scholarly journals A 5-Year Follow-Up After Cartilage Repair in the Knee Using a Platelet-Rich Plasma-Immersed Polymer-Based Implant

2014 ◽  
Vol 8 (1) ◽  
pp. 346-354 ◽  
Author(s):  
Alberto Siclari ◽  
Gennaro Mascaro ◽  
Christian Kaps ◽  
Eugenio Boux
Keyword(s):  
Clinical Outcome ◽  
Cartilage Repair ◽  
Platelet Rich Plasma ◽  
Polyglycolic Acid ◽  
Cartilage Defects ◽  
Bone Marrow Stimulation ◽  
Chondral Defects ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

The aim of our study was to analyze the clinical outcome after repair of cartilage defects of the knee with subchondral drilling and resorbable polymer-based implants immersed with autologous platelet-rich plasma (PRP). Fifty-two patients with focal chondral defects were treated with subchondral drilling, followed by covering with a polyglycolic acid - hyaluronan (PGA-HA) implant (chondrotissue®) immersed with autologous PRP. At 5-year follow-up, patients’ situation was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and compared to the pre-operative situation. The KOOS showed clinically meaningful and significant (p < 0.05) improvement in all subcategories compared to baseline. Subgroup analysis showed that there were no differences in the clinical outcome regarding defect size and localization as well as degenerative condition of the knee. Cartilage repair was complete in 20 out of 21 patients at 4-year follow-up as shown by magnetic resonance observation of cartilage repair tissue (MOCART) scoring. Covering of focal cartilage defects with the PGA-HA implant and PRP after bone marrow stimulation leads to a lasting improvement of the patients’ situation.

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

2019 ◽  
Vol 14 (9) ◽  
pp. 831-840 ◽  
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.

scholarly journals Intradiscal Injection of Autologous Platelet-Rich Plasma Releasate to Treat Discogenic Low Back Pain: A Preliminary Clinical Trial

2017 ◽  
Vol 11 (3) ◽  
pp. 380-389 ◽  
Author(s):  
Koji Akeda ◽  
Kohshi Ohishi ◽  
Koichi Masuda ◽  
Won C. Bae ◽  
Norihiko Takegami ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Platelet Rich Plasma ◽  
Low Back ◽  
Discogenic Low Back Pain ◽  
Intradiscal Injection ◽  
Autologous Platelet Rich Plasma ◽  
The Mean ◽  
Autologous Platelet

<sec><title>Study Design</title><p>Preliminary clinical trial.</p></sec><sec><title>Purpose</title><p>To determine the safety and initial efficacy of intradiscal injection of autologous platelet-rich plasma (PRP) releasate in patients with discogenic low back pain.</p></sec><sec><title>Overview of Literature</title><p>PRP, which is comprised of autologous growth factors and cytokines, has been widely used in the clinical setting for tissue regeneration and repair. PRP has been shown <italic>in vitro</italic> and <italic>in vivo</italic> to potentially stimulate intervertebral disc matrix metabolism.</p></sec><sec><title>Methods</title><p>Inclusion criteria for this study included chronic low back pain without leg pain for more than 3 months; one or more lumbar discs (L3/L4 to L5/S1) with evidence of degeneration, as indicated via magnetic resonance imaging (MRI); and at least one symptomatic disc, confirmed using standardized provocative discography. PRP releasate, isolated from clotted PRP, was injected into the center of the nucleus pulposus. Outcome measures included the use of a visual analog scale (VAS) and the Roland-Morris Disability Questionnaire (RDQ), as well as X-ray and MRI (T2-quantification).</p></sec><sec><title>Results</title><p>Data were analyzed from 14 patients (8 men and 6 women; mean age, 33.8 years). The average follow-up period was 10 months. Following treatment, no patient experienced adverse events or significant narrowing of disc height. The mean pain scores before treatment (VAS, 7.5±1.3; RDQ, 12.6±4.1) were significantly decreased at one month, and this was generally sustained throughout the observation period (6 months after treatment: VAS, 3.2±2.4, RDQ; 3.6±4.5 and 12 months: VAS, 2.9±2.8; RDQ, 2.8±3.9; <italic>p</italic>&lt;0.01, respectively). The mean T2 values did not significantly change after treatment.</p></sec><sec><title>Conclusions</title><p>We demonstrated that intradiscal injection of autologous PRP releasate in patients with low back pain was safe, with no adverse events observed during follow-up. Future randomized controlled clinical studies should be performed to systematically evaluate the effects of this therapy.</p></sec>

scholarly journals A comparative study between local injection of autologous platelet rich plasma and injection of corticosteroid in functional improvement of plantar fasciitis

2019 ◽  
Vol 6 (3) ◽  
pp. 653 ◽  
Author(s):  
Vithal Prakash Puri ◽  
Anil Kumar Gaur
Keyword(s):  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Tertiary Care ◽  
Functional Improvement ◽  
Significant Difference ◽  
Group A ◽  
Autologous Platelet Rich Plasma ◽  
Group B ◽  
Autologous Platelet

Background: Plantar fasciitis is a common cause of heel pain in adults. Although it is usually a self-limiting condition, the pain may become prolonged and severe enough to cause significant distress and disruption to the patient’s daily activities and work. The primary objective of the study was to evaluate and compare the effectiveness of autologous platelet rich plasma (PRP) and steroid injections in chronic cases of plantar fasciitis (PF).Methods: A prospective, randomized study was conducted from December 2013 to December 2015 amongst 60 patients with chronic PF were randomized prospectively in single tertiary care center in India. All the patients were enrolled according to inclusion criteria and divided into 2 groups i.e. group A (n=30) received PRP and group B (n=30) received corticosteroids injections. Roles and Maudsley score (RM Score) and Foot Function Index (FFI) was evaluated for all the included patients. The follow-up scheduled at 1 and 6 months after complete enrolment of patients.Results: Between both the groups, the significant difference was observed at 1 and 6 months follow-up from the baseline. At 1-month follow-up, statistically significant improvement in mean RM scores were seen in both the groups from baseline and when RM scores were compared between two groups, group B had statistically better mean scores. At 1-month follow-up there was no statistically significant difference between the mean FFI score values between two groups. At 6-month follow-up, statistically significant improvement in mean FFI scores were seen in both the groups, however when both groups were compared to each other, improvement in mean FFI scores was statistically better in group A as compared to group B.Conclusions: The present study concluded the use of PRP in chronic cases of plantar fasciitis seems more safe and effective in long term than the traditional treatment of steroid injection at different time period.

scholarly journals Glenoid Labral Tear: follow up case series on ultrasound guided autologous platelet rich plasma in conjunction with a progressive rehabilitation program

F1000Research ◽  
2012 ◽  
Vol 1 ◽  
pp. 68 ◽  
Author(s):  
Robert Vander Kraats ◽  
Arockia Doss
Keyword(s):  
Glenohumeral Joint ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Rehabilitation Program ◽  
Labral Tear ◽  
Work Activities ◽  
Labral Tears ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Background: Labral tears commonly occur in both the general and sporting population, often leading to significant pain and dysfunction. Patients often engage in progressive rehabilitative programs, and surgical intervention may be required in severe cases. Autologous platelet rich plasma (PRP) injections have been growing in popularity in musculoskeletal medicine as an alternative to corticosteroid injections. This paper looks at the effectiveness of PRP injections in glenoid labral lesions.Methods: The clinical and radiological findings are presented for two patients who have been treated with autologous PRP into the glenohumeral joint adjacent to the labral tear, in conjunction with a progressive rehabilitative program. Follow up occurred at 18 months and 13 months, respectively.Results: Both subjects tolerated the PRP injection well with no adverse effects, and were compliant with their rehabilitative programs. On initial presentation, pain on the visual analogue scale (VAS) was 7/10 and 6/10 and at follow up it was reported as 0/10. Both subjects have now returned to normal sporting and work activities.Conclusions: The findings from this case series suggest that PRP in conjunction with appropriate rehabilitation can assist in the clinical recovery of glenoid labral tears. Further research is required with greater sample numbers and improved methodological parameters.

scholarly journals P303 Local Application of Autologous Platelet-rich Plasma leads to Sustained Healing of Crohn’s Perianal Fistulae – One Year follow-up Results from a Single Center Pilot Study

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S331-S332
Author(s):  
D Podmanicky ◽  
M Jezberova ◽  
J Lucenicova ◽  
V Bak ◽  
B Kadleckova ◽  
...  
Keyword(s):  
Wound Repair ◽  
Platelet Rich Plasma ◽  
Complete Healing ◽  
End Point ◽  
Perianal Fistulae ◽  
Autologous Platelet Rich Plasma ◽  
One Year ◽  
Mri Score ◽  
Autologous Platelet

Abstract Background Failure of wound repair and dysregulated inflammation in considered to play a key role in the persistence of Crohn’s perianal fistulae (pCD). Few preliminary reports suggest that autologous platelet-rich plasma (PRP) can enhance wound repair and may be effective in treating pCD. Therefore, the aim of our study was to determine the efficacy of autologous PRP in the treatment of pCD. Methods A prospective, uncontrolled, single center study in a referral IBD center was conducted between July 2018 and March 2021. Adult Crohn′s disease patients with pCD failing on antibiotics, immune suppression and/or biologics were eligible for the study. All patients had non-cutting setons for a minimal period of 6 weeks prior study intervention. Autologous PRP was separated by centrifugation 60 ml of peripheral blood in Harvest SmartPrep© System at the time of operation. After the seton removing, internal openings were closed by PDS 2/0 single suture and PRP was injected close to internal openings and fistula tracts. Patients were examined at outpatient clinic at week 1, month 1, 3, 6 and 12. Any suspected side-effects of the treatment were noted. Treatment effect was assessed by perianal Crohn Disease Activity Index (PCDAI assessed at baseline, month 1, 3, 6, 12) and van Assche MRI score (assessed at baseline and month 6 and 12). The primary end-point was complete healing at month 6 defined as closure of all external fistula openings and absence of abscess on MRI. The secondary end-point was sustained response at month 12. Results In total, 25 patients (pts) with pCD were included (mean age 36 years, range 21-61; 15 men). The majority of pts were using antiTNF biologics (9 adalimumab, 9 infliximab), 4 pts were treated by ustekinumab, one by vedolizumab, two patients were on immunomodulators monotherapy. By March 2021, 24 patients finished the 6 months and 21 patients the 12 months follow-up. The primary end-point of complete healing at month 6 was reached by 18 out of 24 pts (75%). All but one patients with complete healing had persistent complete healing at 12 months follow-up. Baseline PCDAI (median 5, range 2-15) decreased significantly as early as at month 1 (median 1, range 0-8; p&lt;0.001) and remained further stable over 12 months. Van Assche MRI score decreased significantly from median of 9 (range 3-18) at baseline to 5 (range 0-18) and 5.5 (range 0-18) at month 6 (p=0.001) and 12 (p=0.03); respectively. Conclusion Local application of autologous platelet-rich plasma leads to rapid healing of difficult-to-treat Crohn’s perianal fistulae in 75% of patients and this effect is sustained up to minimal period of one year.

scholarly journals The use of autologous platelet rich plasma gel in bulbar and penile buccal mucosa urethroplasty: Preliminary report of our first series

2016 ◽  
Vol 88 (4) ◽  
pp. 274 ◽  
Author(s):  
Marcello Scarcia ◽  
Francesco Paolo Maselli ◽  
Giuseppe Cardo ◽  
Giuseppe Mario Ludovico
Keyword(s):  
Buccal Mucosa ◽  
Preliminary Report ◽  
Platelet Rich Plasma ◽  
Donor Site ◽  
Blood Bank ◽  
Urethral Strictures ◽  
Venous Sample ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Objective: The Buccal Mucosa (BM) UrethroPlasty (UP) is one of the preferred treatments for long or compli-cated urethral strictures. We propose the use of autologous Platelet Rich Plasma gel (aPRPg) in order to enhance to vascularization of BM graft and reduce the fibrous spongy. We report the outcome of our ten cases of bulbar and penile UP and the safety of this technique. Materials and metods: Ten patients underwent to BM UP with use of aPRP gel. Median age was 46. Stricture etiology was idiopathic, failed hypospadias and flogistic. Average stricture length was 3.7 cm. All patient were preoperatively evaluated with uroflowmetry , retrograde urethrography, cystoscopy and questionnaire. The harvesting of the aPRP was performed in blood bank from peripheral venous sample. Catheter was usually removed after 3 weeks and urethrography was performed after 6 weeks. Results: All patients reported no problem on the donor site. At time of follow-up (median 20 month, 12-34) all patients refer no problem and a good uroflowmetry. No re-strictures at the anastomotic sites were demonstrated in any of the patients. Conclusion: However in our experience the follow-up is limited and no definitive conclusion or comparison can be made with the original BM UP. The use of aPRP gel seems feasible and safe. In our opinion it is important to continue investigating this procedure for its advantages in case of complex urethral strictures complicated by fibrous spongy, above all in penile urethral strictures post hypospadia repair.

Combined Bone Marrow Aspirate and Platelet-Rich Plasma for Cartilage Repair: Two-Year Clinical Results

Cartilage ◽  
2019 ◽  
pp. 194760351987632 ◽  
Author(s):  
Kris Hede ◽  
Bjørn B. Christensen ◽  
Jonas Jensen ◽  
Casper B. Foldager ◽  
Martin Lind
Keyword(s):  
Bone Marrow ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Cartilage Repair ◽  
Bone Marrow Aspirate ◽  
Platelet Rich Plasma ◽  
Collagen Scaffold ◽  
Repair Tissue ◽  
Outcome Scores

Purpose To evaluate the clinical and biological outcome of combined bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) on a collagen scaffold for treating cartilage lesions in the knee. Methods and Materials Ten patients (mean age 29.4 years, range 18-36) suffering from large full-thickness cartilage in the knee were treated with BMAC and PRP from January 2015 to December 2016. In a 1-step procedure autologous BMAC and PRP was seeded onto a collagen scaffold and sutured into the debrided defect. Patients were evaluated by clinical outcome scores (IKDC [International Knee Documentation Committee Subjective Knee Form], KOOS [Knee Injury and Osteoarthritis Outcome Score], and pain score using the Numeric Rating Scale [NRS]) preoperatively, after 3 months, and after 1 and 2 years. Second-look arthroscopies were performed ( n = 7) with biopsies of the repair tissue for histology. All patients had magnetic resonance imaging (MRI) preoperatively, after 1 year, and after 2 to 3.5 years with MOCART (magnetic resonance observation of cartilage repair tissue) scores evaluating cartilage repair. Results After 1 year significant improvements were found in IKDC, KOOS symptoms, KOOS ADL (Activities of Daily Living), KOOS QOL (Quality of Life), and pain at activity. At the latest follow-up significant improvements were seen in IKDC, KOOS symptoms, KOOS QOL, pain at rest, and pain at activity. MRI MOCART score for cartilage repair improved significantly from baseline to 1-year follow-up. Histomorphometry of repair tissue demonstrated a mixture of fibrous tissue (58%) and fibrocartilage (40%). Conclusion Treatment of cartilage injuries using combined BMAC and PRP improved subjective clinical outcome scores and pain scores at 1 and 2 years postoperatively. MRI and histology indicated repair tissue inferior to the native hyaline cartilage.

Local injection of Platelet Rich Plasma for Plantar Fasciitis

2021 ◽  
Vol 12 (3) ◽  
pp. 75-80
Author(s):  
Vishwas Sharad Phadke ◽  
Vaibhav Vinayak Antrolikar ◽  
Ajaykumar Ramlu Allamwar
Keyword(s):  
Cohort Study ◽  
Pain Relief ◽  
Plantar Fasciitis ◽  
Platelet Rich Plasma ◽  
Plantar Fascia ◽  
Local Injection ◽  
Vas Score ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Background: Plantar fasciitis can be defined as inflammation at the insertion of plantar fascia and is thought most commonly due to overuse injury. It usually presents as sharp shooting heel pain which is worse in the morning. The location of pain is usually plantar surface of the foot and pain may radiate proximally in long standing and severe cases. In mild cases of plantar fasciitis non steroidal anti-inflammatory drugs and activity modification may be sufficient. Severe cases may require interventions such as night splints and orthotic devices which works by reducing loading of plantar fascia. Recently local injection of autologous platelet rich plasma is used by many researchers with promising results. Aims and Objectives: This prospective cohort study was undertaken to analyze the functional and clinical outcome in patients with plantar fasciitis who were treated by autologous injection of platelet rich plasma. Materials and Methods: This was a prospective cohort study conducted in department of orthopedics of a tertiary care medical college located in an urban area. The patients diagnosed to be having plantar fasciitis were included in this study on the basis of a predefined inclusion and exclusion criteria. Patients were assessed for severity of pain by the Visual Analogue Score for pain and American orthopedic foot and ankle score (AOFAS). A VAS score of 0-3 was taken as pain relief and VAS score of 4-10 was considered as no pain relief. Whereas AOFAS scores of 90-100, 80-89, 60-79 and less than 60 were taken as excellent, good, fair and poor outcome respectively. All patients were treated by local injection of autologous platelet rich plasma. The patients were followed up at 4 weeks, 8 weeks and 12 weeks. During follow up visits the pain relief was assessed by VAS and AOFAS scores. For statistical purposed SSPS 21.0 software was used and p value less than 0.05 was taken as statistically significant. Results: A total of 60 patients were included in this study out of which there were 22 (36.67%) males and 38 (63.33%) females with a M:F ratio of 1:1.72. The most common affected age group was between the age of 41-50 years (35%) followed by 51-60 years (21.67%) and 31-40 years (20%). Twenty-seven (45%) patients were either overweight or obese. A statistically significant reduction in pain was documented at the time of follow up of 4 weeks. At the end of 12 weeks 58 (96.67%) patients experienced significant pain relief and only 2 (3.33%) patients had significant pain. Also, there was statistically significant difference between AOFAS scores at the time of presentation and at 4 weeks, 8 weeks and 12 weeks follow up visits. Conclusion: Injection of autologous platelet rich plasma for chronic plantar fasciitis is found to have promising results in terms of pain relief (reduced VAS score) and functional outcome (Improvement in AOFAS score).

Autologous Platelet-rich Plasma Versus Conventional Dressing in Treatment of Chronic Venous Leg Ulcers

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Hesham Adel Alaa Aldein ◽  
Wafi Fouad Salib ◽  
Ramy Mikhael Nageeb ◽  
Abdelrahman Ahmed Mohamed ◽  
Ahmad Farid Elsayed Mostafa Radwan
Keyword(s):  
Platelet Rich Plasma ◽  
Compression Therapy ◽  
Control Group ◽  
Study Group ◽  
Leg Ulcers ◽  
Venous Leg Ulcers ◽  
Venous Ulcers ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

Abstract Background Prevalence of active venous leg ulcers was reported to be around 0.5% in different populations severely reduces quality of life, and increases the cost of health care. Management of VLUs include many modalities to obtain good result and improving patients life-style, these modalities include compression therapy, medical treatment, surgical and interventional procedures and local wound care. Objective: To compare between autologous platelet rich plasma and saline dressing in treatment of chronic leg venous ulcer concerning reduction of ulcer area. Patients and Methods That prospective study included 40 patients with chronic venous leg ulcers recruited from Ain shams university hospitals for whom treatment with PRP was done for 20 patients weekly for up to 3 weeks(one session of injection per week)(study group) and applying saline dressing for 20 patients(control group) in addition to compression therapy and follow up for4 months. Our objective was to compare rate of wound healing. Results A total of 44 venous ulcers from 40 patients who met the inclusion criteria were treated. Application of PRP was done for 20 patients weekly for up to 3 weeks(one session of injection per week)(study group) and applying saline dressing for 20 patients(control group) in addition to compression therapy and follow up for4 months. Conclusion We can draw the conclusion our study's results reveal that the use of PRP contributes to improving the results of treatment of venous ulcers and that it is an effective and safe therapy. Nonetheless, we need to consider that application of this or any other treatment should always be accompanied by the necessary management of the underlying disease, in addition to a suitable pressure bandage that improves venous return and facilitates favourable clinical course of lesions.

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