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Averell N, Goodwin B, Park S, Spicer S, Wilson M, Mitchell J, Martinez N, Palhang M, Jabon J, Jermyn R. The concentration of platelets in PRP does not affect pain outcomes in lateral epicondylitis: a systematic review and meta-analysis. Pain Manag 2024; 14:223-233. [PMID: 38874535 DOI: 10.1080/17581869.2024.2360381] [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: 10/04/2023] [Accepted: 05/23/2024] [Indexed: 06/15/2024] Open
Abstract
Aim: To investigate the analyze the relationship between concentration platelet-dose in platelet-rich plasma (PRP) injections and improvements in pain when treating lateral epicondylitis. Methods: A systematic review was conducted into five medical databases, exploring the difference in pain outcomes based on concentration of PRP. Results: Initial querying of the databases yielded 1408 articles with 20 articles ultimately included. There was no statistical significance between effect sizes of the two treatment groups (high and low platelet concentration; p = 0.976). Conclusion: Both large and small concentrations of platelets depict significant reduction in pain, however, between subgroups there was no significance. It can thus be concluded that concentration of platelets in PRP does not impact overall pain relief.
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Affiliation(s)
- Nicholas Averell
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
- Futures Forward Research Institute, Toms River, NJ 08753, USA
| | - Brandon Goodwin
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
- Futures Forward Research Institute, Toms River, NJ 08753, USA
| | - Seungkyu Park
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
| | - Seth Spicer
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
- Futures Forward Research Institute, Toms River, NJ 08753, USA
| | - Margaret Wilson
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
| | - Jessica Mitchell
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
| | - Nichole Martinez
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
| | - Meejan Palhang
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
| | - Jaimy Jabon
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
| | - Richard Jermyn
- Department of Medicine, Rowan University School of Osteopathic Medicine, Stratford, NJ 08043, USA
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Bacevich BM, Smith RDJ, Reihl AM, Mazzocca AD, Hutchinson ID. Advances with Platelet-Rich Plasma for Bone Healing. Biologics 2024; 18:29-59. [PMID: 38299120 PMCID: PMC10827634 DOI: 10.2147/btt.s290341] [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: 10/05/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
Despite significant advances in the understanding and delivery of osteosynthesis, fracture non-union remains a challenging clinical problem in orthopaedic surgery. To bridge the gap, basic science characterization of fracture healing provides a platform to identify and target biological strategies to enhance fracture healing. Of immense interest, Platelet-rich plasma (PRP) is a point of care orthobiologic that has been extensively studied in bone and soft tissue healing given its relative ease of translation from the benchtop to the clinic. The aim of this narrative review is to describe and relate pre-clinical in-vitro and in-vivo findings to clinical observations investigating the efficacy of PRP to enhance bone healing for primary fracture management and non-union treatment. A particular emphasis is placed on the heterogeneity of PRP preparation techniques, composition, activation strategies, and delivery. In the context of existing data, the routine use of PRP to enhance primary fracture healing and non-union management cannot be supported. However, it is acknowledged that extensive heterogeneity of PRP treatments in clinical studies adds obscurity; ultimately, refinement (and consensus) of PRP treatments for specific clinical indications, including repetition studies are warranted.
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Affiliation(s)
- Blake M Bacevich
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Richard David James Smith
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Alec M Reihl
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
| | - Augustus D Mazzocca
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
- Medical Director, Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Brigham, Boston, MA, USA
| | - Ian D Hutchinson
- Division of Sports Medicine, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Massachusetts General Brigham, Boston, MA, USA
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Zhao S, Zhou L, Jiang Y, Xing X. Er:YAG laser therapy in combination with GLUMA desensitizer reduces dentin hypersensitivity in children with molar-incisor hypomineralization: a randomized clinical trial. Lasers Med Sci 2023; 38:280. [PMID: 38030798 DOI: 10.1007/s10103-023-03944-6] [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: 06/12/2023] [Accepted: 11/24/2023] [Indexed: 12/01/2023]
Abstract
This study aimed to investigate the effectiveness of erbium-doped yttrium garnet (Er:YAG) laser and GLUMA desensitizer for dentin hypersensitivity in teeth affected by Molar-Incisor Hypomineralization (MIH). One hundred twenty children were randomly allocated to four groups: the control (Co) group, the desensitizer (De) group, the laser (La) group, and the laser + desensitizer (La + De) group. Outcome measures included Visual Analogue Scale (VAS) and 14-item Oral Health Impact Profile (OHIP-14) evaluation. For mean VAS scores, a significant reduction was found over time in all groups. Co and De groups, Co and La groups, Co and La + De groups, De and La + De groups, and La and La + De groups differed significantly (p < 0.05). For mean scores in all dimensions of OHIP-14 after treatment 6 months, the La + De group was significantly lower (p < 0.001). The La + De groups and the La groups as well as the La + De groups and the De groups differed significantly in total OHIP, functional limitation, physical disability, and psychological disability (p < 0.05). Physical pain between the La + De groups and the La groups and handicap between the La + De groups and De groups differed significantly (p < 0.05). The mean values of each dimension differed significantly between the group Co and the La + De group (p < 0.0001). Combination therapy of Er:YAG laser and GLUMA desensitizer had greater desensitizing effects and oral health-related quality improvement of life, which might be an effective alternative treatment in dentin hypersensitivity in MIH children.
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Affiliation(s)
- Shuya Zhao
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Lisha Zhou
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Yuan Jiang
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Xianghui Xing
- Department of Pediatric Dentistry, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
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