1
|
Montes-Salas R, Mahillo-Durán R, Gómez-Carrión Á, Gómez-Aguilar E, Fernández-Gibello A, Castillo-Lopez JM. Ultrasound-guided procedures for plantar fasciitis: a randomized clinical study. J Orthop Surg Res 2024; 19:436. [PMID: 39060929 PMCID: PMC11282737 DOI: 10.1186/s13018-024-04946-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Corticosteroid injections are commonly used for the treatment of plantar fasciitis. In recent years, ultrasound-guided multipuncture treatment of the fascia has been described in the literature. Our study aimed to compare the effectiveness of these two techniques in the treatment of plantar fasciitis. METHODS The outcomes achieved over 120 days following the use of these techniques to treat plantar fasciitis were examined. A total of 81 patients were randomly selected for the study; 41 were treated with ultrasound-guided multipuncture and 40 with ultrasound-guided corticosteroid injection. Clinical examinations and ultrasound assessments were performed before treatment and at 30, 60 and 120 days post-treatment. Clinical assessments included the use of a visual analog scale (VAS) to record pain and the Foot Function Index (FFI) to evaluate function. Ultrasound was used to measure the thickness of the plantar fascia. RESULTS Both the ultrasound-guided multipuncture and corticosteroid injection techniques were associated with significant functional and echographic improvements at 4 months post-treatment (P < 0.001). Pain did not improve significantly after 120 days with ultrasound-guided corticosteroid injection, whereas significant pain reduction was observed with ultrasound-guided multipuncture. CONCLUSION Corticosteroid injection provides better short-term results in terms of VAS pain and FFI scores. However, ultrasound-guided multipuncture shows superior outcomes in VAS pain and FFI scores at 120 days.
Collapse
Affiliation(s)
- Rubén Montes-Salas
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, 41009, Spain
| | - Ramón Mahillo-Durán
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, 41009, Spain
| | - Álvaro Gómez-Carrión
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, Madrid, 28040, Spain.
| | | | | | - José Manuel Castillo-Lopez
- Podiatry Department, Faculty of Nursing, Physiotherapy, and Podiatry, Universidad de Sevilla, Sevilla, 41009, Spain
| |
Collapse
|
2
|
Deng Z, Long ZS, Chen G. Mini-Review: Tendon-Exposed Wound Treatments. J INVEST SURG 2023; 36:2266758. [PMID: 37813390 DOI: 10.1080/08941939.2023.2266758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/28/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Tendon-exposed wounds are complex injuries with challenging reconstructions and no unified treatment mode. Furthermore, insufficient tissue volume and blood circulation disorders affect healing, which increases pain for the patient and affects their families and caretakers. REVIEW As modern medicine advances, considerable progress has been made in understanding and treating tendon-exposed wounds, and current research encompasses both macro-and micro-studies. Additionally, new treatment methods have emerged alongside the classic surgical methods, such as new dressing therapies, vacuum sealing drainage combination therapy, platelet-rich plasma therapy, and live-cell bioengineering. CONCLUSIONS This review summarizes the latest treatment methods for tendon-exposed wounds to provide ideas and improve their treatment.
Collapse
Affiliation(s)
- Zhuan Deng
- Department of Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Zhi-Sheng Long
- Department of Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Gang Chen
- Department of Orthopedics, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| |
Collapse
|
3
|
Peng Y, Du L, Yang B, Fan D, Jia S, Zheng C. Efficacy of platelet-rich plasma and platelet-rich fibrin in arthroscopic rotator cuff repair: A systematic review and meta-analysis. PM R 2023; 15:1643-1653. [PMID: 37526570 DOI: 10.1002/pmrj.13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/27/2023] [Accepted: 07/07/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Basic scientific studies have demonstrated positive effects of platelet-rich therapies, such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF), on tendon repair. However, clinical evidence indicating improved prognosis is controversial. In this study, we aimed to determine whether augmentation of arthroscopic rotator cuff repair with PRP and PRF improves outcomes compared to arthroscopic repair alone. LITERATURE SURVEY PubMed, Embase, and Cochrane library databases were comprehensively searched for randomized controlled trials (RCTs) published until June 2022 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. No language restriction was applied. METHODOLOGY The primary outcomes were the rate of repeat tears after arthroscopic rotator cuff repair (retear rate) and clinical function scores (Constant-Murley Score, University of California, Los Angeles Score), and the extracted data were assessed for quality. Statistical analyses were performed using Review manager 5.3, and p < .05 was considered statistically significant. SYNTHESIS Ten RCTs with 628 patients were included. The results showed that augmenting surgery with PRP reduces retear rates compared to surgery alone (risk ratio [RR] = 0.40, 95% confidence interval [CI] 0.23-0.69, p = .001), whereas PRF has no effect on retear rates (p = .92). Regarding clinical function, PRP improves Constant-Murley scores (mean difference [MD] = 2.03, 95% CI 0.13-3.93, p = .04) and University of California, Los Angeles scores (MD = 1.30, 95% CI 0.36-2.24, p = .007), whereas PRF improves only Constant-Murley scores (MD = 3.93, 95% CI 1.50-6.36, p = .002). However, these differences were small and below the minimum clinically important difference threshold. CONCLUSIONS This study showed that compared to arthroscopic rotator cuff repair alone, the application of PRP in arthroscopic rotator cuff repair reduces retear rate and improves clinical function scores, whereas the application of PRF has no clinically meaningful benefit. The small number and heterogeneity of studies as well as methodological limitations and risk of bias limit confidence in the true effect.
Collapse
Affiliation(s)
- Yundong Peng
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Liang Du
- Department of Rehabilitation Medicine, PLA Middle Military Command General Hospital, Wuhan, China
| | - Bowen Yang
- Division of Pediatric Healthcare, Department of Pediatrics, Children's Rehabilitation Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Donghao Fan
- Department of Rehabilitation Medicine, People's Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Shaohui Jia
- Hubei Key Laboratory of Sport Training and Monitoring, College of Sports Medicine, Wuhan Sports University, Wuhan, China
| | - Cheng Zheng
- Department of Sports Medicine, Affiliated Hospital, Wuhan Sports University, Wuhan, China
| |
Collapse
|
4
|
Ushiki T, Mochizuki T, Suzuki K, Kamimura M, Ishiguro H, Suwabe T, Watanabe S, Omori G, Yamamoto N, Kawase T. Strategic analysis of body composition indices and resting platelet ATP levels in professional soccer players for better platelet-rich plasma therapy. Front Bioeng Biotechnol 2023; 11:1255860. [PMID: 37711445 PMCID: PMC10499317 DOI: 10.3389/fbioe.2023.1255860] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
Background: Autologous platelet-rich plasma (PRP) therapy is ambiguously thought to be more effective in elite athletes than in sedentary patients, although the possible importance of recipient responsiveness remains poorly understood. To address this issue, along with the well-known PRP quality, in this initial study, we evaluated two candidate biomarkers: body composition indices (BCIs), which reflect systemic physical conditions, and resting platelet ATP levels, which reflect platelet energy expenditure and the mass of energy generation units. Methods: In this cross-sectional cohort study, blood samples were collected from male professional soccer players (PSPs) on a local professional team during the off-season and platelet ATP levels were quantified using an ATP luminescence assay kit. BCIs were measured using the body mass impedance method. Age-matched male sedentary participants were used as the controls. Results: Among the BCIs, the body mass index, basal metabolic rate (BMR), and skeletal muscle weight levels were higher in the PSPs than in the controls. The platelet ATP levels in the PSPs group were significantly lower than those in the control group. The correlation between BMR and platelet ATP levels was moderately negative in the control group, but weakly positive in the PSPs group. Conclusion: Owing to regular physical exercise, PSPs had higher BMR levels and lower platelet ATP levels without a significant mutual correlation compared to sedentary controls. This study did not indicate the influence of these biomarkers on the success of PRP therapy but provided evidence for a better understanding of PRP therapy, particularly for elite athletes.
Collapse
Affiliation(s)
- Takashi Ushiki
- Division of Hematology and Oncology, Graduate School of Health Sciences, Niigata University, Niigata, Japan
- Department of Transfusion Medicine, Cell Therapy and Regenerative Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
- Department of Hematology, Endocrinology and Metabolism, Faculty of Medicine, Niigata University, Niigata, Japan
| | - Tomoharu Mochizuki
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Katsuya Suzuki
- Department of Transfusion Medicine, Cell Therapy and Regenerative Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Masami Kamimura
- Department of Transfusion Medicine, Cell Therapy and Regenerative Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Hajime Ishiguro
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tatsuya Suwabe
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoshi Watanabe
- Department of Orthopaedic Surgery, Niigata Medical Center, Niigata, Japan
| | - Go Omori
- Department of Health and Sports, Faculty of Health Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Noriaki Yamamoto
- Department of Orthopaedic Surgery, Niigata Rehabilitation Hospital, Niigata, Japan
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| |
Collapse
|
5
|
Caponio VCA, Baca-González L, González-Serrano J, Torres J, López-Pintor RM. Effect of the use of platelet concentrates on new bone formation in alveolar ridge preservation: a systematic review, meta-analysis, and trial sequential analysis. Clin Oral Investig 2023; 27:4131-4146. [PMID: 37439800 PMCID: PMC10415431 DOI: 10.1007/s00784-023-05126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone. MATERIALS AND METHODS A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted. RESULTS Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47-2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP). CONCLUSION The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed. CLINICAL RELEVANCE When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.
Collapse
Affiliation(s)
- Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Laura Baca-González
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - José González-Serrano
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain.
- Departamento de Especialidades Clínicas Odontológicas, Facultad de Odontología, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain.
| | - Jesús Torres
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| |
Collapse
|
6
|
Hermida-Nogueira L, Blanco J, García Á. Secretome Profile of Leukocyte-Platelet-Rich Fibrin (L-PRF) Membranes. Methods Mol Biol 2023; 2628:207-219. [PMID: 36781788 DOI: 10.1007/978-1-0716-2978-9_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
In the last years, platelet concentrates such as leukocyte-platelet-rich fibrin (L-PRF) have been used in different clinical scenarios as a huge source of growth factors to enhance wound healing. However, platelet concentrates release many other proteins that also participate in tissue regeneration processes. In this context, the analysis of the L-PRF secretome would provide relevant information on the different proteins and growth factors released by these platelet concentrates, how such secretion varies with the time, and how relevant this could be for the regenerative properties of these products. In the present chapter, we will provide a protocol for isolation, culture, and secretome analysis of L-PRF membranes. Qualitative and quantitative proteomic approaches will be presented, including gel-based and quantitative Sequential Window Acquisition of All Theoretical Mass Spectra (SWATH-MS)-based approaches. This protocol has been recently applied with success to define the L-PRF secretome composition, setting the stage for further research that can provide relevant information on the clinical properties of these platelet concentrates' subtype.
Collapse
Affiliation(s)
- Lidia Hermida-Nogueira
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, and Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Juan Blanco
- Periodontology Unit, Medical-Surgical Dentistry Research Group (OMEQUI), Faculty of Medicine and Odontology, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ángel García
- Platelet Proteomics Group, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), Universidade de Santiago de Compostela, and Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
| |
Collapse
|
7
|
Liu X, Tian S, Xu S, Lu W, Zhong C, Long Y, Ma Y, Yang K, Zhang L, Yang J. A pressure-resistant zwitterionic skin sensor for domestic real-time monitoring and pro-healing of pressure injury. Biosens Bioelectron 2022; 214:114528. [PMID: 35816848 DOI: 10.1016/j.bios.2022.114528] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/08/2022] [Accepted: 06/29/2022] [Indexed: 11/15/2022]
Abstract
Pressure injury (PI) is a hard-to-heal wound to patients with the limited mobility, especially paralyzed or elderly persons. These patients also commonly suffer from sensation loss or dementia that is unable to indicate symptoms in time, resulting in missing the "golden period" for treatment. Therefore, it is highly required to domestic continously real-time monitoring as well as promoting wound healing of PI. However, no existing device has realized these functions for PI. Herein, we prepare a zwitterionic skin sensor that enables pro-healing as well as domestic real-time monitoring the multi-indicators of PI. To apply for a PI dressing that requires to tolerate patient body weight, organosilicon nanoparticles (OSNPs) are designed as crosslinks in the zwitterionic conductive hydrogel (CH-OSNP), which exhibits pressure-resistant properties (99.81% compression to recovery) as well as anti-bacterial adhesion. Moreover, the CH-OSNP-based skin sensor is developed, and the resultant sensor can be sensitive to stress stimuli even under a long-term constant heavy load, which stimulates the pressure of a PI person lying down. In vivo results show that this sensor can not only promote PI healing, but also continuously monitor and distinguish multiple information, such as exudate, swelling, and infection, to prevent PI from being worsen. This work provides a domestic feasible device to cure and monitor the PI of patients.
Collapse
Affiliation(s)
- Xinmeng Liu
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China
| | - Shu Tian
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China
| | - Sijia Xu
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China
| | - Wenyi Lu
- Binzhou Institute of Technology, Weiqiao-UCAS Science and Technology Park, Binzhou City, Shandong Province, 256606, China
| | - Cheng Zhong
- Binzhou Institute of Technology, Weiqiao-UCAS Science and Technology Park, Binzhou City, Shandong Province, 256606, China
| | - You Long
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China
| | - Yiming Ma
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China
| | - Kai Yang
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China
| | - Lei Zhang
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China
| | - Jing Yang
- Department of Biochemical Engineering, Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China; Frontier Technology Research Institute, Tianjin University, Tianjin, 301700, China.
| |
Collapse
|
8
|
Fernández-Fuertes J, Arias-Fernández T, Acebes-Huerta A, Álvarez-Rico M, Gutiérrez L. Clinical Response After Treatment of Knee Osteoarthritis With a Standardized, Closed-System, Low-Cost Platelet-Rich Plasma Product: 1-Year Outcomes. Orthop J Sports Med 2022; 10:23259671221076496. [PMID: 35387363 PMCID: PMC8977725 DOI: 10.1177/23259671221076496] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background: Intra-articular infiltration of platelet-rich plasma (PRP) is an alternative
therapeutic option to classic hyaluronic acid for the treatment of
symptomatic knee osteoarthritis (KOA). However, variation in preparation
methods and quality assessment of PRP makes the study of its real clinical
efficacy difficult. Purpose: To (1) evaluate the clinical efficacy of a characterized PRP product prepared
in a standardized manner and in a closed-system for the treatment of KOA and
to (2) evaluate the association of the clinical response to PRP-related
variables. Study Design: Case series; Level of evidence, 4. Methods: We recruited 130 patients with nonoperative KOA and evaluated them for 1
year. PRP was prepared from a donation of autologous blood, obtaining 3
aliquots of approximately 10mL of product, which were frozen, allowing
platelet disruption, platelet factor release, and long-term storage, until
administration. Patients were treated 3 consecutive times every 4 weeks with
an intra-articular PRP knee injection under sterile conditions. Complete
blood count was performed on the whole-blood sample and the processed PRP
before freezing it, for product quality assessment. Patients were assessed
using the Western Ontario and McMaster Universities Osteoarthritis Index
(WOMAC) and basic satisfaction scale at 3 months, 6 months, and 1 year after
intervention. Results: Quality assessment confirmed a leukocyte-poor PRP product (white blood cell
count, 0.09 ± 0.09 × 109/L) with a high platelet purity (platelet
count, 630.86 ± 191.75 × 109/L). WOMAC scores improved, and basic
satisfaction was achieved in 70% of patients. No adverse events were
reported. No correlations were observed between PRP quality parameters and
clinical results. PRP complete treatment production costs were €108/US$125
(€36/US$41.6 per injection). Conclusion: This standardized PRP production method resulted in improved WOMAC scores at
1 year postoperatively in 70% of patients with KOA. This technique was safe
and affordable and ensured consecutive infiltrations with the same product
to each patient.
Collapse
Affiliation(s)
- Judit Fernández-Fuertes
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Orthopedics and Trauma Surgery, Hospital Universitario de Cabueñes (CAHU), Gijón, Asturias, Spain
| | - Tamara Arias-Fernández
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Hematology, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain
| | - Andrea Acebes-Huerta
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
| | - Marlene Álvarez-Rico
- Department of Orthopedics and Trauma Surgery, Hospital Universitario de Cabueñes (CAHU), Gijón, Asturias, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
| |
Collapse
|
9
|
Bezuglov E, Zholinsky A, Chernov G, Khaitin V, Goncharov E, Waśkiewicz Z, Barskova E, Lazarev A. Conservative Treatment of the Fifth Metatarsal Bone Fractures in Professional Football Players Using Platelet-Rich Plasma. Foot Ankle Spec 2022; 15:62-66. [PMID: 34142576 DOI: 10.1177/19386400211017368] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Injuries of the metatarsal bones in football are relatively rare and in most cases are localized in the fifth metatarsal. The gold standard of the diagnosis of fractures in this area can be X-rays, which in most cases allows verifying the diagnosis. The treatment tactics depend on the localization of the fracture according to Lawrence and Botte's classification: 3 zones of localization are distinguished. Fractures located in zones 2 and 3 belong to a high-risk group due to delayed consolidation and nonunion and therefore athletes are most often treated with osteosynthesis using intramedullary screws. The minimal recovery time for this type of treatment is at least 8 weeks. This report describes 7 cases of the fifth metatarsal bone fractures, located in zones 2 and 3 in professional football players who were treated with an immobilization boot, cryotherapy, nutritional supplements of calcium and vitamin D, and local injections of platelet-rich plasma, which contains numerous growth factors. The deadline for returning to regular training activities was 43 to 50 days, and there was no relapse of damage within 6 months of follow-up.Levels of Evidence: Level of evidence 4: case report study.
Collapse
Affiliation(s)
- Eduard Bezuglov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.,Russian Football Union, Moscow, Russian Federation.,Federal Research and Clinical Center of Sports Medicine and Rehabilitation, Federal Medical Biological Agency, Moscow, Russian Federation
| | - Andrey Zholinsky
- Federal Research and Clinical Center of Sports Medicine and Rehabilitation, Federal Medical Biological Agency, Moscow, Russian Federation
| | | | | | - Evgeniy Goncharov
- Russian Medical Academy of Continuous Professional, Moscow, Russian Federation.,Traumatology and Orthopedics Center, Central Clinical Hospital of the Russian Academy of Sciences, Moscow, Russian Federation
| | - Zbigniew Waśkiewicz
- Institute of Sport Science, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Ekaterina Barskova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.,High Performance Sports Laboratory, Moscow Witte University
| | - Artemii Lazarev
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation.,High Performance Sports Laboratory, Moscow Witte University.,A.I. Burnazyan Federal Medical and Biophysical Center, Federal Biomedical Agency of Russia, Moscow, Russian Federation
| |
Collapse
|
10
|
Intra-Articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Review of Their Current Molecular Mechanisms of Action and Their Degree of Efficacy. Int J Mol Sci 2022; 23:ijms23031301. [PMID: 35163225 PMCID: PMC8836227 DOI: 10.3390/ijms23031301] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 12/24/2022] Open
Abstract
Knee osteoarthritis (OA) is estimated to affect more than 10% of the population, with a lifetime risk of 45%. Contemporary guidelines advise control of body weight, therapeutic physical exercise, drug treatment (oral non-steroidal anti-inflammatory drugs, paracetamol, opioids), and mechanical aids (walking aids, braces, orthoses). Nevertheless, these treatments typically have only short-term benefits. Intra-articular corticosteroids are typically advised, but only for short-term pain alleviation, given that their benefits last only a few weeks. The efficacy of hyaluronic acid is controversial. When the aforesaid options fail, total knee arthroplasty is generally recommended as an efficacious treatment. However, it is costly and can involve medical and postoperative complications. Therefore, determining alternate safe and effective treatments for knee OA is paramount. Platelet-rich plasma (PRP) has lately been investigated for the treatment of knee OA. This article reviews recent knowledge concerning PRP’s molecular mechanisms of action. The effectiveness of intra-articular PRP injections in the knee joint remains controversial, although most recent publications show pain alleviation in the short term. Orthopedic surgeons treating people with knee OA are becoming increasingly interested in PRP, despite indecisive clinical data and basic science information. Further studies comparing PRP with placebo are required.
Collapse
|
11
|
Derwich M, Mitus-Kenig M, Pawlowska E. Mechanisms of Action and Efficacy of Hyaluronic Acid, Corticosteroids and Platelet-Rich Plasma in the Treatment of Temporomandibular Joint Osteoarthritis-A Systematic Review. Int J Mol Sci 2021; 22:ijms22147405. [PMID: 34299024 PMCID: PMC8308010 DOI: 10.3390/ijms22147405] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/08/2021] [Accepted: 07/08/2021] [Indexed: 12/20/2022] Open
Abstract
Temporomandibular joint osteoarthritis (TMJ OA) is a low-inflammatory disorder with multifactorial etiology. The aim of this review was to present the current state of knowledge regarding the mechanisms of action and the efficacy of hyaluronic acid (HA), corticosteroids (CS) and platelet-rich plasma (PRP) in the treatment of TMJ OA.: The PubMed database was analyzed with the keywords: "(temporomandibular joint) AND ((osteoarthritis) OR (dysfunction) OR (disorders) OR (pain)) AND ((treatment) OR (arthrocentesis) OR (arthroscopy) OR (injection)) AND ((hyaluronic acid) OR (corticosteroid) OR (platelet rich plasma))". After screening of 363 results, 16 studies were included in this review. Arthrocentesis alone effectively reduces pain and improves jaw function in patients diagnosed with TMJ OA. Additional injections of HA, either low-molecular-weight (LMW) HA or high-molecular-weight (HMW) HA, or CS at the end of the arthrocentesis do not improve the final clinical outcomes. CS present several negative effects on the articular cartilage. Results related to additional PRP injections are not consistent and are rather questionable. Further studies should be multicenter, based on a larger group of patients and should answer the question of whether other methods of TMJ OA treatment are more beneficial for the patients than simple arthrocentesis.
Collapse
Affiliation(s)
- Marcin Derwich
- ORTODENT, Specialist Orthodontic Private Practice in Grudziadz, 86-300 Grudziadz, Poland
- Correspondence: ; Tel.: +48-660-723-164
| | - Maria Mitus-Kenig
- Department of Experimental Dentistry and Prophylaxis, Medical College, Jagiellonian University in Krakow, 31-008 Krakow, Poland;
| | - Elzbieta Pawlowska
- Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland;
| |
Collapse
|
12
|
Xu Z, Liang B, Tian J, Wu J. Anti-inflammation biomaterial platforms for chronic wound healing. Biomater Sci 2021; 9:4388-4409. [PMID: 34013915 DOI: 10.1039/d1bm00637a] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Nowadays, there has been an increase in the number of people with chronic wounds, which has resulted in serious health problems worldwide. The rate-limiting stage of chronic wound healing has been found to be the inflammation stage, and strategies for shortening the prolonged inflammatory response have proven to be effective for increasing the healing rate. Recently, various anti-inflammatory strategies (such as anti-inflammatory drugs, antioxidant, NO regulation, antibacterial, immune regulation and angiogenesis) have attracted attention as potential therapeutic pathways. Moreover, various biomaterial platforms based on anti-inflammation therapy strategies have also emerged in the spotlight as potential therapies to accelerate the repair of chronic wounds. In this review, we systematically investigated the advances of various biomaterial platforms based on anti-inflammation strategies for chronic wound healing, to provide valuable guidance for future breakthroughs in chronic wound treatment.
Collapse
Affiliation(s)
- Zejun Xu
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Shenzhen 518107, P. R. China.
| | - Biao Liang
- Center of Digestive Endoscopy, Guangdong Second Provincial general Hospital, No. 466, Xingang Middle Road, Guangzhou 510317, Haizhu District, China.
| | - Junzhang Tian
- Center of Digestive Endoscopy, Guangdong Second Provincial general Hospital, No. 466, Xingang Middle Road, Guangzhou 510317, Haizhu District, China.
| | - Jun Wu
- Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Shenzhen 518107, P. R. China.
| |
Collapse
|
13
|
Yang CP, Hung KT, Weng CJ, Chen ACY, Hsu KY, Chan YS. Clinical Outcomes of Meniscus Repair with or without Multiple Intra-Articular Injections of Platelet Rich Plasma after Surgery. J Clin Med 2021; 10:jcm10122546. [PMID: 34207554 PMCID: PMC8228048 DOI: 10.3390/jcm10122546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 11/17/2022] Open
Abstract
Preservation of the meniscal volume is crucial in meniscus repair. The goal of this study was to evaluate the clinical outcome of repeated intra-articular platelet-rich plasma (PRP) injections after arthroscopic repair of a traumatic meniscal tear. We retrospectively reviewed 61 primary meniscal repairs in 61 patients (PRP group: 30; non-PRP: 31) from 2017 to 2018. Patients in the PRP group received repeated intra-articular PRP injections in week 2,4,6 after the primary meniscus repair. Subsequent meniscal repair treatment or meniscectomy, knee arthroplasty, and IKDC changes of less than 11.5 points were defined as healing failures. After following up for at least 24 months, the IKDC score was 75.1 ± 13.6, and the Lysholm score was 80.6 ± 14.9 in the PRP group and 72.6 ± 15.8 (IKDC) and 77.7 ± 17.2 (Lysholm) in the non-PRP group. Healing rates of the PRP and the non-PRP groups were 93.3% (Kaplan-Meier 91.6%) and 87.1% (Kaplan-Meier 84.7%), respectively (log rank test p = 0.874). Our study is the first to use multiple intra-articular PRP injections to facilitate meniscal healing after meniscal repair. Though selection bias may be present in this study, the PRP group had similar functional outcome and healing rate compared to non-PRP group.
Collapse
Affiliation(s)
- Cheng-Pang Yang
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Kung-Tseng Hung
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Chun-Jui Weng
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Alvin Chao-Yu Chen
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Kuo-Yao Hsu
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
| | - Yi-Sheng Chan
- Department of Orthopedic Surgery, Division of Sports Medicine Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou 333, Taiwan; (C.-P.Y.); (K.-T.H.); (C.-J.W.); (A.C.-Y.C.); (K.-Y.H.)
- Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou 333, Taiwan
- Correspondence: ; Tel.: +886-3-3281200 (ext. 2163)
| |
Collapse
|
14
|
Oudelaar BW, Huis In 't Veld R, Ooms EM, Schepers-Bok R, Nelissen RGHH, Vochteloo AJH. Efficacy of Adjuvant Application of Platelet-Rich Plasma After Needle Aspiration of Calcific Deposits for the Treatment of Rotator Cuff Calcific Tendinitis: A Double-Blinded, Randomized Controlled Trial With 2-Year Follow-up. Am J Sports Med 2021; 49:873-882. [PMID: 33566629 DOI: 10.1177/0363546520987579] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Needle aspiration of calcific deposits (NACD) is a frequently used treatment for rotator cuff calcific tendinitis (RCCT). However, a substantial number of patients experience recurrent or persisting shoulder symptoms after NACD. PURPOSE To compare the effects of adjuvant application of platelet-rich plasma (PRP) after NACD (NACP+PRP) with those of conventional NACD with corticosteroids (NACD+corticosteroids) on pain, shoulder function, and quality of life (QoL). STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS In a single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic RCCT were randomly allocated to receive NACD+corticosteroids or NACD+PRP. Pain, shoulder function, and QoL were assessed at baseline; 6 weeks; and 3, 6, 12, and 24 months after treatment using a numeric rating scale for pain (NRS); the Constant-Murley score (CMS); the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH); the Oxford Shoulder Score (OSS); and the EuroQol 5-dimension scale (EQ-5D). Additionally, resorption of calcific deposits and the integrity of rotator cuff tendons were assessed by using standard radiographs and ultrasound examination, respectively. The results were analyzed using noninferiority analysis for NRS scores and a mixed model for repeated measures. RESULTS Eighty patients were included (48 female; mean age, 49 ± 6 years; 41 patients in the NACD+PRP group). Both groups showed improvement of clinical scores at the 2-year follow-up (P < .001 for all clinical scores). NACD+PRP was found to be noninferior to NACD+corticosteroids with regard to the mean decrease of NRS scores (4.34 vs 3.56; P = .003). Mixed-model analysis showed a significant difference in favor of NACD+PRP (CMS, P < .001; DASH, P = .002; OSS, P = .010; EQ-5D, P < .001). However, clinically relevant differences in favor of NACD+PRP were only seen at the 6-month follow-up for NRS and CMS scores, whereas at the 6-week follow-up a clinically relevant difference in favor of NACD+corticosteroids was found for all clinical scores except for the NRS. Full resorption of calcific deposits was present in 84% of the NACD+PRP group compared with 66% in the NACD+corticosteroids group (P = .081). In the NACD+PRP group, 10 (24%) patients required a second NACD procedure compared with 19 (49%) patients in the NACD+corticosteroids group (P = .036). Six complications, of which 5 were frozen shoulders, occurred in the NACD+PRP group compared with 1 complication in the NACD+corticosteroids group (P = .11). CONCLUSION NACD+PRP resulted in worse clinical scores at the 6-week follow-up but better clinical scores at the 6-month follow-up compared with NACD+corticosteroids. At the 1- and 2-year follow-ups, the results were comparable between groups. Furthermore, PRP seemed to reduce the need for additional treatments but was associated with more complications. In conclusion, NACD+corticosteroids had a favorable early effect on pain and function combined with low comorbidity. Thus, it remains the treatment of choice for patients with RCCT. REGISTRATION NCT02173743 (ClinicalTrials.gov identifier).
Collapse
Affiliation(s)
- Bart W Oudelaar
- Centre for Orthopaedic Surgery OCON, Hengelo, the Netherlands
| | | | - Edwin M Ooms
- Centre for Orthopaedic Surgery OCON, Hengelo, the Netherlands
| | | | - Rob G H H Nelissen
- Department of Orthopaedic Surgery, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | | |
Collapse
|
15
|
Xue Y, Lu T, Xu Y, Cao X. The efficacy of platelet-rich plasma in arthroscopic rotator cuff repair: A protocol of randomized controlled trial. Medicine (Baltimore) 2020; 99:e23232. [PMID: 33285699 PMCID: PMC7717821 DOI: 10.1097/md.0000000000023232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Platelet-rich plasma (PRP), an autologous platelet concentrate (contain a large number of growth factors), has been widely investigated in healing and rebuilding the bone and tendon tissue. The objective of this prospective randomized research is to study and then compare the long-term effectiveness of the repair of arthroscopic rotator cuff without and with the platelet-rich plasma. It is assumed that there is no difference in the clinical results between patients receiving the repair of arthroscopic rotator cuff and the patients who do not receive PRP enhancement. METHODS This current study is a prospective, single-center, controlled, and randomized experiment. This study was reviewed and permitted via the institutional review committee of our hospital. All the patients will receive the written informed consent in order to involve in our clinical experiment. Patients were selected from the patients who received the repair of arthroscopic rotator cuff. Patients who meet the following conditions will be included in this study: ages ranges from 18 to 55; patients with complete tear of rotator cuff confirmed during operation; the patients agreed to wear the abduction stent for 4 weeks after operation; the preoperative count of platelet count is >150,000. All patients were evaluated at follow-up and baseline for the scores of Constant-Murley (CM) and American Shoulder and Elbow Surgeons (ASES), the numerical rating scale (NRS), and retear rate. The analysis is implemented with the SPSS 16.0 (SPSS Inc., Chicago, IL), the significance level remain at P < .05. CONCLUSIONS The results of this study will provide useful new information on whether PRP is effective in the arthroscopic rotator cuff repair patients. TRIAL REGISTRATION This study protocol was registered in Research Registry (researchregistry6108).
Collapse
|
16
|
Lui M, Shih W, Yim N, Brandstater M, Ashfaq M, Tran D. Systematic Review and Meta-Analysis of Nonoperative Platelet-Rich Plasma Shoulder Injections for Rotator Cuff Pathology. PM R 2020; 13:1157-1168. [PMID: 33131197 DOI: 10.1002/pmrj.12516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 09/29/2020] [Accepted: 10/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Platelet-rich plasma (PRP) injections have been introduced to augment the recovery of patients with shoulder pathology. Although multiple studies have been published, no large-scale trials or meta-analyses have assessed the efficacy of nonoperative shoulder PRP injection. OBJECTIVE To assess the efficacy of nonoperative PRP shoulder injection in rotator cuff pathology for pain as measured by the visual analog scale (VAS) and range of motion (ROM). DESIGN Two authors independently screened the Medline and Cochrane databases to include prospective studies that reported VAS and ROM outcomes for nonoperative shoulder PRP injections for rotator cuff pathology. Study quality was assessed using the revised Cochrane Collaboration risk-of-bias tool and modified Downs and Black checklist. Subsequent meta-analysis was performed to determine the effect of nonoperative PRP injections on pain and ROM 3 to 12 months after intervention. RESULTS Six studies met systematic review criteria. The included studies used different PRP formulations (concentration, leukocyte count), injection protocols (approach, injection number), and varied study designs. Three studies concluded that PRP provided no significant benefit for pain and ROM when compared to physical therapy. Within-group meta-analysis of six fairly heterogeneous studies (I2 77.8%) demonstrated a statistically significant (P < .001) improvement in pain 3 to 12 months after PRP injection. Within-group meta-analysis for four studies for shoulder flexion and abduction was found to be too heterogeneous to derive meaningful results. CONCLUSION There is a limited quantity of high-quality studies that assess the efficacy of nonoperative PRP shoulder injection for pain and ROM. Systematic review of PRP injections did not demonstrate an improvement in pain or ROM compared to physical therapy. Although within-group meta-analysis of nonoperative PRP statistically showed that nonoperative PRP improved pain, the lack of adequate negative controls precludes the ability to conclude whether improvements were due to natural recovery or nonoperative PRP.
Collapse
Affiliation(s)
- Mickey Lui
- Department of Physical Medicine and Rehabilitation, Loma Linda University Medical Center, Loma Linda, CA, USA.,Department of Physical Medicine and Rehabilitation, VA Loma Linda Healthcare System, Loma Linda, CA, USA
| | - Wendy Shih
- School of Public Health, Loma Linda University, Loma Linda, CA, USA
| | - Nicole Yim
- Department of Physical Medicine and Rehabilitation, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Murray Brandstater
- Department of Physical Medicine and Rehabilitation, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Majid Ashfaq
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Duc Tran
- Department of Physical Medicine and Rehabilitation, Loma Linda University Medical Center, Loma Linda, CA, USA
| |
Collapse
|
17
|
Xu J, Gou L, Zhang P, Li H, Qiu S. Platelet-rich plasma and regenerative dentistry. Aust Dent J 2020; 65:131-142. [PMID: 32145082 PMCID: PMC7384010 DOI: 10.1111/adj.12754] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2020] [Indexed: 11/30/2022]
Abstract
Regenerative dentistry is an emerging field of medicine involving stem cell technology, tissue engineering and dental science. It exploits biological mechanisms to regenerate damaged oral tissues and restore their functions. Platelet‐rich plasma (PRP) is a biological product that is defined as the portion of plasma fraction of autologous blood with a platelet concentration above that of the original whole blood. A super‐mixture of key cytokines and growth factors is present in platelet granules. Thus, the application of PRP has gained unprecedented attention in regenerative medicine. The rationale underlies the utilization of PRP is that it acts as a biomaterial to deliver critical growth factors and cytokines from platelet granules to the targeted area, thus promoting regeneration in a variety of tissues. Based on enhanced understanding of cell signalling and growth factor biology, researchers have begun to use PRP treatment as a novel method to regenerate damaged tissues, including liver, bone, cartilage, tendon and dental pulp. To enable better understanding of the regenerative effects of PRP in dentistry, this review describes different methods of preparation and application of this biological product, and provides detailed explanations of the controversies and future prospects related to the use of PRP in dental regenerative medicine.
Collapse
Affiliation(s)
- J Xu
- Shenzhen Longgang Institute of Stomatology, Shenzhen, Guangdong, China.,Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
| | - L Gou
- Center for Genetic Medicine, Xuzhou Maternity and Child Health Care Hospital, Xuzhou, Jiangsu, China
| | - P Zhang
- Shenzhen Longgang Institute of Stomatology, Shenzhen, Guangdong, China.,Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
| | - H Li
- Shenzhen Longgang Institute of Stomatology, Shenzhen, Guangdong, China.,Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
| | - S Qiu
- Department of Otolaryngology, Longgang E.N.T. Hospital & Shenzhen Key Laboratory of E.N.T., Institute of E.N.T, Shenzhen, Guangdong, China
| |
Collapse
|
18
|
Schwitzguebel AJ, Kolo FC, Tirefort J, Kourhani A, Nowak A, Gremeaux V, Saffarini M, Lädermann A. Efficacy of Platelet-Rich Plasma for the Treatment of Interstitial Supraspinatus Tears: A Double-Blinded, Randomized Controlled Trial. Am J Sports Med 2019; 47:1885-1892. [PMID: 31161947 DOI: 10.1177/0363546519851097] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND The benefits of platelet-rich plasma (PRP) for the treatment of rotator cuff tears remain inconclusive, as it is administered either as an adjuvant to surgical repair or as a primary infiltration without targeting the index lesion, which could dilute its effect. PURPOSE To determine whether PRP infiltrations are superior to saline solution infiltrations (placebo) at improving healing, pain, and function when injected under ultrasound guidance within isolated interstitial supraspinatus tears. STUDY DESIGN Randomized controlled trial; Level of evidence, 1. METHODS In this single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic isolated interstitial tears of the supraspinatus, confirmed by magnetic resonance arthrography, were randomized to PRP or saline injections. Each patient received 2 injections with a 1-month interval. The primary outcome was the change in lesion volume, calculated on magnetic resonance arthrography, at 7 months. The secondary outcomes were improvements in shoulder pain and the Single Assessment Numerical Evaluation (SANE) score at >12 months. RESULTS Preoperative patient characteristics did not differ between the 2 groups. At 7 months, there were no significant differences between the PRP and control groups in terms of a decrease in lesion size (-0.3 ± 23.6 mm3 vs -8.1 ± 84.7 mm3, respectively; P = .175); reduction of pain on a visual analog scale (VAS) (-2.3 ± 3.0 vs -2.0 ± 3.0, respectively; P = .586); and improvement in SANE (16.7 ± 20.0 vs 14.9 ± 29.0, respectively; P = .650), Constant (8.6 ± 13.0 vs 10.7 ± 19.0, respectively; P = .596), and American Shoulder and Elbow Surgeons (19.5 ± 20.0 vs 21.9 ± 28.0, respectively; P = .665) scores. At >12 months, there were no significant differences between the PRP and control groups in terms of a reduction of pain on a VAS (-3.3 ± 2.6 vs -2.3 ± 3.2, respectively; P = .087) or improvement in the SANE score (24.4 ± 27.5 vs 23.4 ± 24.9, respectively; P = .846). At 19.5 ± 5.3 months, the incidence of adverse effects (pain >48 hours, frozen shoulder, extension of lesion) was significantly higher in the PRP group than the control group (54% vs 26%, respectively; P = .020). CONCLUSION PRP injections within interstitial supraspinatus tears did not improve tendon healing or clinical scores compared with saline injections and were associated with more adverse events. REGISTRATION NCT02672085 (ClinicalTrials.gov identifier).
Collapse
Affiliation(s)
- Adrien J Schwitzguebel
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.,Division of Physical Medicine and Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Jérôme Tirefort
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
| | - Abed Kourhani
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Alexandra Nowak
- Division of Physical Medicine and Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | - Vincent Gremeaux
- Division of Physical Medicine and Rehabilitation, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospital, Geneva, Switzerland
| |
Collapse
|
19
|
Veith AP, Henderson K, Spencer A, Sligar AD, Baker AB. Therapeutic strategies for enhancing angiogenesis in wound healing. Adv Drug Deliv Rev 2019; 146:97-125. [PMID: 30267742 DOI: 10.1016/j.addr.2018.09.010] [Citation(s) in RCA: 427] [Impact Index Per Article: 85.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 09/15/2018] [Accepted: 09/24/2018] [Indexed: 12/19/2022]
Abstract
The enhancement of wound healing has been a goal of medical practitioners for thousands of years. The development of chronic, non-healing wounds is a persistent medical problem that drives patient morbidity and increases healthcare costs. A key aspect of many non-healing wounds is the reduced presence of vessel growth through the process of angiogenesis. This review surveys the creation of new treatments for healing cutaneous wounds through therapeutic angiogenesis. In particular, we discuss the challenges and advancement that have been made in delivering biologic, pharmaceutical and cell-based therapies as enhancers of wound vascularity and healing.
Collapse
|
20
|
Similar effect of ultrasound-guided platelet-rich plasma versus platelet-poor plasma injections for chronic plantar fasciitis. Foot (Edinb) 2019; 38:30-33. [PMID: 30572281 DOI: 10.1016/j.foot.2018.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/11/2018] [Accepted: 11/25/2018] [Indexed: 02/04/2023]
Abstract
BACKGROUND There are conflicting reports regarding the therapeutic effect of platelet-rich plasma (PRP) versus autologous whole-blood (platelet poor plasma, PPP) injections for plantar fasciitis. Therefore, this study was conducted to compare the effectiveness of a single ultrasound (US)-guided PRP versus PPP injection in patients with chronic plantar fasciitis. MATERIALS AND METHODS 36 patients were recruited with clinical and sonographic evidence of chronic (>6 months) plantar fasciitis, refractory to analgesics and physical therapy in a double-blinded, randomized, prospective study. The patients were randomly allocated into two groups with a sealed envelope method. Group A included 18 patients who underwent a single US-guided PRP injection and group B included another 18 patients who underwent PPP injection with the same technique. Follow-up was set at 3 and 6 months; no patient was lost to follow-up. Pain, function and satisfaction were assessed using visual analogue scales, and occurrence of complications. RESULTS All scores statistically significantly improved for both groups from baseline at the 3- and 6-month follow-up evaluation, without, however, any statistically significant differences between the two groups with respect to pain, function and satisfaction scores. Complications were not observed. CONCLUSIONS A single US-guided PRP injection yields similar results with PPP injection in patients with chronic plantar fasciitis. Both treatments provide significant improvement at 3 and 6-month follow-up after the injection.
Collapse
|
21
|
The Role of Platelet-Rich Plasma in Cartilage Pathology: An Updated Systematic Review of the Basic Science Evidence. Arthroscopy 2019; 35:961-976.e3. [PMID: 30733026 DOI: 10.1016/j.arthro.2018.10.125] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 10/06/2018] [Accepted: 10/29/2018] [Indexed: 02/02/2023]
Abstract
PURPOSE To review the basic science studies on platelet-rich plasma (PRP) for cartilage and determine whether there has been an improvement in methodology and outcome reporting that would allow for a more meaningful analysis regarding the mechanism of action and efficacy of PRP for cartilage pathology. METHODS The PubMed/MEDLINE and EMBASE databases were screened in May 2017 with publication dates of January 2011 through May 2017 using the following key words: "platelet-rich plasma OR PRP OR autologous conditioned plasma (ACP) OR ACP AND cartilage OR chondrocytes OR chondrogenesis OR osteoarthritis OR arthritis." Two authors independently performed the search, determined study inclusion, and extracted data. Data extracted included cytology/description of PRP, study design, and results. RESULTS Twenty-seven studies (11 in vitro, 13 in vivo, 3 in vitro and in vivo) met the inclusion criteria and were included in the study. All of the studies (100%) reported the method by which PRP was prepared. Two studies reported basic cytologic analysis of PRP, including platelet, white blood cell, and red blood cell counts (6.7%). Nine studies reported both platelet count and white blood cell count (30.0%). Twelve studies reported platelet count alone (40.0%). Nine studies (30.0%) made no mention at all as to the composition of the PRP used. PRP was shown to increase cell viability, cell proliferation, cell migration, and differentiation. Several studies demonstrated increased proteoglycan and type II collagen content. PRP decreased inflammation in 75.0% of the in vitro studies reporting data and resulted in improved histologic quality of the cartilage tissue in 75.0% of the in vivo studies reporting data. CONCLUSIONS Although the number of investigations on PRP for cartilage pathology has more than doubled since 2012, the quality of the literature remains limited by poor methodology and outcome reporting. A majority of basic science studies suggest that PRP has beneficial effects on cartilage pathology; however, the inability to compare across studies owing to a lack of standardization of study methodology, including characterizing the contents of PRP, remains a significant limitation. Future basic science and clinical studies must at a minimum report the contents of PRP to better understand the clinical role of PRP for cartilage pathology. CLINICAL RELEVANCE Establishing proof of concept for PRP to treat cartilage pathology is important so that high-quality clinical studies with appropriate indications can be performed.
Collapse
|
22
|
Use of stem cells and growth factors in rotator cuff tendon repair. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 29:747-757. [PMID: 30627922 DOI: 10.1007/s00590-019-02366-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/03/2019] [Indexed: 12/13/2022]
Abstract
The management of rotator cuff tears continues to prove challenging for orthopaedic surgeons. Such tears affect most age groups and can lead to significant morbidity in patients. The aetiology of these tears is likely to be multifactorial; however, an understanding of the mechanisms involved is still under review. Despite advancements in surgical operative techniques and the materials used, post-operative recurrence rates after surgical repair remain high. A growing area of research surrounds biological adjuncts used to improve the healing potential of the repaired tissues. This review of recent publications focuses on the strengths and limitations of using stem cells and growth factors in rotator cuff repair.
Collapse
|
23
|
Centeno C, Markle J, Dodson E, Stemper I, Williams C, Hyzy M, Ichim T, Freeman M. Symptomatic anterior cruciate ligament tears treated with percutaneous injection of autologous bone marrow concentrate and platelet products: a non-controlled registry study. J Transl Med 2018; 16:246. [PMID: 30176875 PMCID: PMC6122476 DOI: 10.1186/s12967-018-1623-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Accepted: 08/29/2018] [Indexed: 12/13/2022] Open
Abstract
Background Bone marrow concentrate (BMC) has shown promise in the treatment of several orthopedic conditions. This registry study investigated the use of autologous BMC and platelet products for percutaneous anterior cruciate ligament (ACL) treatment. Methods Twenty-nine patients presenting to a single outpatient interventional musculoskeletal and pain practice with symptomatic grade 1, 2, or 3 ACL tears with less than 1 cm retraction were enrolled. Patients were treated with a percutaneous ACL injection of autologous BMC and platelet products using fluoroscopic guidance. Pre- and post-treatment magnetic resonance imaging analysis was completed for 23 patients using ImageJ software for an objective quantitative analysis of pixel density as a proxy for ACL integrity. Subjective clinical outcome measures collected pre-treatment and at 1, 3, 6, 12, 18, 24, and 36 months post-treatment include the Numerical Pain Scale (NPS), the Lower Extremity Functional Scale (LEFS), the International Knee Documentation Committee (IKDC) form, and a modified version of the Single Assessment Numeric Evaluation. Results Seventy-seven percent of patients treated with BMC injections into the ACL showed significant improvement (p < 0.01) in objective measures of ACL integrity at an average of 8.8 months (median 4.7 months). The mean of last patient-reported improvement was 72% (SD = 35) at an average of 23 (SD = 10) months post-treatment. Mean scores were found to be significantly different (p < 0.05) for the NPS at 6, 18, and 24 months, and LEFS and IKDC at all time points (i.e. 1, 3, 6, 12, 18, 24, and 36 months) relative to baseline. Conclusion In symptomatic patients with grade 1, 2, or even grade 3 tears with minimal retraction, ACL treatment with percutaneous injection of BMC and platelet products shows promise as a non-surgical alternative. However, a larger randomized controlled trial is warranted to confirm these findings. Trial registration NCT03011398. A Clinical Registry of Orthobiologics Procedures. https://clinicaltrials.gov/ct2/show/NCT03011398?term=orthobiologics&rank=1. Registered 29 December 2016. Enrollment 1 December 2011-retrospectively registered
Collapse
Affiliation(s)
- Christopher Centeno
- Centeno-Schultz Clinic, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA.,Regenexx, LLC, Des Moines, IA, 50321, USA
| | - Jason Markle
- Centeno-Schultz Clinic, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA
| | | | | | | | - Matthew Hyzy
- Centeno-Schultz Clinic, 403 Summit Blvd Suite 201, Broomfield, CO, 80021, USA
| | | | - Michael Freeman
- CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
24
|
Adriani E, Moio M, Di Paola B, Salustri W, Alfieri A, Parisi P, Ruggiero M, Borab Z, Carlesimo B. Percutaneous Fat Transfer to Treat Knee Osteoarthritis Symptoms: Preliminary Results. JOINTS 2017; 5:89-92. [PMID: 29114637 PMCID: PMC5672865 DOI: 10.1055/s-0037-1603672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Purpose This study aims to evaluate the safety and efficacy of autologous aspirated and purified fat tissue injected percutaneously into the knee joint for the treatment of symptomatic osteoarthritis (OA). Methods We reviewed 30 patients, who received an autologous percutaneous fat injection for the treatment of knee OA, from January 2012 to March 2015. Mean patients' age was 63.3 ± 5.3 years (range, 50-80 years). Body mass index was 25.1 ± 1.7. Clinical evaluation was based on pain visual analog scale (VAS) and WOMAC score for functional and subjective assessment. We also noted the adverse reactions and the consumption of nonsteroidal anti-inflammatory drugs in the posttreatment period. Results All patients reported improvements with respect to pain: average VAS was 7.7 ± 1.2 at baseline, 5.2 ± 0.2 at 1-month follow-up, and 4.3 ± 1 at 3-month follow-up. A slight deterioration (5.0 ± 1.1) was evidenced at 1 year. Total WOMAC score was 89.9 ± 1.7 at baseline, 66.3 ± 1 at 1 month, 68.6 ± 1.7 at 3 months, and 73.2 ± 1.8 at 12 months of follow-up. Conclusion Our preliminary findings suggest that autologous percutaneous fat injections are a valid treatment option for knee OA. Level of Evidence Level IV, therapeutic case series.
Collapse
Affiliation(s)
- Ezio Adriani
- Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
| | - Mariagrazia Moio
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | | | - Walter Salustri
- Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
| | - Andrea Alfieri
- Department of Orthopedics and Traumatology, Sport Clinique, Rome, Italy
| | - Paola Parisi
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Marco Ruggiero
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Zack Borab
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| | - Bruno Carlesimo
- Department of Plastic Surgery, Policlinico Umberto I, "La Sapienza" University of Rome, Rome, Italy
| |
Collapse
|
25
|
Jena BP, Stemmer PM, Wang S, Mao G, Lewis KT, Walz DA. Human Platelet Vesicles Exhibit Distinct Size and Proteome. J Proteome Res 2017; 16:2333-2338. [PMID: 28587468 DOI: 10.1021/acs.jproteome.7b00309] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the past 50 years, isolated blood platelets have had restricted use in wound healing, cancer therapy, and organ and tissue transplant, to name a few. The major obstacle for its unrestricted use has been, among others, the presence of ultrahigh concentrations of growth factors and the presence of both pro-angiogenic and anti-angiogenic proteins. To overcome this problem requires the isolation and separation of the membrane bound secretory vesicles containing the different factors. In the current study, high-resolution imaging of isolated secretory vesicles from human platelets using atomic force microscopy (AFM) and mass spectrometry enabled characterization of the remaining vesicles size and composition following their immunoseparation. The remaining vesicles obtained following osmotic lysis, when subjected to immunoseparation employing antibody to different vesicle-associated membrane proteins (VAMPs), demonstrate for the first time that VAMP-3-, VAMP-7-, and VAMP-8-specific vesicles each possesses distinct size range and composition. These results provide a window into our understanding of the heterogeneous population of vesicles in human platelets and their stability following both physical manipulation using AFM and osmotic lysis of the platelet. This study further provides a platform for isolation and the detailed characterization of platelet granules, with promise for their future use in therapy. Additionally, results from the study demonstrate that secretory vesicles of different size found in cells reflect their unique and specialized composition and function.
Collapse
Affiliation(s)
- Bhanu P Jena
- Department of Physiology, School of Medicine, ‡Department of Chemical Engineering & Materials Science, College of Engineering, and §Institute of Environment Health Sciences, Wayne State University , Detroit, Michigan 48201, United States
| | - Paul M Stemmer
- Department of Physiology, School of Medicine, ‡Department of Chemical Engineering & Materials Science, College of Engineering, and §Institute of Environment Health Sciences, Wayne State University , Detroit, Michigan 48201, United States
| | - Sunxi Wang
- Department of Physiology, School of Medicine, ‡Department of Chemical Engineering & Materials Science, College of Engineering, and §Institute of Environment Health Sciences, Wayne State University , Detroit, Michigan 48201, United States
| | - Guangzhao Mao
- Department of Physiology, School of Medicine, ‡Department of Chemical Engineering & Materials Science, College of Engineering, and §Institute of Environment Health Sciences, Wayne State University , Detroit, Michigan 48201, United States
| | - Kenneth T Lewis
- Department of Physiology, School of Medicine, ‡Department of Chemical Engineering & Materials Science, College of Engineering, and §Institute of Environment Health Sciences, Wayne State University , Detroit, Michigan 48201, United States
| | - Daniel A Walz
- Department of Physiology, School of Medicine, ‡Department of Chemical Engineering & Materials Science, College of Engineering, and §Institute of Environment Health Sciences, Wayne State University , Detroit, Michigan 48201, United States
| |
Collapse
|
26
|
Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. TISSUE ENGINEERING PART B-REVIEWS 2016; 23:83-99. [PMID: 27672729 DOI: 10.1089/ten.teb.2016.0233] [Citation(s) in RCA: 225] [Impact Index Per Article: 28.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The growing multidisciplinary field of tissue engineering aims at predictably regenerating, enhancing, or replacing damaged or missing tissues for a variety of conditions caused by trauma, disease, and old age. One area of research that has gained tremendous awareness in recent years is that of platelet-rich fibrin (PRF), which has been utilized across a wide variety of medical fields for the regeneration of soft tissues. This systematic review gathered all the currently available in vitro, in vivo, and clinical literature utilizing PRF for soft tissue regeneration, augmentation, and/or wound healing. In total, 164 publications met the original search criteria, with a total of 48 publications meeting inclusion criteria (kappa score = 94%). These studies were divided into 7 in vitro, 11 in vivo, and 31 clinical studies. In summary, 6 out of 7 (85.7%) and 11 out of 11 (100%) of the in vitro and in vivo studies, respectively, demonstrated a statistically significant advantage for combining PRF to their regenerative therapies. Out of the remaining 31 clinical studies, a total of 8 reported the effects of PRF in a randomized clinical trial, with 5 additional studies (13 total) reporting appropriate controls. In those clinical studies, 9 out of the 13 studies (69.2%) demonstrated a statistically relevant positive outcome for the primary endpoints measured. In total, 18 studies (58% of clinical studies) reported positive wound-healing events associated with the use of PRF, despite using controls. Furthermore, 27 of the 31 clinical studies (87%) supported the use of PRF for soft tissue regeneration and wound healing for a variety of procedures in medicine and dentistry. In conclusion, the results from the present systematic review highlight the positive effects of PRF on wound healing after regenerative therapy for the management of various soft tissue defects found in medicine and dentistry.
Collapse
Affiliation(s)
- Richard J Miron
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
| | - Masako Fujioka-Kobayashi
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida.,2 Cranio-Maxillofacial Surgery, Bern University Hospital , Inselspital, Bern, Switzerland .,3 Department of Oral Surgery, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School , Tokushima, Japan
| | - Mark Bishara
- 4 West Bowmanville Family Dental , Ontario, Canada
| | - Yufeng Zhang
- 5 Department of Oral Implantology, University of Wuhan , Wuhan, China
| | - Maria Hernandez
- 1 Department of Periodontology, Nova Southeastern University , Fort Lauderdale, Florida
| | | |
Collapse
|
27
|
Malanga G, Abdelshahed D, Jayaram P. Orthobiologic Interventions Using Ultrasound Guidance. Phys Med Rehabil Clin N Am 2016; 27:717-31. [DOI: 10.1016/j.pmr.2016.04.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
28
|
Fu CJ, Sun JB, Bi ZG, Wang XM, Yang CL. Evaluation of platelet-rich plasma and fibrin matrix to assist in healing and repair of rotator cuff injuries: a systematic review and meta-analysis. Clin Rehabil 2016; 31:158-172. [DOI: 10.1177/0269215516634815] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To perform a meta-analysis examining the effectiveness of platelet-rich plasma and platelet-rich fibrin matrix for improving healing of rotator cuff injuries. Data sources/design: A meta-analysis of eligible studies was performed after searching Medline, Cochrane, and EMBASE on 14 December 2015. Setting: University hospital. Participants: Patients with rotator cuff injuries. Review methods/intervention: Databases were searched using the keywords “PRP or platelet-rich plasma,” “PRFM or platelet-rich fibrin matrix,” “rotator cuff,” and “platelet-rich” for studies comparing outcomes of patients with rotator cuff injuries that did and did not receive a platelet-rich product. Main measures: The primary outcome was a functional score change from pre- to post-treatment (Scorepost–Scorepre). The secondary outcome was a visual analogue scale (VAS) pain score change from pre- to post-treatment (VASpost–VASpre). Results: A total of 11 studies were included in the meta-analysis. The total number of patients that received platelet-rich plasma or platelet-rich fibrin matrix was 320 and the number of control patients was 318. The standard difference in means of the functional scores was similar between patients administered platelet-rich plasma/fibrin matrix and patients in the control group (standard difference in means for functional scores = 0.029; 95% confidence interval (CI): –0.132 to 0.190; p = 0.725). The standard difference in means was similar between patients administered platelet-rich plasma and the controls (standard difference in means = 0.142; 95% CI: –0.080 to 0.364; p = 0.209). Conclusion: The results of this meta-analysis do not support the use of platelet-rich plasma/platelet-rich fibrin matrix in patients with rotator cuff injuries.
Collapse
Affiliation(s)
- Chun-Jiang Fu
- Department of Orthopedics, Harbin Medical University, Harbin, China
| | - Jia-Bing Sun
- Department of Orthopedics, Harbin Medical University, Harbin, China
| | - Zheng-Gang Bi
- Department of Orthopedics, Harbin Medical University, Harbin, China
| | - Xu-Ming Wang
- Department of Orthopedics, Harbin Medical University, Harbin, China
| | - Cheng-Lin Yang
- Department of Orthopedics, Harbin Medical University, Harbin, China
| |
Collapse
|
29
|
Immunohistochemical Expression of Collagens in the Skin of Horses Treated with Leukocyte-Poor Platelet-Rich Plasma. BIOMED RESEARCH INTERNATIONAL 2015; 2015:893485. [PMID: 26236743 PMCID: PMC4508476 DOI: 10.1155/2015/893485] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 05/05/2015] [Accepted: 05/12/2015] [Indexed: 12/30/2022]
Abstract
This study evaluated the immunohistochemical expression of type I (COL I) and III (COL III) collagens during the healing process of skin treated with leukocyte-poor platelet-rich plasma (LP-PRP). Seven healthy gelding crossbred horses aged 16 to 17 years were used. Two rectangle-shaped wounds were created surgically in the right and left gluteal regions. Twelve hours after wound induction, 0.5 mL of the LP-PRP was administered in each edge of the wounds of one of the gluteal regions. The contralateral region was used as control (CG). Three samples were obtained: after wound induction (T0), 14 days (T1) of healing process, and after complete closure of the skin (T2). The normal skin (T0) showed strong staining for type III and I collagen in papillary and reticular dermis, respectively. In the scar of the treated group, COL III showed important (p < 0.05) increase in immunoreaction in T2 compared with T1. The administration of a single dose of LP-PRP 12 h after induction of wound in horses does not influence formation of collagens I and III. However, the intense labeling for COL III suggests that the tissue was still weak during the macroscopic closure of the wound, demonstrating that healing was not completely finished.
Collapse
|