-
1.
Efficacy of autologous platelet-rich plasma gel in the treatment of refractory pressure injuries and its effect on wound healing time and patient quality of life
Liu Q, Zhang N, Li Z, He H
Clinics (Sao Paulo, Brazil). 2021;76:e2355
Abstract
OBJECTIVES To evaluate the efficacy of autologous platelet-rich plasma (PRP) gel in the treatment of refractory pressure injuries and its effect on wound healing time and quality of life of patients. METHODS A random number table method was used to group 102 patients with refractory pressure injuries into either a control group (CG) (51 cases) receiving negative pressure wound therapy (NPWT) or a study group (SG) (51 cases) receiving NPWT+PRP gel. RESULTS The total efficacy rate in the SG (92.16%) was higher than that in the CG (76.47%) (p<0.05). The SG exhibited lower visual analog scale (VAS) scores and pressure ulcer scale for healing (PUSH) scores, smaller wound sizes and depths, and shorter wound healing times than the CG after 21 days of treatment (p<0.05). After 6 months of treatment, the SG scored higher than the CG on the psychological, physiological, social functions, and daily activity domains on the World Health Organization Quality of Life (WHOQOL-BREF) scale (p<0.05). The incidence of postoperative complications in the SG (13.73%) was not significantly different from that of the CG (7.84%) (p>0.05). CONCLUSION In the treatment of refractory pressure injuries, PRP gel can accelerate wound healing, reduce wound pain, shorten the treatment cycle, regulate tissue inhibitor matrix metalloproteinase-1 (TIMP-1) and matrix metalloproteinase-9 (MMP-9) levels and the expression of specific proteins in granulation tissue, reduce the levels of the inflammatory factors interleukin-1β (IL-1β), IL-8, and tumor necrosis factor-α (TNF-α), and improve the quality of life of patients without increasing complications.
-
2.
Randomized, placebo-controlled analysis of the knee synovial environment following platelet rich plasma treatment for knee osteoarthritis
Tucker JD, Goetz LL, Duncan MB, Gilman JB, Elmore LW, Sell SA, McClure MJ, Quagliano PV, Martin CC
PM & R : the journal of injury, function, and rehabilitation. 2021
-
3.
Effects of ultrasound guided leukocyte-rich platelet-rich plasma (LR-PRP) injection in patients with pes anserinus tendinobursitis
Karabaş Ç, Talay Çaliş H, Topaloğlu US, Karakükçü Ç
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis. 2021;:103048
Abstract
OBJECTIVES To demonstrate the efficacy and safety of ultrasound guided leukocyte-rich platelet-rich plasma (LR-PRP) injection in patients with pes anserinus tendinobursitis(PATB). METHODS A prospective, randomized and single-blinded study of 60 patients with PATB were randomly assigned into 2 groups. Whereas 2 mL LR-PRP injection was applied to one grup, once accompanied by ultrasonography (USG), 2 mL LR-PRP injection was applied to the other group accompanied by USG twice with a one-week interval. Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 6-minute walking test (6MWT), Likert Scale were evaluated pre-treatment, at the 4th and 12th weeks after treatment. RESULTS There was no statistical difference between the two groups in terms of age, gender, body mass index, duration of symptoms, affected side. When both groups are compared within themselves before and after treatment, there was a significant improvement in all VAS, in all WOMAC subgroups, 6MWT, at the 4th and 12th weeks after treatment. When the two groups are compared with each other, there was no statistical difference. In addition, when all patients were evaluated with Likert scale in the 12th week after treatment, complete healing in 22(36.7 %) patients, significant relief in 25(41.7 %) patients, mild relief in 4(6.7 %) patients, 5(8.3 %) same as before treatment patients, and worsened pain in 4(6.7 %) patients were seen. CONCLUSION Both single-dose and double-dose local LR-PRP is a safe and effective treatment option for patients with PATB syndrome. We believe that once LR-PRP injection may be sufficient for the treatment efficacy in PATB.
-
4.
Evaluation of Arthrocentesis with and Without Platelet-Rich Plasma in the Management of Internal Derangement of Temporomandibular Joint: A Randomized Controlled Trial
Singh AK, Sharma NK, Kumar PGN, Singh S, Mishra N, Bera RN
Journal of maxillofacial and oral surgery. 2021;20(2):252-257
Abstract
PURPOSE The purpose of this study was to compare the efficacy of intra-articular injection of platelet-rich plasma after arthrocentesis versus arthrocentesis alone as a treatment modality in patients with internal derangement of temporomandibular joint. METHODS Twenty-four patients suffering from internal derangement of temporomandibular joint were included in the study. The patients were randomly divided into two groups as follows-twelve patients underwent arthrocentesis followed by intra-articular injection of platelet-rich plasma (study group) and the other twelve were treated by arthrocentesis alone (control group). Pain intensity was recorded on visual analogue scale (VAS); maximum mouth opening and joint sound were measured before and after intervention. The patients were clinically evaluated at the intervals of 1 month, 3 and 6 months subsequently. RESULTS There was no statistically significant difference in all the parameters between the groups. Intra-group analysis showed statistically significant improvement in all the parameters. CONCLUSION In both groups, improvement of pain, maximum mouth opening and TMJ sound were observed at all intervals, but there was no statistically significant improvement in arthrocentesis with PRP group when compared with arthrocentesis alone.
-
5.
The effect of platelet-rich plasma-fibrin glue dressing in combination with oral vitamin E and C for treatment of non-healing diabetic foot ulcers: A randomized, double-blind, parallel-group, clinical trial
Yarahmadi A, Saeed Modaghegh MH, Mostafavi-Pour Z, Azarpira N, Mousavian A, Bonakdaran S, Jarahi L, Samadi A, Peimani M, Hamidi Alamdari D
Expert opinion on biological therapy. 2021
Abstract
OBJECTIVE The current study assesses the effects of platelet-rich plasma-fibrin glue (PRP-FG) dressing along with oral vitamin E and C on wound healing and biochemical markers in patients with non-healing diabetic foot ulcers (non-healing DFU). METHODS This randomized, double-blind, placebo-controlled trial was performed on twenty-five patients with non-healing DFU. Patients were treated with PRP-FG dressing plus oral vitamin E and C (intervention group) or PRP-FG dressing plus placebo (control group) for eight weeks. RESULTS Eight weeks after treatment, six wounds in the intervention group and two wounds in the control group were completely closed, and also wound size significantly reduced in both intervention (-9.7 ± 6.9 cm(2), p = 0.002), and control (-5.6 ± 5.4 cm(2), p = 0.003) groups. This reduction in wound size was significantly greater in the intervention group compared to the control group (p = 0.019). Also, a significant decrease in prooxidant-antioxidant balance (PAB) index, ESR, and hs-CRP were observed in the intervention group compared to the control group (p < 0.05). CONCLUSION Results of this trial showed that PRP-FG dressing along with oral vitamin E and C could be used to increase wound healing in patients with non-healing DFU by enhancing the wound healing process and reducing oxidative stress. TRIAL REGISTRATION This trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT04315909).
-
6.
Platelet-rich plasma or extracorporeal shockwave therapy for plantar fasciitis
Haddad S, Yavari P, Mozafari S, Farzinnia S, Mohammadsharifi G
International journal of burns and trauma. 2021;11(1):1-8
Abstract
BACKGROUND Plantar fasciitis is a common cause of plantar pain which is prevalent among adults. Conservative tractions, invasive injections, shock therapies and also surgical procedures are known as beneficial methods in non-responsive cases. Here we evaluated and compared the injection of platelet rich plasma (PRP) and usage of extracorporeal shockwave therapy (ESWT) in pain reduction in patients with chronic plantar fasciitis. METHODS This is a randomized clinical trial that was performed in 2017-2020 on patients with chronic plantar fasciitis who did not respond to conservative therapies. A total number of 110 patients with plantar fasciitis were entered based on inclusion and exclusion criteria. Patients were then divided into two groups. The pain of patients was measured using visual analogue scale (VAS) before interventions. The first group underwent PRP injections while the second group underwent ESWT using Shock Master 500. Patients were visited 2, 4, 8, 12, 16, and 24 weeks after interventions and the pain scores were noted using VAS. RESULTS Data of 104 patients were analyzed. Initial VAS scores of patients were also analyzed. These data indicated no significant differences between the pains of patients before interventions (P = 0.413). Pain evaluations in 2, 4, 8, 12, 16, and 24 weeks after interventions with controlling age and sex showed significantly reduced VAS scores in both groups after interventions (P = 0.002). We should also note that pain in the PRP group reduced more than ESWT group and this difference was also significant (P = 0.001). CONCLUSION Here we showed that PRP injections and ESWT are both beneficial in pain amelioration in patients with chronic plantar fasciitis. We also indicated that PRP injections were associated with better pain reduction results compared to ESWT.
-
7.
Corticosteroids or platelet-rich plasma injections for rotator cuff tendinopathy: a randomized clinical trial study
Dadgostar H, Fahimipour F, Pahlevan Sabagh A, Arasteh P, Razi M
Journal of orthopaedic surgery and research. 2021;16(1):333
Abstract
BACKGROUND Studies evaluating the role of both corticosteroids and platelet-rich plasma (PRP) in the treatment of rotator cuff (RC) tendinopathies have been contradicting. We compared structural and clinical changes in RC muscles after corticosteroids and PRP injections. METHODS This is a randomized double-blind clinical trial. All individuals with diagnosis of RC tendinitis during 2014-2017 were considered. Individuals were randomly allocated to either receive PRP or corticosteroids. Overall, 3cc of PRP was injected within the subacromial joint and another 3cc was injected at the site of the tendon tear, under the guide of sonography. For the corticosteroid group, 1cc of Depo-medrol 40mg and 1cc of lidocaine (2%) was injected within the subacromial joint. RESULTS Overall, 58 patients entered the study. Comparison of pain, range of motion (ROM), Western Ontario RC (WORC), Disability of Arm-Hand-Shoulder (DASH) scores, and supraspinatus thickness showed significant improvement during follow-ups in both groups (p<0.05). During 3 months of follow-up, pain improvement was significantly better within the PRP group during (from 6.66±2.26 to 3.08±2.14 and 5.53±1.80 to 3.88±1.99, respectively; p=0.023). Regarding ROM, the PRP group had significant improvement in adduction (20.50°±8.23° to 28°±3.61° and 23.21°±7.09° to 28.46°±4.18° for the PRP and corticosteroid groups, respectively; p=0.011) and external rotation (59.66°±23.81° to 76.66°±18.30° and 57.14°±24.69° to 65.57°±26.39°, for the PRP and corticosteroid groups, respectively; p=0.036) compared to the corticosteroid group. CONCLUSION We found that PRP renders similar results to that of corticosteroids in most clinical aspects among patients with RC tendinopathies; however, pain and ROM may show more significant improvement with the use of PRP. Considering that the use of corticosteroids may be contraindicated in some patients and may be associated with the risk of tendon rupture, we suggest the use of PRP in place of corticosteroid-based injections among patients with RC tendinopathy. TRIAL REGISTRATION Clinical trial registration code: IRCT201302174251N9.
-
8.
Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy
Bansal H, Leon J, Pont JL, Wilson DA, Bansal A, Agarwal D, Preoteasa I
Scientific reports. 2021;11(1):3971
Abstract
Despite encouraging results reported with regards to Platelet-rich plasma (PRP) application in osteoarthritis (OA) knee, still critical issues like conclusive structural evidence of its efficacy, standard dose and good manual method of preparation to obtain high yield remains unanswered. Present study is an attempt to optimise the dose and concentration of therapeutic PRP and its correlation with structural, physiologic efficacy with a new manual method of PRP preparation. A total of one hundred and fifty patients were randomized to receive either PRP (10 billion platelets) or hyaluronic acid (HA; 4 ml; 75 patients in each group) and followed up till 1 year. An addition of filtration step with 1 µm filter in manual PRP processing improved platelet recovery upto 90%. Significant improvements in WOMAC (51.94 ± 7.35 vs. 57.33 ± 8.92; P < 0.001), IKDC scores (62.8 ± 6.24 vs 52.7 ± 6.39; P < 0.001), 6-min pain free walking distance (+ 120 vs. + 4; P < 0.001) persisted in PRP compared to HA group at 1 year. Significant decline IL-6 and TNF-α levels observed in PRP group (P < 0.05) compared to HA at 1 month. Study demonstrated that an absolute count of 10 billion platelets is crucial in a PRP formulation to have long sustained chondroprotective effect upto one year in moderate knee OA.
-
9.
Intravenous tranexamic acid reduce postoperative drainage and pain after open elbow arthrolysis: A randomized controlled trial
Cui H, Yu S, Ruan J, Sun Z, Li J, Chen S, Fan C
Journal of shoulder and elbow surgery. 2021
Abstract
BACKGROUND Open elbow arthrolysis (OEA), which has become an established treatment for post-traumatic elbow stiffness (PTES), requires complete release of contracture tissue and wide excision of ectopic bone, which results in extensive bleeding. The aim of the present study is to evaluate the efficacy of intravenous tranexamic acid (TXA) on postoperative drainage, calculated blood loss and early clinical outcomes in patients undergoing OEA. METHODS A double-blind, randomized, placebo-controlled trial including 96 patients undergoing OEA was undertaken. Patients received intravenously either 100 mL saline (placebo group, n = 48), or 100 mL saline plus 1 g TXA (TXA group, n = 48) before skin incision. The primary outcome was the drainage volume on postoperative day (POD) 1 to 3. Secondary outcomes included the calculated blood loss, elbow pain score measured by Visual Analog Scale (VAS), elbow function valued by Mayo Elbow Performance Score (MEPS), and rate of complications after OEA. RESULTS Mean total postoperative drainage volume (TXA group: 182 mL vs. placebo group: 214 mL, p = 0.003) and mean calculated total blood loss (TXA group: 582 mL vs. placebo group: 657 mL, p = 0.004) were significantly lower in the TXA group. No transfusions were necessary in either group. Mean VAS pain scores in elbow motion showed marked differences between both groups on POD 1 (TXA: 5 vs. placebo: 6, p = 0.003) and POD 2 (TXA: 4 vs. placebo: 5, p = 0.023), but not in other postoperative time points. No differences were detected in complications, such as pin-related infection, hematoma, new or exacerbation of ulnar nerve symptoms, and recurrent heterotopic ossification. At the 6-month follow-up, no statistical differences were found between the two groups with respect to the elbow functions including range of motion, VAS score and MEPS. CONCLUSION Intravenous administration of TXA significantly decreased the postoperative drainage volume and the total estimated blood loss, and alleviated the elbow pain with motion during early postoperative days in patients undergoing OEA. LEVEL OF EVIDENCE Level I; Randomized Controlled Trial; Treatment Study.
-
10.
Topical Erythropoietin Accelerates Wound Closure in Patients with Diabetic Foot Ulcers: A Prospective, Multicenter, Single-Blind, Randomized, Controlled Trial
Hamed S, Ullmann Y, Belokopytov M, Shoufani A, Kabha H, Masri S, Safadi M, Feldbrin Z, Kogan L, Kruchevsky D, et al
Rejuvenation research. 2021
Abstract
The diabetic foot ulcer (DFU) is a major disabling complication of diabetes mellitus. Growing evidence suggests topical erythropoietin (EPO) can promote wound healing. The aim of this study is to clinically assess the efficacy of a proprietary topical EPO-containing hydrogel for treating DFUs. We conducted a randomized, controlled trial in 20 patients with DFUs. After a 14-day screening period, the DFUs of 20 eligible participants who fulfilled the inclusion criteria were randomly assigned (1:1) to either a 12-week of daily treatment with topical EPO and standard-of-care (SOC) or SOC treatment alone. The DFUs were assessed weekly until week 12. The primary outcome was 75% ulcer closure or higher. After 12 weeks of treatment, 75% ulcer closure was achieved in six of the ten patients whose DFUs were treated with topical EPO and in one of the eight patients whose DFUs were treated with SOC alone. The mean area of the DFUs which were treated with topical EPO and SOC was significantly smaller than those treated with SOC alone (1.2±1.4cm2 versus 4.2±3.4cm2; p=0.023). Reepithelialization was faster in the topically EPO-treated DFUs than in the SOC-treated DFUs. There were no treatment-related adverse events. We conclude that topical EPO is a promising treatment for promoting the healing of DFUs.
