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Prospective Comparison of Functional and Radiological Outcomes of Arthroscopic Anterior Cruciate Ligament Reconstruction by Hamstring Graft Alone and Platelet-Rich Plasma Added to the Hamstring Graft
Kumar A, Kushwaha NS, Kumar D, Singh A, Gupta V, Kumar S
Cureus. 2022;14(3):e23017
Abstract
AIMS AND OBJECTIVES To measure the additional effect of platelet-rich plasma (PRP) on functional outcome of anterior cruciate ligament tear managed by augmenting anterior cruciate ligament (ACL) reconstruction with PRP. METHODS The present study was conducted on patients with ACL tear admitted in the department of orthopaedics, King George's Medical University, Lucknow wherein a total of 70 subjects were assigned into two groups of 35 patients each randomly, viz Group 1 in which the patients were treated by quadruple hamstring graft alone and Group 2 in which the patients were treated with augmented hamstring graft with PRP. The standardized anterior drawer test, Lachman's test, Lysholm knee score were quantified both preoperatively and postoperatively at different follow-ups and also tibial tunnel widening was measured postoperatively at different follow-ups. RESULT The present study had 70 patients with ACL tears. The mean age of patients in non-PRP groups was 29.71 ±2.99 years while that in the PRP group was 28.34±4.32 years. On comparing the improvement in grades at pre-op, immediate postop, 6 weeks, and 3 months follow-ups, there was no statistically significant difference between the two groups. The tibial tunnel widening also showed no significant difference between the two groups. CONCLUSION In our study, it was found that both the groups showed improvements in grades of anterior drawer test and Lachman's test postoperatively but the difference between both the groups was not significant. Similarly, while comparing the improvements in Lysholm knee score and tibial tunnel widening among both the groups, the difference was not significant. Follow up of 3 months was a limiting factor in our study. This technique needs further clinical evaluation to assess the long-term results.
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Clinical and radiographic evaluation of demineralized freeze-dried bone allograft with concentrated growth factor versus concentrated growth factor alone in the treatment of intrabony defects
Vaid T, Kumar S, Mehta R, Shah S, Joshi S, Bhakkand S, Hirani T
Medicine and pharmacy reports. 2021;94(2):220-228
Abstract
BACKGROUND Periodontal disease is one of the major causes of alveolar bone loss. There are various ways of regenerating the lost bone, i.e. guided tissue regeneration, bone grafts, and growth factors. In this purview, it becomes immensely important for a clinician to decide the best modality of treatment. In this study, we compared the effect of demineralized freeze-dried bone allograft (DFDBA) in combination with concentrated growth factors (CGF) verses CGF alone. METHODS This double-blind, split-mouth study was conducted on ten patients with two comparable bilateral intrabony defects. Each pair of defects was randomly treated by DFDBA + CGF or CGF alone. Clinical parameters such as plaque index (PI), modified gingival index (MGI), pocket probing depth (PPD), and relative attachment level (RAL) were recorded at baseline, three months, and six months. In addition, radiograph with grids was also taken at baseline and six months. The paired t-test was used to compare the pre- and post-treatment values and the unpaired t-test was used to compare the test and control group. RESULTS The PI score decreased significantly from baseline to six months. Similarly, the mean MGI score decreased significantly from baseline to six months. The intragroup comparison showed that there was a significant reduction in PPD in both the test and control group. However, the intergroup comparison showed that the reduced pocket depth was not significant. The intragroup radiographic comparison showed that there was the significant formation of bone in both the test and control group but inter-group showed that the formation of bone among both the group were non-significant. CONCLUSION Radiographic and clinical outcomes of this study concluded that post six months, both groups demonstrated significant improvement in clinical and radiographic parameters. However, the addition of DFDBA to CGFs did not give any additional benefits.
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3.
A randomized comparative study of platelet-rich fibrin along with hydroxyapatite graft for the treatment of 3-walled defects in chronic periodontitis
Thetay AA, Kumar S, Irfan M, Lund RG, Desai K, Hirani T, Sevak J
Medicine and pharmacy reports. 2021;94(4):471-476
Abstract
BACKGROUND Platelet Rich Fibrin (PRF) is a concentrate of leucocyte and platelets that contains various polypeptide growth factors. It has immense potential for use as a periodontal regenerative material in periodontal defects. Porous hydroxyapatite (HA) has long been used as bone grafting material. Recently it has been reported that when PRF is used in combination with HA, itgives a synergistic effect and results in a better periodontal regeneration. The present study aims to explore the clinical and radiographic effectiveness of autologous PRF versus PRF+HA in the regenerative treatment of intrabony defects (IBD) in patients with chronic periodontitis. METHODS Sixty patients with IBDs were divided into test and control groups. The test group patients were treated with autologous PRF, whereas the control group patients were treated with PRF+HA. Clinical parameters were recorded at baseline, three months, six months and nine months' time interval. Radiographic measurements were recorded at baseline and nine months. RESULTS A reduction in PI, MGI, PPD, RAL, and IBD was observed in both the groups at nine months. Mean IBD reduction in the control group was 3.70 ± 1.16 mm, whereas, the mean reduction in the test group was 4.80 ± 1.03 mm, showing a significant reduction in IBDs. Similarly, the percentage of bone fill in the test group was 65% ± 3.67%, whereas bone fill in controls was 56.7% ± 3.56%, showing a significant bone fill in the study group. CONCLUSION Treatment of IBDs with PRF+HA showed a significant improvement in all the clinical and radiographic parameters. When HA was added to PRF, it increased the regenerative effect in the treatment of 3 wall IBDs.
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Comparison of plantar fasciitis injected with platelet-rich plasma vs corticosteroids
Jain S K, Suprashant K, Kumar S, Yadav A, Kearns S R
Foot & Ankle International. 2018;39((7):):780-786
Abstract
BACKGROUND Plantar fasciitis is one of the most common causes of heel pain. This prospective study compared the efficacy of local injection of corticosteroids vs platelet-rich plasma (PRP) in the treatment of plantar fasciitis. METHODS Patients were randomly allocated into 2 groups of 40 each (group A and group B). Patients were treated with local corticosteroid injection in group A and autologous PRP injection in group B. Clinical assessment was done prior to the injection and at 1 month, 3 months, and 6 months following the injection, which included visual analog pain scale, subjective rating using the modified Roles and Maudsley score, functional outcome score by the Foot and Ankle Outcome Instrument (FAI) core scale, and the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale. Radiological assessment was done by measuring the thickness of the plantar fascia using ultrasonography. The mean age, sex, and body mass index of both groups were comparable. RESULTS Postinjection, there was significant improvement of visual analog score, modified Roles and Maudsley score, FAI core scale, AOFAS ankle-hindfoot score, and plantar fascia thickness in both the groups. However, with the numbers available, no significant difference in improvement could be detected between the above-mentioned variables in the 2 groups. CONCLUSION We found that the treatment of plantar fasciitis with steroid or PRP injection was equally effective. LEVEL OF EVIDENCE Level II, prospective randomized comparative series.
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5.
Effect of platelet-rich fibrin on healing of apicomarginal defects: a randomized controlled trial
Dhiman M, Kumar S, Duhan J, Sangwan P, Tewari S
Journal of Endodontics. 2015;41((7)):985-91.
Abstract
INTRODUCTION The purpose of this prospective, randomized controlled trial was to evaluate the healing outcomes of platelet-rich fibrin (PRF) in periapical surgeries involving apicomarginal defects and to compare these results with surgeries not using any guided tissue regeneration techniques. METHODS Thirty patients with suppurative chronic apical periodontitis and apicomarginal communication were randomly assigned to either the PRF or the control group. Clinical and radiographic parameters including pocket depth (PD), clinical attachment level, gingival marginal position, size of periapical lesion, and percentage reduction of the periapical radiolucency were recorded at baseline and at an interval of 3 months for a period of 12 months. RESULTS The overall success rate was 83.33%, with a success rate of 86.66% (13 of 15 teeth) for PRF group and 80% (12 of 15 teeth) for control group. Both the groups exhibited a significant reduction in PD, clinical attachment level, gingival marginal position, and size of periapical lesion at 12-month period. No significant differences were observed between the 2 groups for these parameters except PD, which showed a statistically significant reduction in the PRF group (P < .05). CONCLUSIONS The adjunctive use of regenerative techniques may not promote healing of apicomarginal defects of endodontic origin.Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.