Comparative analysis of leucocyte poor vs leucocyte rich platelet-rich plasma in the management of lateral epicondylitis: Systematic review &amp; meta-analysis of randomised controlled trials

Muthu, Sathish; Patel, Sandeep; Selvaraj, Preethi; Jeyaraman, Madhan

doi:10.1016/j.jcot.2021.05.020

Cited by 14 publications

(10 citation statements)

References 52 publications

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“…Although leukocytes play a key role in tissue repair and provide ideal protection against infectious factors, their pro-inflammatory and immune effects can also cause adverse local reactions, which will weaken the role of platelets, that is, low leukocyte PRP has greater benefits. 25 - 27 Therefore, the centrifugal conditions for the preparation of PRP need to be optimized.…”

Section: Resultsmentioning

confidence: 99%

Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review

Liang

Wang

et al. 2022

CARTILAGE

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Objective This paper reviews the research of platelet-rich plasma (PRP) in articular cartilage injury repair, to assess the mechanism, utilization, and efficacy of PRP in the treatment of articular cartilage injury, hoping to provide a theoretical basis for the clinical application of PRP in the future. Materials and Methods A comprehensive database search on PRP applications in cartilage repair was performed. Among them, the retrieval time range of PRP in clinical trials of repairing knee cartilage injury was from January 1, 2021 to January 1, 2022. Non-clinical trials and studies unrelated to cartilage injury were excluded. Result PRP can affect inflammation, angiogenesis, cartilage protection, and cellular proliferation and differentiation after articular cartilage injury through different pathways. In all, 13 clinical trials were included in the analysis. Conclusion PRP is an emergent therapeutic approach in tissue engineering. Most studies reported that PRP has a positive effect on cartilage injury, improving the joint function, meanwhile there is a lack of standardized standards. The technology of PRP in the repair and treatment of articular cartilage injury is worthy of further research.

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Section: Resultsmentioning

confidence: 99%

Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review

Liang

Wang

et al. 2022

CARTILAGE

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“…The use of preparations with a low content of platelets can be confusing and could be the reason for inconclusive results of systemic reviews and meta-analyses. On the other hand, research increasingly shows that there is no significant difference in the clinical effect between the different types of PRP [15]; therefore, it cannot be ruled out with certainty that the injection technique itself is of great importance in achieving clinical improvement [48]. Due to the lack of comparison with the control group, it cannot be excluded for sure, that the positive results of the PRP treatment in our study were related to the injection technique itself, a placebo-effect or to the recommended post-treatment rehabilitation protocol.…”

Section: Discussionmentioning

confidence: 99%

“…There are many doubts about the efficacy of PRP injection in lateral elbow tendinopathy. Most publications have presented significant improvements, being better than corticosteroid injection at more than three months after treatment or even being equal to surgery [13][14][15][16]. On the other hand, some studies have reported similarly good outcomes after saline or autologous blood injection [14,17] while three months appeared to be the cut-off point for positive PRP treatment results.…”

Section: Introductionmentioning

confidence: 99%

“…Additional potential benefits of the use of a leukocyte-rich PRP include its antimicrobial properties and the ability to influence an immune response. The existing concerns about the negative impact on tissue healing due to an ability to stimulate catabolic reactions, and the release of pro-inflammatory cytokines and proteinases have not been confirmed in in vivo studies [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Lateral Elbow Tendinopathy Treatment Depends on the Content of Biologically Active Compounds in Autologous Platelet-Rich Plasma

Dejnek

Moreira

Płaczkowska

et al. 2022

JCM

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Autologous platelet-rich plasma (PRP) injection is an alternative treatment option for patients with lateral elbow tendinopathy. The treatment is supposed to accelerate tissue regeneration by providing high concentrations of growth factors derived from platelets. The aim of the study was to assess the relationship between the content of biologically active compounds in PRP and the clinical effect of the treatment. Thirty patients with lateral elbow tendinopathy treated with a single PRP injection, were evaluated. The pain intensity (measured by a visual analogue scale (VAS)), the pressure pain threshold (PPT), the grip strength and strength of the main arm and forearm muscle groups, and the functional outcome (measured by the Disability of Arm, Shoulder and Hand (DASH) and Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaires), were assessed before PRP injection and at one- and three-months follow-up. Flow cytometry measurements of the growth factors and inflammatory cytokines in PRP were performed, and the results were used to establish the relationship between those molecules and the clinical outcome. After three months from the intervention, the minimal clinically important difference in pain reduction and functional improvement was observed in 67% and 83% of patients, respectively. Positive correlations were found between the extent of pain reduction after three months and concentrations in the PRP of platelets, epidermal growth factor (EGF), vascular endothelial growth factor, and platelet-derived growth factors. The concentration of EGF in the PRP significantly correlated with an improvement in grip strength, strength of wrist extensors, and the size of functional improvement measured by the PRTEE. The local injection of PRP is a safe and effective treatment option for lateral elbow tendinopathy, and the clinical outcome is correlated with concentrations of its biologically active compounds.

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“…Even some studies have shown a catabolic gene expression in leucocyte-rich PRP relating to impaired tissue healing in in-vitro studies. 15,16 However, various randomized controlled trials and meta-analyses of studies 17,18 that analyzed this variable did not nd any clinical difference in either of the groups.…”

Section: Introductionmentioning

confidence: 98%

Standardization and Validation of a High Yield Conventional Platelet-rich Plasma Preparation Protocol

Muthu¹,

Ramanathan²

2022

Preprint

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Introduction: Platelet-rich plasma (PRP) has been demonstrated to benefit a variety of disciplines for diseases of inflammatory or degenerative origin. But there exists heterogeneity in the results obtained due to the lack of standardization of the preparation protocols employed in them. This study aims to identify and standardize a preparation protocol for PRP with maximum recovery of platelets to obtain reproducible results across studies. Materials & Methods: Blood samples were collected from 40 healthy volunteers who signed informed consent for participation in the study. The double spin protocol of PRP preparation was analyzed for variables such as centrifugal acceleration, time, and volume of blood processed and final product utilized. The final PRP prepared was investigated for platelet recovery, concentration, integrity, and viability. Each protocol investigated was run twice in all the samples to avoid reporting and sampling bias. Results: We noted maximum platelet recovery (86-99%) with a consistent 6.4±0.8 times baseline concentration of platelets with double centrifugation cycles at 100 and 1600g for 15 and 20 minutes respectively. We also noted that 10 ml of the volume of blood in a 15 ml tube was the ideal volume of blood to be processed to maximize platelet recovery. We noted the upper 2/3rd of the final product was free of platelets thereby making the lower 1/3rd the ideal volume to be utilized. We did not note a loss of integrity or viability of the platelets in the final product from the above-said protocol. Conclusion: Preparation of PRP by the double spin protocol of 10 ml of blood at 100g and 1600g for 15 and 20 minutes respectively in a 15ml tube and using the lower 1/3rd of the final product demonstrated consistent high platelet recovery (86-99%) and concentration (6x) without disturbing the platelet integrity or viability.

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Comparative analysis of leucocyte poor vs leucocyte rich platelet-rich plasma in the management of lateral epicondylitis: Systematic review & meta-analysis of randomised controlled trials

Cited by 14 publications

References 52 publications

Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review

Platelet Rich Plasma in the Repair of Articular Cartilage Injury: A Narrative Review

Effectiveness of Lateral Elbow Tendinopathy Treatment Depends on the Content of Biologically Active Compounds in Autologous Platelet-Rich Plasma

Standardization and Validation of a High Yield Conventional Platelet-rich Plasma Preparation Protocol

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