Can Platelet-Rich Plasma Enhance Tendon Repair?

Mos, Marieke de; Windt, A.E. van der; Jahr, Holger; Schie, Hans T. M. van; Weinans, Harrie; Verhaar, Jan A N; Osch, Gerjo J.V.M. van

doi:10.1177/0363546508314430

Cited by 397 publications

(316 citation statements)

References 30 publications

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“…Releasate from platelet-rich plasma has been seen to activate circulation-derived cells [21] that play a crucial role in the tissue healing process and stimulate gene expression of the matrix molecules, collagen production and tendon cell proliferation [22]. In vitro studies demonstrated this mitogenic activity and that the stimulated tenocytes synthesise VEGF and HGF, thus suggesting a beneficial effect for the treatment of tendon injuries by inducing cell proliferation and promoting the synthesis of angiogenic factors during the healing process.…”

Section: Discussionmentioning

confidence: 99%

Use of platelet-rich plasma for the treatment of refractory jumper’s knee

Filardo

Kon

Villa³

et al. 2009

International Orthopaedics (SICOT)

280

205

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The aim of this study was to evaluate the efficacy of multiple platelet-rich plasma (PRP) injections on the healing of chronic refractory patellar tendinopathy after previous classical treatments have failed. We treated 15 patients affected by chronic jumper's knee, who had failed previous nonsurgical or surgical treatments, with multiple PRP injections and physiotherapy. We also compared the clinical outcome with a homogeneous group of 16 patients primarily treated exclusively with the physiotherapy approach. Multiple PRP injections were performed on three occasions two weeks apart into the site of patellar tendinopathy. Tegner, EQ VAS and pain level were used for clinical evaluation before, at the end of the treatment and at six months follow-up. Complications, functional recovery and patient satisfaction were also recorded. A statistically significant improvement in all scores was observed at the end of the PRP injections in patients with chronic refractory patellar tendinopathy and a further improvement was noted at six months, after physiotherapy was added. Moreover, comparable results were obtained with respect to the less severe cases in the EQ VAS score and pain level evaluation, as in time to recover and patient satisfaction, with an even higher improvement in the sport activity level achieved in the PRP group. The clinical results are encouraging, indicating that PRP injections have the potential to promote the achievement of a satisfactory clinical outcome, even in difficult cases with chronic refractory tendinopathy after previous classical treatments have failed.

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Section: Discussionmentioning

confidence: 99%

Use of platelet-rich plasma for the treatment of refractory jumper’s knee

Filardo

Kon

Villa³

et al. 2009

International Orthopaedics (SICOT)

280

205

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“…De Mos et al [23] showed that both platelet-rich clot releasate (PRCR) and platelet-poor clot releasate (PPCR) increased tenocyte cell number and collagen production in vitro. In this study, PRP was ''activated'' by placing calcium chloride into the PRP concentrate to induce the platelets to clot and to release their growth factors.…”

Section: Basic Sciencementioning

confidence: 99%

PRP: review of the current evidence for musculoskeletal conditions

Malanga

Goldin

2014

Curr Phys Med Rehabil Rep

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Injection of platelet-rich plasma (PRP) is an evolving treatment option for various musculoskeletal injuries. There is basic scientific evidence that suggests that the various growth factors present in PRP can help to augment the body's natural healing. There are also clinical studies suggesting efficacy for several conditions, particularly tendinopathy and osteoarthritis. This article reviews the definition and first uses of PRP, the basic scientific rationale for its use, and the basic science and evidence for its use in the treatment of tendon, joint, ligament, and muscle injuries. There are varying levels of evidence for and against the use of PRP for these types of injuries, and this article reviews studies that support as well as studies that refute the use of this new treatment. There are several studies that have assessed the basic science supportive of PRP treatments, as well as the clinical efficacy of this treatment in vivo. While the current evidence is mixed, several recent studies have demonstrated therapeutic benefit in the treatment of various tendinopathies and degenerative joint diseases of the knee. There are several factors that need to be addressed to elucidate whether PRP is truly effective. These include fully defining the PRP mixture (e.g. concentration, growth factor levels, presence of white cells and red cells, etc.), determining the optimal preparation and delivery of the PRP graft, calculating the appropriate number of injections for each specific pathologic process, and defining optimal post-procedure rehabilitation.

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“…Zhang et al reported that PRP releasate in adult rabbits promoted the differentiation of tendon cells into active tenocytes that exhibited high proliferation rates and collagen production capabilities [65]. Human tenocytes cultured in PRP showed increased cell proliferation and total collagen production [10].…”

Section: Tendon Healingmentioning

confidence: 99%

The Role of Platelet-Rich Plasma in Inducing Musculoskeletal Tissue Healing

Halpern¹,

Chaudhury²,

Rodeo³

2012

HSS Jrnl

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Background Platelet-rich plasma [PRP] has received increasing interest across many musculoskeletal disciplines and has been widely applied clinically to stimulate tissue healing in numerous anatomical regions. The known actions of platelet-derived factors suggest that PRP may have significant potential in the treatment of pathological conditions of cartilage, tendon, ligament, and muscle. Purpose The aim of this manuscript is to review current literature regarding the biology of PRP and the efficacy of using PRP to augment healing of tendon ligament and muscle injuries, as well as early osteoarthritis. Methods A comprehensive literature review of musculoskeletal applications of PRP was performed, including basic science and clinical studies such as randomized controlled trials, case controlled series, and case series. Results The most compelling evidence to support the efficacy of PRP is for its application to tendon damage associated with lateral and medial epicondylitis. Although some promising studies have been reported supporting the use of PRP in osteoarthritis and ligament and muscle injuries, it currently remains unknown whether PRP effectively alters the progression of osteoarthritis or aids the healing of ligament and muscle tissues. Conclusion The rationale for the use of PRP to improve tissue healing is strong, but the efficacy for many musculoskeletal applications remains unproven. PRP has been shown to be a safe treatment. A number of questions regarding PRP remain unanswered, including the optimal concentration of platelets, what cell types should be present, the ideal frequency of application, or the optimal rehabilitation regimen for tissue repair and return to full function.

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Can Platelet-Rich Plasma Enhance Tendon Repair?

Cited by 397 publications

References 30 publications

Use of platelet-rich plasma for the treatment of refractory jumper’s knee

Use of platelet-rich plasma for the treatment of refractory jumper’s knee

PRP: review of the current evidence for musculoskeletal conditions

The Role of Platelet-Rich Plasma in Inducing Musculoskeletal Tissue Healing

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