectively, p < 0.001) compared to the conservative group (32.23 ± 3.75 and 33.64 ± 3.63). Similarly, the PRP group showed better functional improvement at six months (PRTEE function subscale: 20.00 ± 3.19 in PRP vs. 30.73 ± 4.11 in conservative, p < 0.001). No complications were reported in either group. Conclusions PRP injections provide superior long-term pain relief and functional recovery compared to conservative management in patients with chronic lateral epicondylitis. While conservative treatments are effective in the short term, PRP offers a more durable solution with no reported complications. These findings support the use of PRP as a viable alternative for the long-term management of lateral epicondylitis.

Ozone therapy vs. classical treatment in musculoskeletal disorders

With aging and weight gain, the population is significantly overweight and faces additional pressure on vertebral and peripheral joints (ankles, knees, hips, shoulders), which affects muscles, tendons, ligaments, and nerves. Muscle contraction, translated by pain, sends the patient to the doctor. Lumbar and cervical spine disorders occur in 70-80% of the world's population during their lifetime. They are a major problem because they reduce the quality of life and increase the costs borne by health services and patients. There are multiple therapeutic options, both classic medication and alternative treatment, to combat pain for a longer or shorter period. Relief or suppression of pain, the dominant symptom in the manifestations of degenerative arthritic diseases, is an important goal of treatment, ultimately improving the quality of life. Patients, for various reasons, frequently seek alternative therapies, especially to surgical treatment. Finding the most comprehensive treatment is often a challenge. If we consider the benefit that a treatment (therapy) should bring to the health condition, then an individualized therapeutic plan must be chosen. A retrospective study on the effects of ozone and platelet-rich plasma (PRP) treatment compared to classic medication shows the role of ozone therapy in pain relief and the beneficial effect of this therapy, especially in combination with PRP, over a longer period.

The Potential of Intra-Articular Therapies in Managing Knee Osteoarthritis: A Systematic Review.

Knee osteoarthritis (KOA) is a common degenerative and progressive joint disorder that negatively influences patients' quality of life. Intra-articular therapies, such as hyaluronic acid (HA) and platelet-rich plasma (PRP), have garnered attention for their potential to manage osteoarthritis OA symptoms effectively. This systematic review aims to identify the effectiveness and safety of HA and PRP treatment modalities in treating KOA. A literature search was conducted across MEDLINE (PubMed), Web of Science Core Collection, and Science Direct Collection Elsevier. Twenty-three randomized controlled trials, cohort studies, and observational studies were included in the review. The selection criteria focused on studies published in English within the last 10 years, involving subjects with KOA treated with intra-articular injections of HA or PRP and reporting on pain, function, or overall treatment efficacy outcomes. The analysis showed that both HA and PRP significantly improve functionality and reduce pain in KOA patients. High molecular weight HA consistently reduced pain and improved joint mobility in various studies. PRP had better long-term outcomes when combined with HA, leading to greater pain reduction and functional improvement. Both therapies had generally favorable safety profiles, with only minor adverse events reported. However, there were potential biases identified across the studies, such as selection, performance, detection, and reporting biases, which impacted the reliability of the results. Intra-articular treatments with HA and PRP show promise in managing knee osteoarthritis, with personalized treatment plans and further research needed to confirm these findings.

Comparative efficacy of synthetic peptide, platelet-rich plasma, and hyaluronic acid alone or in combination in microfracture treatment of focal chondral defects

Aims: Although previous limited studies have evaluated the efficacy of adjuvants used alone or in combination to augment microfracture (MF) treatment for focal chondral defects, there are no studies comparing the outcomes of the synthetic peptide (SP) with other adjuvants such as platelet-rich plasma (PRP), hyaluronic acid (HA), or their combinations. This study aimed to evaluate whether the efficacy of MF treatment in focal chondral defects is influenced by the use of adjuvants either alone or in combination. Methods: Thirty-six rats were included in the study. Group 1 received MF alone, Group 2 received PRP after MF, Group 3 received HA after MF, Group 4 received a SP after MF, Group 5 received a SP plus PRP therapy after MF, and Group 6 received a SP plus HA therapy. The knees of the rats were assessed according to the International Cartilage Repair Society (ICRS) Cartilage Repair Assessment 1 (ICRS-1) and 2 (ICRS-2). Results: The median ICRS-1 and ICRS-2 scores in Group 1 were lower compared to the other groups, while these scores in Group 2 and Group 4 were similar and higher than the other groups. Also, these scores in Group 5 and Group 6 were similar and lower compared to Group 3 (Group 1: 1 vs. Group 2: 12 vs. Group 3: 9 vs. Group 4: 11 vs. Group 5: 7 vs. Group 6: 7, p &lt; 0.001 for ICRS-1 scores; Group 1: 0 vs. Group 2: 85 vs. Group 3: 70 vs. Group 4: 80 vs. Group 5: 45 vs. Group 6: 45, p &lt; 0.001 for ICRS-2 scores). Conclusion: In the MF treatment of focal chondral defects, SP, PRP, and HA injections have a beneficial adjuvant effect based on macroscopic and histopathological findings. However, the combination of these adjuvants is less beneficial than their individual usage.