Effect of Platelet-Rich Plasma Injections vs Placebo on Ankle Symptoms and Function in Patients With Ankle Osteoarthritis

Background. Autologous whole blood and platelet-rich plasma (PRP) have been both suggested to treat chronic tennis elbow. The aim of the present study was to compare the effects of PRP versus autologous whole blood local injection in chronic tennis elbow. Methods. Forty patients with tennis elbow were randomly divided into 2 groups. Group 1 was treated with a single injection of 2 mL of autologous PRP and group 2 with 2 mL of autologous blood. Tennis elbow strap, stretching, and strengthening exercises were administered for both groups during a 2-month followup. Pain and functional improvements were assessed using visual analog scale (VAS), modified Mayo Clinic performance index for the elbow, and pressure pain threshold (PPT) at 0, 4, and 8 weeks. Results. All pain and functional variables including VAS, PPT, and Mayo scores improved significantly in both groups 4 weeks after injection. No statistically significant difference was noted between groups regarding pain scores in 4-week follow-up examination (P>0.05). At 8-week reevaluations, VAS and Mayo scores improved only in PRP group (P<0.05). Conclusion. PRP and autologous whole blood injections are both effective to treat chronic lateral epicondylitis. PRP might be slightly superior in 8-week followup. However, further studies are suggested to get definite conclusion.

Download Full-text

Platelet rich plasma is better than corticosteroid in longterm outcome in planter fasciitis: A study in a tertiary level teaching hospital at Dhaka, Bangladesh

Z H Sikder Women’s Medical College Journal ◽

10.47648/zhswmcj.2020.v0102.03 ◽

2019 ◽

Vol 1 (Number 2) ◽

pp. 11-14

Author(s):

Md. Johurul Hoque ◽

Muhammad Emam Zaman ◽

Ripon Kumar Das ◽

Mohammad Sayeed AL Mahmud ◽

Mahbuba Khatun

Keyword(s):

Platelet Rich Plasma ◽

Corticosteroid Injection ◽

Plantar Fascia ◽

Heel Pain ◽

P Value ◽

Heel Pad ◽

Patient Reported ◽

Long Term Follow Up ◽

Prospective Comparative Study ◽

And Function

This is a prospective comparative study to compare the efficacy of PRP injection versus corticosteroid injection for planter fasciitis. 35 male and 25 female (Mean Age 35.5 yrs.) presenting with planter fasciitis were randomized to receive there Platelet-rich plasma (PRP) injection (2ml PRP with 2ml of 2% xylocaine) given by a single surgeon. Patients were assessed before (Days0) and after (Days 30, 60, 90) treatment for chronic heel pain more than 6 months. Patients where followed up 1 year to assess heel pain over the calcaneal tuberocity. In the present study of 60 patients there were 35 male and 25 female. In the present study of 60 patients the mean age was 35.5 years (Range between 35 to 65 years). Infection, rupture of plantar fascia, heel pad atrophy and neurovascular damage where not found. Five patient reported pain for unto 9 days after PRP injection. In both groups heel pain improved dramatically after treatment, but the mode of improvement different. Compared with PRP injection. Corticosteroid injection improve at a faster rate over the first 30 days and then started to decline slightly until 90 days. After PRP injection heel pain, function improve steadily and where eventually better. PRP injection and Corticosteroid injection 30 days and faster rate 60 days of both group P-Value 0.0001. Almost high grater rate 60 days, group comparison with heel pain and function of the patients. PRP was more effective over the long term follow up period then corticosteroid injection in improving heel pain and function. That’s way we recommend PRP in a first line injection treatment because it is very simple, cheap and more effective.

Download Full-text

Knee Osteoarthritis: A Review of Pathogenesis and State-Of-The-Art Non-Operative Therapeutic Considerations

Genes ◽

10.3390/genes11080854 ◽

2020 ◽

Vol 11 (8) ◽

pp. 854

Author(s):

Dragan Primorac ◽

Vilim Molnar ◽

Eduard Rod ◽

Željko Jeleč ◽

Fabijan Čukelj ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Platelet Rich Plasma ◽

Treatment Options ◽

Stromal Vascular Fraction ◽

Disease Stage ◽

Knee Oa ◽

Marrow Mesenchymal Stem Cells ◽

The Moment ◽

And Function ◽

Orthopedic Patients

Being the most common musculoskeletal progressive condition, osteoarthritis is an interesting target for research. It is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function. All of these changes are mediated by a complex and not yet fully researched interplay of proinflammatory and anti-inflammatory cytokines, chemokines, growth factors and adipokines, all of which can be measured in the serum, synovium and histological samples, potentially serving as biomarkers of disease stage and progression. Another key aspect of disease progression is the epigenome that regulates all the genetic expression through DNA methylation, histone modifications, and mRNA interference. A lot of work has been put into developing non-surgical treatment options to slow down the natural course of osteoarthritis to postpone, or maybe even replace extensive surgeries such as total knee arthroplasty. At the moment, biological treatments such as platelet-rich plasma, bone marrow mesenchymal stem cells and autologous microfragmented adipose tissue containing stromal vascular fraction are ordinarily used. Furthermore, the latter two mentioned cell-based treatment options seem to be the only methods so far that increase the quality of cartilage in osteoarthritis patients. Yet, in the future, gene therapy could potentially become an option for orthopedic patients. In the following review, we summarized all of the latest and most important research in basic sciences, pathogenesis, and non-operative treatment.

Download Full-text

Platelets, inflammation and tissue regeneration

Thrombosis and Haemostasis ◽

10.1160/ths10-11-0720 ◽

2011 ◽

Vol 105 (S 06) ◽

pp. S13-S33 ◽

Cited By ~ 355

Author(s):

Alan Nurden

Keyword(s):

Skin Diseases ◽

Platelet Rich Plasma ◽

Blood Platelets ◽

Blood Stream ◽

Cellular Growth ◽

Biologically Active ◽

Wide Range ◽

The Central Nervous System ◽

Membrane Budding ◽

And Function

SummaryBlood platelets have long been recognised to bring about primary haemostasis with deficiencies in platelet production and function manifesting in bleeding while upregulated function favourises arterial thrombosis. Yet increasing evidence indicates that platelets fulfil a much wider role in health and disease. First, they store and release a wide range of biologically active substances including the panoply of growth factors, chemokines and cytokines released from α-granules. Membrane budding gives rise to microparticles (MPs), another active participant within the blood stream. Platelets are essential for the innate immune response and combat infection (viruses, bacteria, micro-organisms). They help maintain and modulate inflammation and are a major source of pro-inflammatory molecules (e.g. P-selectin, tissue factor, CD40L, metalloproteinases). As well as promoting coagulation, they are active in fibrinolysis; wound healing, angiogenesis and bone formation as well as in maternal tissue and foetal vascular remodelling. Activated platelets and MPs intervene in the propagation of major diseases. They are major players in atherosclerosis and related diseases, pathologies of the central nervous system (Alzheimers disease, multiple sclerosis), cancer and tumour growth. They participate in other tissue-related acquired pathologies such as skin diseases and allergy, rheumatoid arthritis, liver disease; while, paradoxically, autologous platelet-rich plasma and platelet releasate are being used as an aid to promote tissue repair and cellular growth. The above mentioned roles of platelets are now discussed.

Download Full-text

Platelet-Rich plasma Injection Management for Ankle osteoarthritis study (PRIMA): protocol of a Dutch multicentre, stratified, block-randomised, double-blind, placebo-controlled trial

BMJ Open ◽

10.1136/bmjopen-2019-030961 ◽

2019 ◽

Vol 9 (10) ◽

pp. e030961

Author(s):

LDA Paget ◽

SMA Bierma-Zeinstra ◽

S Goedegebuure ◽

GMMJ Kerkhoffs ◽

R Krips ◽

...

Keyword(s):

Randomised Controlled Trial ◽

The Netherlands ◽

Platelet Rich Plasma ◽

Controlled Trial ◽

Foot And Ankle ◽

Ankle Osteoarthritis ◽

Knee Oa ◽

Plasma Injection ◽

Pain Subscale ◽

Randomised Controlled

IntroductionPlatelet-rich plasma (PRP) is a potentially efficacious treatment for ankle osteoarthritis (OA), but its use has not been examined in high-quality studies. Systematic reviews show that PRP injections significantly decrease pain and improve function in patients with knee OA. Ankle OA is more common than hip or knee OA in the young active population; with a prevalence of 3.4%.PRP injections in ankle OA are shown to be safe and improve quality of life over time, but no randomised controlled trial has been conducted. Our randomised controlled trial will evaluate the efficacy of PRP injections for symptom reduction and functional improvement, compared with placebo, in the treatment of ankle (talocrural) OA.Methods and analysisWe will conduct the Platelet-Rich plasma Injection Management for Ankle OA study: a multicentre, randomised, placebo-controlled trial. One hundred patients suffering from ankle OA will be randomised into two treatment groups: PRP injection or placebo (saline) injection. Both groups will receive two injections of PRP or placebo at an interval of 6 weeks. Primary outcome is the American Orthopaedic Foot and Ankle Society score at 26 weeks. Secondary outcomes determined at several follow-up moments up to 5 years, include Ankle Osteoarthritis Score, Foot and Ankle Outcome Score, pain subscale of (0–40), Visual Analogue Scale score (0–100), Ankle Activity Score (0–10), subjective patient satisfaction Short Form Health Survey-36, Global Attainment Scaling and the EuroQol-5 dimensions-3 levels utility score. A cost-effectiveness analysis will be performed at 1 year.Ethics and disseminationThe study is approved by the Medical Ethics Review Committee Amsterdam Medical Center, the Netherlands (ABR 2018–042, approved 23 July 2018) and registered in the Netherlands trial register (NTR7261). Results and new knowledge will be disseminated through the Dutch Arthritis Association (ReumaNederland), Dutch patient federation, conferences and published in a scientific peer-reviewed journal.Trial registration numberNTR7261.

Download Full-text

Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5–9 years

Regenerative Medicine ◽

10.2217/rme-2019-0040 ◽

2019 ◽

Vol 14 (9) ◽

pp. 831-840 ◽

Cited By ~ 4

Author(s):

Jennifer Cheng ◽

Kristen A Santiago ◽

Joseph T Nguyen ◽

Jennifer L Solomon ◽

Gregory E Lutz

Keyword(s):

Platelet Rich Plasma ◽

Controlled Trial ◽

Intervertebral Discs ◽

Discogenic Pain ◽

Autologous Platelet Rich Plasma ◽

Clinically Significant ◽

And Function ◽

Pain Patients ◽

Autologous Platelet

Aim: This study assessed pain and function at 5–9 years postinjection in a subset of patients who received intradiscal platelet-rich plasma (PRP) injections for moderate-to-severe lumbar discogenic pain. Patients & methods: All patients received injections of intradiscal PRP in a previous randomized controlled trial. Data on pain, function, satisfaction, and need for surgery were collected at one time point of 5–9 years postinjection and compiled with existing data. Results: In comparison to baseline, there were statistically significant improvements in pain and function (p < 0.001). All improvements were clinically significant. Six patients had undergone surgery during the follow-up period. Conclusion: This subset of patients demonstrated statistically and clinically significant improvements in pain and function at 5–9 years postinjection.

Download Full-text

Use of Platelet-Rich Plasma for the Improvement of Pain and Function in Rotator Cuff Tears: Letter to the Editor

The American Journal of Sports Medicine ◽

10.1177/0363546520918194 ◽

2020 ◽

Vol 48 (6) ◽

pp. NP38-NP39

Author(s):

Eoghan T. Hurley ◽

Leo Pauzenberger ◽

Hannan Mullett ◽

Laith M. Jazrawi

Keyword(s):

Rotator Cuff ◽

Platelet Rich Plasma ◽

Rotator Cuff Tears ◽

Letter To The Editor ◽

And Function

Download Full-text

Use of Platelet-Rich Plasma and Platelet-Rich Fibrin in Dentistry and Oral Surgery: Introduction and Review of the Literature

Journal of Veterinary Dentistry ◽

10.1177/0898756419876057 ◽

2019 ◽

Vol 36 (2) ◽

pp. 109-123 ◽

Cited By ~ 5

Author(s):

Kristina Feigin ◽

Bonnie Shope

Keyword(s):

Soft Tissues ◽

Oral Surgery ◽

Platelet Rich Plasma ◽

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Platelet Concentrates ◽

Platelet Rich Fibrin ◽

Wide Range ◽

Comprehensive Examination ◽

And Function

Platelet concentrates, mostly represented by platelet-rich plasma and platelet-rich fibrin, have gained significant interest in various medical and oral disciplines because of their potential to stimulate and boost regeneration of hard and soft tissues. Prepared from the patient’s own blood, they have been tested and used in various different surgical fields including oral and maxillofacial surgery. The effects of these biomaterials are described to be a result of the large concentration of platelets which contain a wide range of growth factors. The aim of this article is to introduce the principle and function of these platelet concentrates, to review their preparation, and to provide a comprehensive examination of the published oral and maxillofacial literature on this subject.

Download Full-text