Effect of platelet concentration on clinical improvement in treatment of early stage-knee osteoarthritis with platelet-rich plasma concentrations.

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[Purpose] To compare two platelet-rich plasma kits with different platelet concentrations for treatment of knee osteoarthritis. [Subjects and Methods] Male and female patients with knee osteoarthritis who had confirmed diagnosis with X-ray and magnetic resonance imaging were included in this retrospective study. Eligible patients were divided into two groups: Group I, which received platelet-rich plasma kit I, and Group II, which received platelet-rich plasma kit II. Platelet concentrations of both kits were measured by manual counting. For each group, platelet-rich plasma kit was injected twice with a one-month interval between injections. The Western Ontario and McMaster Universities Osteoarthritis Index and the Visual Analog Scale were applied for clinical evaluation before the first injection and one, three and six months after the second injection. [Results] Kits I and II contained 1,000,000 and 3,000,000 platelets/µl respectively. In both groups, initial Western Ontario and McMaster Universities Osteoarthritis Index and Visual Analog Scale scores were significantly higher compared to the latter evaluations. However, no significant difference was observed between groups in terms of clinical evaluations.

[Conclusion] Similar clinical results were found in groups receiving different platelet concentrations, therefore, a concentration of 1,000,000 platelet/µl is considered sufficient for pain relief and functional recovery.

Source: Journal of Physical Therapy Science

Therapeutic effect of microneedling and autologous platelet-rich plasma in the treatment of atrophic scars: A randomized study.

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Background

New treatments and techniques were being added over the last few years to treat atrophic scars with variable results and adverse effects.

Aim of the work

The aim of this study was to evaluate and compare the therapeutic efficacy and safety of microneedling, autologous platelet-rich plasma, and combination of both procedures in the treatment of atrophic scars.

Patients and methods

This study included 90 patients with atrophic scars and were classified randomly into three groups: I: 28 patients treated with microneedling, one session every 4 weeks; II: 34 patients treated with intradermal injection of platelet-rich plasma, one session every 2 weeks; and III: 28 patients treated with alternative sessions of each microneedling and platelet-rich plasma, 2 weeks between each session, for a maximum of six sessions.

Results

There was a statistically significant improvement in the appearance of atrophic scars, with reduction in the scores associated with the clinical evaluation scale for atrophic scarring in all groups, but the improvement was more obvious in group III.

Conclusions

Although a single treatment may give good results, combination between skin needling and platelet-rich plasma is more effective, safe with less number of sessions in all types of atrophic scars.

 Journal of Cosmetic Dermatology.

The effect of autologous activated platelet-rich plasma injection on female pattern hair loss: A randomized placebo-controlled study.

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RESULTS:

There was a statistical significant difference between PRP and placebo areas (P<.005) regarding both hair density and hair thickness as measured by a folliscope. The hair pull test became negative in PRP-injected areas in 25 patients (83%) with average number of three hairs. Global pictures showed a significant improvement in hair volume and quality together with a high overall patient satisfaction in PRP-injected sites, and these results were maintained during the 6-month follow- up.

CONCLUSION:

Platelet-rich plasma injections can be regarded as an alternative for the treatment of female pattern hair loss with minimal morbidity and a low cost-to-benefit ratio.

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Platelet Rich Plasma for Chronic Synovitis Treatment in Patients with Haemophilia.

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Abstract

INTRODUCTION:

Haemophilic synovitis is caused by chronic accumulation of blood in the joint. Conservative treatment is insufficient to solve this pathology. Platelet-rich plasma (PRP) has a high concentration of growth factors (GFs) that play a key role in regulation and stimulation of healing processes. The aim of this study was to describe the effect of PRP injection in chronic synovitis of the joints in patients with haemophilia (PWH).

PATIENTS AND METHODS:

Nineteen patients with 28 joints were treated at our centre in Buenos Aires, Argentina between December 2014 and December 2015. Eighteen were Haemophilia type A (17 severe, one mild) and one was type B severe. Mean age was 26 years old. Chronic synovitis was present in two ankles, seven elbows and 19 knee joints. All affected joints were evaluated for range of motion (ROM), perimeter, Haemophilia Joint Health Score (HJHS), number of bleedings episodes and Visual Analogue Scale (VAS). Evaluations were before treatment and 3 and 6 months after treatment.

RESULTS:

A mean volume of 4 mL of PRP was injected into the joint cavity. The statistical analysis before and after treatments revealed a statistically significant (P < 0.001) decrease in the HJHS score. Decrease in joint bleeding episodes was also statistically significant (P < 0.001). All patients reported pain relief and VAS scores were statistically significant (P < 0.001). Joint perimeter also showed a statistically significant difference (P < 0.001). No complications were observed in any of the patients, either during blood collection or during PRP injection, even for inhibitor patients.

CONCLUSION:

Platelet-rich plasma is a useful, safe, and inexpensive treatment for chronic haemophilic synovitis.

Short-term clinical results of intra-articular PRP injections for early osteoarthritis of the knee

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PURPOSE: To assess the short-term results of repeated intra-articular platelet rich plasma (PRP) injections into the knee in patients with early osteoarthritis (OA) and to determine a better treatment protocol.

METHODS: This is a retrospective study in 191 knees (127 patients) with minimum of 12 months follow-up. We compared the clinical results of three types of injection method, once a month, twice monthly, and three injections at monthly interval. The outcomes were assessed using Visual Rating Scale (VRS), functional score, knee score, range of motion (ROM), WOMAC Stiffness/Pain/Function score, IKDC score, before the first injection and at 12 months post treatment.

RESULTS: There were significant improvements in all scores after treatment as compared to the pre-treatment values (p < 0.05), except Knee score after 1st and 2nd injection and ROM in three groups. The parameters of Visual Rating Scale (VRS), functional score, and WOMAC Stiffness/Pain/Function score showed significant differences among the three groups in favour of the three injections group (p < 0.05). At 12 months, the effects began to decline in one injection and two injections groups, and the data in one injection group showed significant difference compared to two injection group (p < 0.001). Three injections group had higher scores and more improvement at 12 months after treatment when compared to the other two groups.

CONCLUSION: PRP injection appears to be effective in early symptomatic OA knees. The results after treatment are encouraging with significant reduction in pain and improvement in knee function at 12 months after treatment when compared to the pre-treatment status. Three injections per month yielded significantly better results in short-term follow-up.

Men and women regrowing hair with PRP therapy

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Vickie McKenna wasn't always a fan of getting photographed. She had been losing her fine, thin hair for years and was self conscious of the bald spot on the back of her head.

Nothing seemed to work. 

"I've tried every product under the sun," she told us. 

So when McKenna heard about Platelet-rich plasma, or PRP, she was ready to try it. But she wasn't prepared for the results. 

"This is crazy, because I feel so pretty. I'm going to cry because I never could have long hair," she exclaimed after undergoing treatment. 

 

Read more.

Knee Pain? Consider These Steps Before Resorting To Replacement Surgery

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NEW YORK (CBSNewYork) — If your knees hurt and you think you’re headed for a knee replacement, there are ways to preserve your joints and hold off surgery.

The most common cause of knee pain is osteoarthritis, often called wear and tear arthritis. Years of activity or injury at work or play grinds down the smooth cartilage in the knees.

CBS2’s Dr. Max Gomez says he grew up a catcher in baseball, playing tennis and squash, and riding a bicycle, but now he’s paying the price.

A big part of what keeps his knees functional and mostly pain free over the years is frequent physical therapy at Corinthian Therapy, where Pam Schwarzer has taught him that strong muscles actually keep joints happy.

 

Learn more.

PRP & Knee Osteoarthritis

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The influence of platelet rich plasma on synovial fluid volumes, protein concentrations, and severity of pain in patients with knee osteoarthritis.

Chen CPC1, Cheng CH2, Hsu CC3, Lin HC1, Tsai YR1, Chen JL4.

Author information

Abstract

Knee pain is commonly seen in orthopedic and rehabilitation outpatient clinical settings. Patients with knee osteoarthritis (OA) are often complicated with joint soreness, swelling, weakness, and pain. These complaints are often caused by the excessive amount of synovial fluid (SF) accumulated in the bursae around the knee joint. This study was aimed to evaluate the effectiveness of platelet rich plasma (PRP) in treating patients with minor to moderate knee osteoarthritis (OA) combined with supra-patellar bursitis using a proteomic approach and clinical evaluation tool. In this study, 24 elderly patients with minor to moderate knee OA combined with supra-patellar bursitis were recruited. Musculoskeletal ultrasound was used for accurate needle placement for the aspiration of SF followed by subsequent PRP injections. Three monthly PRP injections were performed to the affected knees for a total of 3months. Approximately after the 2nd PRP injection, significant decreases in SF total protein concentrations, volumes, and Lequesne index values were observed. SF proteins associated with chelation and anti-aging physiological functions such as matrilin, transthyretin, and complement 5 increased at least 2-fold in concentrations. Proteins associated with inflammation, such as apolipoprotein A-I, haptoglobin, immunoglobulin kappa chain, transferrin, and matrix metalloproteinase decreased at least 2-fold in concentrations. Therefore, at least two monthly PRP injections may be beneficial for treating patients with minor to moderate knee OA combined with supra-patellar bursitis.

Anosmia treatment by platelet rich plasma injection.

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Abstract

INTRODUCTION:

Platelets are known for their key role in hemostasis and controlling the bleeding after injury. The fact that platelets secrete growth factors and active metabolites means that their applied use can have a positive influence in clinical situations requiring rapid healing and tissue regeneration.

OBJECTIVES:

Platelet Rich Plasma has been described as a promising but unproven therapy.

MATERIALS AND METHODS:

Whole blood was undergoing one stage of centrifugation. The whole blood was then separated into three layers. One ml of the lowest layer of plasma was administered to the patient's nose.

RESULTS:

After the third and finally the fourth therapy, 4 of 5 patients said that "their smell came back", while the remaining one patient said that he could smell a lot but not everything.

CONCLUSION:

Based on our results, platelet rich plasma administration to the olfactory region could be a promising, last chance therapy for complete anosmia.

Source: https://www.ncbi.nlm.nih.gov/pubmed/28452719

PRP for Androgenetic Alopecia

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Local injection of platelet-rich plasma (PRP) for androgenic alopecia was associated with an increased number of hairs and some hair thickness improvement, according to a systematic literature review published in the Journal of Cosmetic Dermatology.

The investigators reviewed six studies involving 177 patients.

There was a significant increase (24%) in local hair number per cm2 with PRP compared to control (scalp areas treated with placebo, vitamin preparations or interfollicular placental extract).

Similarly, the percentage increase in hair thickness for the PRP group was 42% after treatment, representing a 33% increase over control.

Marlins' Wei-Yin Chen feeling strong despite partial UCL tear

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Chen received a platelet-rich plasma injection, which uses a person’s own blood to help promote healing of the ligament. He said Tommy John surgery — which sidelines pitchers for roughly a year — was never a serious consideration since the tear was not significant. Instead, he recovered in time to make three starts at season’s end.

“PRP was the quickest way for me to recover and come back,” said Chen, who has had his left UCL repaired once already, via Tommy John surgery in 2006 when he was pitching in Japan.

The rest-and-rehab path — aided by PRP treatment — that Chen chose is not uncommon for pitchers with partial UCL tears. The New York Yankees’ Masahiro Tanaka has avoided surgery since rehabbing his partial tear in 2014, and the St. Louis Cardinals’ Adam Wainwright pitched with his for more than a half-decade before having surgery in 2011.

Read more.

Effects of Platelet-Rich Plasma With Concomitant Use of a Corticosteroid on Tenocytes From Degenerative Rotator Cuff Tears

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CONCLUSION:

This study shows that the addition of PRP does not interfere with the anti-inflammatory effects of a corticosteroid on IL-1β-treated tenocytes from degenerative rotator cuff tears but that it does avoid the deleterious side effects of a corticosteroid.

CLINICAL RELEVANCE:

PRP can be clinically useful with a corticosteroid as a treatment for tendinopathy.

Read more.

Autologous platelet-rich plasma versus readymade growth factors in skin rejuvenation: A split face study.

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RESULTS:

Both procedures yielded significant improvement regarding both GAIS (skin turgor and overall vitality) and OCT (epidermal and dermal thickness) assessment. Significant negative correlation was detected between patients' age, sun exposure, and GAIS. Burning sensation was significantly higher in area A. Patient satisfaction was significantly higher in area B. Improvement was more sustained in area B on follow-up.

CONCLUSION:

Platelet-rich plasma is effective and safe for skin rejuvenation, comparable to readymade growth factors with noticeable higher longevity.

Read more.

PRP & Flexor Strain - Mariners place Drew Smyly on the 60-day disabled list

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Smyly received a platelet rich plasma (PRP) injection into the injured area on Tuesday morning. A PRP injection consists of taking blood from the patient, separating the platelets from the blood cells on a centrifuge and then injecting the concentrated platelets into the affected area. Smyly will have five to seven days to recover from the injection. He’ll then begin the rehab process in Seattle.

Read more.

Autologous Pure Platelet-Rich Plasma Dermal Injections for Facial Skin Rejuvenation: Clinical, Instrumental, and Flow Cytometry Assessment.

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RESULTS:

Clinical and patient evaluation showed improvement of skin texture. Skin gross elasticity, skin smoothness parameters, skin barrier function, and capacitance were significantly improved. No difference between PRP and PB lymphocyte immunological asset was observed. A leukocyte population (mainly CD3) and neutrophils depletion were documented in all the PRP samples.

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Comparison of intra-articular injection of plasma rich in growth factors versus hyaluronic acid following arthroscopy in the treatment of temporomandibular dysfunction: A randomised prospective study.

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PURPOSE:

The main objective of our study was to evaluate the effectiveness of the injection of plasma rich in platelet-derived growth factors (PRGF) versus hyaluronic acid (HA) following arthroscopic surgery in patients diagnosed with internal derangement of the temporomandibular joint (TMJ) with osteoarthritis (OA).

CONCLUSIONS:

The injection of PRGF following arthroscopy is more effective than the injection of HA with respect to pain in patients with advanced internal derangement of the TMJ.

Read more.

Plated-rich plasma for androgenetic alopecia: Does it work? Evidence from meta analysis

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Introduction

The use of plated-rich plasma (PRP) has increased among different surgical specialities for the treatment of various conditions. Androgenetic alopecia is a common condition, with severe attendant psychosocial implications. PRP injections for hair restoration have become a popular practice among plastic surgeons. We performed a meta-analysis comparing local injection of plated-rich plasma versus control to evaluate this issue in order to investigate the effectiveness of PRP local injections for androgenetic alopecia.

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Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials.

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OBJECTIVES:

Lateral epicondylitis (LE) is a common tendinopathy for which an effective treatment is still unknown. The purpose of this meta-analysis was to compare the effectiveness of platelet rich plasma (PRP) vs steroid in reducing pain and improving function of the elbow in the treatment of LE.

METHODS:

A systematic search of the literature was conducted to identify related articles published from January 1980 to September 2016 in Pubmed, Embase, the Cochrane Library and SpringerLink. All studies that compared PRP with steroid administration on LE were included. Main outcomes were collected and analyzed by the Review Manager 5.1.

RESULTS:

Eight randomized controlled trials (RCTs) that involved 511 patients met the criteria. This meta-analysis showed that there was no significant difference in pain relief in the short-term (2 to 4 weeks: SMD = 1.02, P = .03; 6 to 8 weeks: SMD = .73, P = .24) and the intermediate-term (12 weeks: SMD = -0.28, P = .35). Steroid exhibited a better efficacy of function in the short-term (2 to 4 weeks: SMD = .61, P < .001; 6 to 8 weeks: SMD = .53, P < .001). However, PRP was superior to steroid for pain relief in the long-term (half year: SMD = -1.6, P < .001; one year: SMD = -1.45, P < .001), and also for function improving in the intermediate-term (12 weeks: SMD = -0.53, P < .001) and the long-term (half year: SMD = -0.56, P < .001; one year: SMD = -0.7, P < .001). No serious adverse effects of treatment were observed in the two groups.

CONCLUSION:

Treatment of patients with LE by steroid could slightly relieve pain and significantly improve function of elbow in the short-term (2 to 4 weeks, 6 to 8 weeks). PRP appears to be more effective in relieving pain and improving function in the intermediate-term (12 weeks) and long-term (half year and one year). Considering the long-term effectiveness of PRP, we recommend PRP as the preferred option for LE.

Source Pub Med.

New therapy speeds up healing process for athletic injuries

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CHARLOTTESVILLE, Va. (NEWSPLEX) -- A treatment called platelet-rich plasma is used by famous athletes like Kobe Bryant and Tiger Woods to help speed up the healing process for overuse injuries. Now less-serious athletes can take advantage of it's benefits.

Orthopedic surgeons at Sentara Martha Jefferson Hospital are using PRP injections to treat injuries like tendonitis and arthritis.

"Platelets have growth factors in them and those growth factors are known to stimulate healing and that's why this works," said Dr. Matthew Panzarella, an orthopedic surgeon at Sentara Martha Jefferson Hospital. "With tendonitis, it is stimulating the diseased tendon to regenerate and heal."

Panzarella says the procedure is fairly simple and involves a blood draw. Platelets are extracted from the red blood cells and injected into the injured area. The therapy jump starts the healing process, and in some cases, speeds it up.

"Every aspect of orthopedics is looking at it and how it can help them, from rotator cuff repairs, to arthritis, to overuse injuries," he said.

See the news report.