scholarly journals STUDY OF THE PLATELET-RICH PLASMA CLINICAL EFFICACY IN THE TREATMENT OF KNEE OSTEOARTHRITIS

2016 ◽  
Vol 7 (3) ◽  
pp. 54-60
Author(s):  
G D Lazishvili ◽  
К A Egiazaryan ◽  
A A Akhpashev ◽  
M A Danilov ◽  
M A Strakhov ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Clinical Efficacy ◽  
Detection Rate ◽  
Platelet Rich Plasma ◽  
Analog Scale ◽  
Womac Index ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The study of platelet-rich plasma efficacy in the treatment of patients with knee osteoarthritis (OA) was performed. 188 patients were included and divided into three groups. Group 1 - 82 patients with OA, where hyaluronic acid was used for treatment, Group 2 - 36 patients, and Platelet Rich Plasma (PRP) and hyaluronic acid were used, Group 3 - 70 patients, only PRP was used. It`s been found that the use of PRP for treatment is characterized by a pronounced clinical efficacy compared with use of hyaluronic acid, which manifests in reduced detection rate of edema, hyperthermia and hyperemia. The use of PRP leads to pain reduction in the knee joint and increase the functionality of patients, that confirmed by more pronounced declining of visual analog scale indicators, Leken index and the WOMAC index values increase. The presented results of study are consistent with authors who believe that the lack of side effects and complications when using PRP indicates the safety of its use in clinical practice.

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

2021 ◽  
Vol 49 (2) ◽  
pp. 487-496
Author(s):  
Yong-Beom Park ◽  
Jun-Ho Kim ◽  
Chul-Won Ha ◽  
Dong-Hyun Lee
Keyword(s):  
Hyaluronic Acid ◽  
Growth Factors ◽  
Knee Osteoarthritis ◽  
Clinical Outcomes ◽  
Clinical Efficacy ◽  
Global Assessment ◽  
Platelet Rich Plasma ◽  
Patient Global Assessment ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

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).

scholarly journals Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial

2011 ◽  
Vol 129 (4) ◽  
pp. 206-216 ◽  
Author(s):  
Ligia Maria Facci ◽  
Jean Paulus Nowotny ◽  
Fabio Tormem ◽  
Virgínia Fernandes Moça Trevisani
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Analog Scale ◽  
Electrical Nerve Stimulation ◽  
Interferential Current ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

CONTEXT AND OBJECTIVE: Transcutaneous electrical nerve stimulation (TENS) and interferential current are the most used electrotherapy methods, although there is little scientific evidence to support their use. The aim of this study was to compare the effects of TENS and interferential current among patients with nonspecific chronic low back pain. DESIGN AND SETTING: Single-blind randomized controlled trial in the Department of Physiotherapy, Centro Universitário de Maringá. METHODS: One hundred and fifty patients were randomly divided into three groups: TENS (group 1), interferential current (group 2) and controls (group 3). The patients designated for electrotherapy received ten 30-minute sessions, while the control group remained untreated. All patients and controls were evaluated before and after treatment using a visual analog scale and the McGill Pain and Roland Morris questionnaires, and regarding their use of additional medications. RESULTS: There was a mean reduction on the visual analog scale of 39.18 mm with TENS, 44.86 mm with interferential current and 8.53 mm among the controls. In the Roland Morris questionnaire, group 1 had a mean reduction of 6.59; group 2, 7.20; and group 3, 0.70 points. In group 1, 84% of the patients stopped using medications after the treatment; in group 2, 75%; and in group 3, 34%. There was no statistically significant difference between the TENS and interferential current groups (P > 0.05); a difference was only found between these groups and the controls (P < 0.0001). CONCLUSION: There was no difference between TENS and interferential current for chronic low back pain treatment. CLINICAL TRIAL REGISTRATION: NCT01017913.

scholarly journals Combined Effect of Subchondral Drilling and Hyaluronic Acid with/without Diacerein in Full-Thickness Articular Cartilage Lesion in Rabbits

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Wanwisa Suwannaloet ◽  
Wiroon Laupattarakasem ◽  
Peerapol Sukon ◽  
Siriwan Ong-Chai ◽  
Pisamai Laupattarakasem
Keyword(s):  
Hyaluronic Acid ◽  
Cartilage Lesion ◽  
Type Ii Collagen ◽  
Treated Group ◽  
Left Knee ◽  
Full Thickness ◽  
Grading Scale ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The osteochondral healing potential of hyaluronic acid (HA) plus diacerein was evaluated in subchondral-drilling- (SCD-) induced fibrocartilage generation in rabbits. A full-thickness chondral defect was created along the patellar groove of both knees and then SCD was subsequently performed only in the left knee. A week later, the rabbits were allocated into 3 groups to receive weekly intra-articular (IA) injection for 5 weeks with normal saline solution (NSS) (group 1) or with HA (group 2 and group 3). Starting at the first IA injection, rabbits were also gavaged daily for 9 weeks with NSS (group 1 and group 2) or with diacerein (group 3). The animals were then sacrificed for evaluation. The newly formed tissue in SCD lesions showed significantly better histological grading scale and had higher content of type II collagen in HA-treated group compared to NSS control. In addition, adding oral diacerein to HA injection enhanced healing potential of HA.

scholarly journals THE EFFECT OF PHOTODYNAMIC THERAPY AND PLATELET-ENRICHED PLASMA ON THE HEALING OF SKIN RADIATION ULCERS INFECTED BY STAPHYLOCOCCUS AUREUS

2020 ◽  
Vol 25 ◽  
pp. 338-352
Author(s):  
M. Krasnoselsky ◽  
◽  
O. Pushkar ◽  
L. Simonova ◽  
M. Myroshnychenko ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Photodynamic Therapy ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Radiation Ulcer ◽  
Group 3 ◽  
Group 2 ◽  
Radiation Ulcers ◽  
Infected Skin ◽  
Group 1

Objective. To determine in experiment the quality of healing of skin radiation ulcers infected with Staphylococcus aureus (S. aureus) under the photodynamic therapy (PDT) administration and the use of platelet-rich plasma (PRP). Materials and methods. The experiment was performed on 95 male WAG rats of 6 months of age, which were divided into three groups. Group 1 included animals in whom a skin radiation ulcers in the thigh area was simulated, followed by application of a 0.2 ml suspension of reference strain of S. aureus to its surface on the 7th day after irradiation. Group 2 included animals with S. aureus-infected skin radiation ulcers, in whom the PET was administered a day after infection contamination. Group 3 included animals with S. aureus-infected skin radiation ulcers, in whom the PDT was administered a day after infection in the morning, and the PRP was manifold injected in periwound area in the afternoon. The skin with underlying soft tissues from the area of radiation damage were the material for morphological examination. The hematoxylin and eosin, picrofuxin according to van Gizon, Mallory staining were applied to micropreparations. A morphometric study was conducted. Results. In animals with skin radiation ulcers, in whom the PDT was administered upon infection with S. aureus (group 2), compared with animals with simulated infected skin radiation ulcers without treatment (group 1), The activation (i.e. accelerating) of the healing occurred for the period from the 14th to the 52nd day of experiment due to the active processes of wound cleansing from necrotized tissues, less pronounced inflammatory changes in the lesion, and active of appearance and maturation of granulation tissue, less pronounced hemodynamic, ischemic and alternative disorders in the dermis, hypodermis, muscle tissue surrounding the wound cavity, activation of proliferative processes in epithelial layer localized in the marginal parts of the wound. Formation of pathological (hypertrophic or keloid) scar of the skin was the result of healing of skin radiation ulcer infected with S. aureus. In animals with radiation ulcers infected with S. aureus, in the case of PDT and PRP (group 3) the regenerative process was directed not only at accelerating the rate of healing, but also on restoration of original structure of the lost parts of the skin compared with only PDT administration (group 2). Acceleration of the healing of the infected skin radiation ulcer in animals of groups 2 and 3 was due to similar processes. Conclusions. Photodynamic therapy activates and accelerates the healing process of skin radiation ulcers infected with S. aureus and leads to formation of a pathological scar (hypertrophic or keloid). Healing of the infected S. aureus radiation ulcers occurs more actively upon the photodynamic therapy administration in combination with multiple periwound injections of the platelet-enriched plasma, compared with only photodynamic therapy administration, and finishes with an organotypic regeneration and almost complete skin recovery. Key words: photodynamic therapy, platelet-rich plasma, radiation skin ulcer, Staphylococcus aureus, morphology.

scholarly journals Histopathological effect of platelet-rich plasma on cranial dura mater defects

2021 ◽  
Vol 38 (4) ◽  
pp. 525-528
Author(s):  
Kemal PAKSOY ◽  
Kerameddin AYDIN
Keyword(s):  
Dura Mater ◽  
Platelet Rich Plasma ◽  
Healing Process ◽  
Female Rats ◽  
Wound Healing Process ◽  
Surface Areas ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

There are many new studies in the selection of materials used in dura material repair. Platelet has important function in hemostasis and coagulation. Also, activated platelets initiate the wound healing process. They provide regeneration of tissue with the appropriate type of tissue. In this experimental study, we used platelet-rich plasma (PRP) on dura mater defect due to these properties. Materials and method: Our study started after we got the approval of Ondokuz Mayıs University Animal Experiments Local Ethics Committee. Thirty Wistar Albino female rats were used. The rats were divided into three groups, each one includes ten. Results: No significant difference was observed in the thickness and surface areas of dura mater in group 1 and group 2. Significant increase was observed in the thickness and surface areas of dura mater in the PRP applied group (Group 3) compared to other groups. New bone areas and new vasculature were observed more frequently in the PRP rooms group (Group 3). Statistical analysis of the data was done by using SPSS 21.0 for Mac (IBM Corporation) statistical package program and based on 0.05 significance level. A significant difference was observed between Group 1 and Group 3 (p> 0.05), a significant difference was observed between both Group 1 and Group 3 and between Group 2 and Group 3 (p <0.05). Conclusion: Providing the regeneration of dura mater in defect situations will contribute to the protection of the barrier feature. In line with this idea, it is thought that PRP can be beneficial for us to reach this goal.

scholarly journals The Effects of Leukocyte- and Platelet-Rich Plasma (L-Prp) and Pure Platelet-Rich Plasma (P-Prp) an a Rat Endometriosis Model

2019 ◽  
Author(s):  
Ali Doğukan Anğın ◽  
İsmet Gün ◽  
Önder Sakin ◽  
Muzaffer Seyhan Çıkman ◽  
Zehra Meltem Pirioğlu ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Saline Group ◽  
Group 4 ◽  
Vascular Congestion ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Volume Difference ◽  
Group 1

AbstractOur aim was to investigate the effect of platelet-rich plasma (PRP) derivatives, which can be produced from the patient’s own blood and have minimal side effects, on endometriosis. To the best of our knowledge, this is the first study in the literature that studies the relationship between PRP and endometriosis. Endometriosis foci were created in the first operation. In the second operation (30th day) groups were formed. Group 1 (n= 8) was administered saline, group 2 (n= 7) leukocyte- and platelet-rich plasma (L-PRP), and group 3 (n= 8) pure platelet-rich plasma (P-PRP). Group 4 (n= 10) was used to obtain PRP. In the last operation (60th day), the endometriotic foci were measured, and then excised. There was no statistically significant difference between the pre and post volumes of the endometriotic foci, between their volume differences and volume difference rates (p > .05). However, it was observed that existing implant volumes in all groups decreased statistically significantly within their own groups by the end of the experiment compared to the previous volumes (p < .05). When the implants were assessed through histopathological scoring in terms of edema, vascular congestion, inflammatory cell infiltration, hemorrhage, epithelial line, and hemosiderin accumulation and immunohistochemical staining in terms of VEGF, there was no significant difference in the comparison between the groups. Although L-PRP and P-PRP generated more reduction in the endometriosis foci, they did not create any statistical differences.

scholarly journals Treatment of osteoarthritis of large and small joints using an injectable complex action chondroprotector

2021 ◽  
Author(s):  
И.В. Меньшикова ◽  
В.И. Сороцкая
Keyword(s):  
Adverse Reactions ◽  
Joint Stiffness ◽  
Complex Action ◽  
Womac Index ◽  
Results Of Treatment ◽  
Group 3 ◽  
Inflammatory Drugs ◽  
Group 2 ◽  
Group 1

В многоцентровом исследовании «КОЛИБРИ» оценивали эффективность и переносимость инъекционного средства замедленного действия для терапии остеоартроза крупных и мелких суставов. Исследуемую группу составили 49 больных (87,8% женщин, 12,2% мужчин, медиана возраста – 63,4 [52,3; 75,2] года, длительность болезни – 5,86 [3,07; 11,4] года, индекс массы тела – 30,06 [23,1; 41,4] кг/м2): 14,6% – с поражением мелких суставов кистей (1-я группа), 62,5% – с поражением крупных суставов, получавшие препарат внутримышечно (2-я группа), и 22,9% – с поражением крупных суставов, получавшие препарат внутрисуставно (в/с) и внутримышечно (в/м) (3-я группа). В течение года проведено 2 курса инъекций с интервалом 6 мес и последующим наблюдением в течение 3 мес. Результаты лечения оценивали в динамике по визуально-аналоговой шкале (ВАШ) боли, индексам AUSCAN и WOMAC, удовлетворенности пациента и врача по 5-балльной шкале и потребности в нестероидных противовоспалительных препаратах (НПВП). После первого курса лечения отмечено статистически значимое уменьшение боли по шкале ВАШ на 45,4-57,7%, индекса AUSCAN– на 49,3%, индекса WOMACво 2-й группе – на 44,9%, в 3-й группе – на 53,2%. Около 1/3 больных отказались от приема НПВП. К началу второго курса указанные показатели возросли, но не до исходного уровня. После второго курса терапии отмечено дальнейшее улучшение показателей боли по ВАШ – на 20,2-30,8%, индекса AUSCAN – на 28,4%, индекса WOMAC во 2-й группе – на 20,5%, в 3-й группе – на 22,9%. Через 3 месяца наблюдения отмечено уменьшение по сравнению с исходными показателями боли по ВАШ на 60,8-64,8%, индекса AUSCAN – на 34,3%, WOMAC во 2-й группе – на 51,3%, в 3-й группе – на 35,4%. Наиболее выражена была динамика скованности в суставах. 50% пациентов отказались от приема НПВП. Нежелательные реакции (дерматит в месте инъекции и синовит после внутрисуставного введения препарата) выявлены у 2 больных. The aim of the study was to assess the efficacy and tolerability of slow-acting injectable agent for the treatment of osteoarthritis in the treatment of osteoarthritis of large and small joints. The study group consisted of 49 patients (87,8% women, 12,2% men, whose median age – 63,4 [52,3; 75,2] years, the duration of the disease – 5,86 [3,07; 11.4] years, body mass index – 30,06 [23,1; 41,4] kg/m2): 14,6% – with damage to small joints of the hands (group 1), 62,5% with damage to large joints, who received the drug only intramuscularly (group 2) and 22,9% with lesions of large joints, who received the drug intra-articularly and intramuscularly (group 3). During the year, 2 courses of injections were carried out with an interval of 6 months. 3 months follow-up period was held. The results of treatment were assessed by the dynamics of the VAS of pain, AUSCAN and WOMAC indices, patient and doctor satisfaction on a 5-point scale, and the need for non-steroidal anti-inflammatory drugs (NSAIDs). After 1 course of treatment, there was a statistically significant decrease in pain according to VAS in all groups by 45,4-57,7%, in the AUSCAN index – by 49,3%, in the WOMAC index in group 2 – by 44,9%, in group 3 – by 53,2%. About 1/3 of patients refused to take NSAIDs. By the beginning of the 2nd course, these indicators increased, but not to the initial level. After the 2nd course of therapy, further improvement was noted pain according to VAS – by 20,2-30,8%, AUSCAN index – by 28,4%, WOMAC index in group 2 – by 20,5%, in group 3 – by 22 ,9%. After 3 months of follow-up there was a decrease in comparison with the initial indicators: pain according to VAS – by 60,8-64,8%, AUSCAN index – by 34,3%, WOMAC in group 2 – by 51,3%, in group 3 – by 35,4%. The dynamics of joint stiffness was most pronounced. Half of the patients stopped taking NSAIDs. Adverse reactions (dermatitis at the injection site and synovitis after i/a administration of the drug) were detected in 2 patients.

scholarly journals What is better for rotator cuff tendinopathy: dextrose prolotherapy, platelet-rich plasma, or corticosteroid injections? A randomized controlled study

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Hala M. Abd Elsabour Sabaah ◽  
Mary A. Nassif
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Tendon Healing ◽  
Controlled Study ◽  
Clinical Trial Registry ◽  
Western Ontario Rotator Cuff ◽  
Group 3 ◽  
Group 2 ◽  
Rotator Cuff Tendinopathy ◽  
Group 1

Abstract Background Rotator cuff tendinopathy (RCT) is a leading cause of shoulder pain and disability. Management is mainly conservative, but the limited ability of tendons to regenerate is the main cause of unsatisfactory results. So, we conducted our study to compare the efficacy of deep prolotherapy (glucose 25%), platelet-rich plasma (PRP), and betamethasone corticosteroid for treatment of RCT to find the most effective one based on clinical, functional, and radiological assessment. Results Regarding visual analog scale (VAS), it was significantly (p < 0.001) improved after injection among group 1 (prolotherapy group) and group 3 (steroid group) patients, while no significant improvement was noted among group 2 (PRP group) (p = 0.212) patients. The Western Ontario Rotator Cuff (WORC) Index significantly improved among the studied groups (p < 0.001, p = 0.049, and p < 0.001, respectively) after injection. Regarding the range of motion (ROM), a significant improvement (p = 0.029) was achieved in group 1 after injection but no significant improvements were noted among group 2 and 3 patients (p = 0.529 and 0.121, respectively). There was a significant improvement among group 1 and 2 patients (p < 0.001 and p = 0.020, respectively) regarding the grade of tendon lesions but no improvement occurred among group 3 patients (p = 0.470). Conclusion Prolotherapy injections improve shoulder ROM, VAS, WORC index, and rotator cuff tendon healing while PRP injections improve WORC index and tendon healing but steroid injection has no effect on healing. Trial registration PACTR202005610509496. Retrospective registration on May 25, 2020, Pan African Clinical Trial Registry.

scholarly journals TREATMENT OF DEGENERATIVE CHANGES IN THE EPITHELIUM OF THE OCULAR SURFACE WITH "DRY EYE" SYNDROME

2020 ◽  
Vol 20 (2) ◽  
pp. 19-22
Author(s):  
L.K. Voskresenskaya ◽  
V.V. Ryadnova ◽  
O.Yu. Maksimuk ◽  
I.S. Steblovska ◽  
A.V. Voskresenskaya
Keyword(s):  
Hyaluronic Acid ◽  
Dry Eye ◽  
Dry Eye Syndrome ◽  
Bulbar Conjunctiva ◽  
Eye Drops ◽  
Costal Margin ◽  
Department Of Ophthalmology ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

According to recent studies, the prevalence of dry eye syndrome makes up 14% of cases in patients under the age of 50 years and 65-75% in patients over 50 years of age. Risk factors for the development of dry eye syndrome include aging, stress, side effect of frequent instillations of eye preparations, exposure to radiant energy, and diabetes mellitus. Therefore, the purpose of this study is to investigate the possibility of using “Delargin”, an antioxidant medicine, in the treatment of dry eye syndrome. 50 patients (100 eyes) aged 30-70 years were examined at the Department of Ophthalmology and then divided into three groups depending on the treatment used. Group 1 included 10 patients (20 eyes), who were prescribed to instil Oksial eye drops. Group 2 included 10 patients (20 eyes), who received basic therapy by instilling a solution of sodium salt of hyaluronic acid 0.0015 g / ml. Group 3 involved 20 patients (40 eyes), who instilled Delargin and hyaluronic acid. Monitoring the effectiveness of the treatment was carried out using the following methods: to assess basal tear production, a Schirmer 1 test was performed using the Ophthalic Test diagnostic bands (India); a Norn test was performed to control the stability of the tear membrane. Fluorescence test (staining of the cornea with 1% sodium fluorescein solution) was applied to detect corneal defects; Lipcof test was used to assess the degree of lid-parallel fold formation of the bulbar conjunctiva relative to the costal margin of the lower eyelid. As a result of the treatment, the patients of the Group 1 demonstrated that the Norn test scores increased to some extent from 6.8 ± 0.1 s up to 7.5 ± 0.1 s; in the patients of the Group 2 following the treatment, it was 8.5 ± 0.2 s and in the Group 3, the Norn test values were 11.2 ± 0.2 s (P<0.05). The frequency of blinking movements decreased significantly and approached the normal. It has been found out that the therapy of dry eye syndrome that includes the antioxidant Delargin, can significantly promotes normalizing of parameters typical for this process.

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