Does Platelet-Rich Plasma Lead to Earlier Return to Sport When Compared With Conservative Treatment in Acute Muscle Injuries? A Systematic Review and Meta-analysis

Sheth, Ujash; Dwyer, Tim; Smith, Ira; Wasserstein, David; Theodoropoulos, John; Takhar, Sachdeep; Chahal, Jaskarndip

doi:10.1016/j.arthro.2017.06.039

Cited by 47 publications

(46 citation statements)

References 43 publications

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“…In the first stage of screening titles and abstracts, 79 references were selected. Full texts were scrutinised against the inclusion and exclusion criteria, with a final inclusion of 29 SRs (Figure ) . Reasons for exclusion of studies at the second stage are presented by topic and clinical indication in Files …”

Section: Resultsmentioning

confidence: 99%

“…Two SRs focusing on clinical efficacy of PRP in the treatment of acute muscular lesions were identified, both of them were published in 2018. The SR by Grassi et al scored higher in the AMSTAR‐2 tool (AMSTAR‐2 score = 11/16), when compared with the SR conducted by Sheth et al (score AMSTAR = 8/16), and, therefore, its findings were used for underpinning conclusions.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of platelet‐rich plasma for non‐transfusion use: Overview of systematic reviews

2019

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Platelet-rich plasma (PRP) is a blood component with a supraphysiologic concentration of platelets, usually obtained from the processing of autologous blood by different techniques, such as centrifugation and filtering. Despite the fact that strict recommendations on the most adequate techniques that should be employed for the production of PRP are still lacking, it is logical to assume that the type of method used for blood processing may determine the resulting concentration of platelet and other components, possibly impacting on its therapeutic potential. 1 The physiological rationale of the non-transfusion use of PRP relies on the high concentration of growth factors contained in platelets, such as the platelet derived-growth factor, the vascular endothelial growth factor and the fibroblast growth factor. 2 Several biological functions are attributed to these growth factors, including the proliferation of epithelial and mesenchymal cells, the stimulation of myoblasts and fibroblasts and angiogenesis. 3-5 Abstract Introduction: Platelet-rich plasma (PRP) is a blood component therapy with a supraphysiological concentration of platelets derived from allogenic or, more commonly, autologous blood. PRP has been used in different non-transfusion indications because of its role in the promotion of tissue repair and healing, in fields such as Traumatology, Dermatology and Dentistry.Objective: To provide a synthesis of the efficacy of PRP for different clinical situations. Methods: Systematic searches were carried out in MEDLINE, Embase, CochraneLibrary and LILACS in July 2018 to identify systematic reviews (SRs) of randomized clinical trials (RCTs) focusing on PRP for non-transfusion use. Two authors independently screened all retrieved references in two stages (titles and abstracts at a first stage and full texts at a second stage). The methodological quality of SRs that met the eligibility criteria was appraised by AMSTAR 2. Conclusions were based on the most recent SRs with highest quality. Results:One thousand two hundred and forty references were retrieved. After checking the inclusion criteria, 29 SRs of RCTs related to three different fields (wound care, Orthopedics and Dentistry) were included. The results suggest the benefit of PRP for different clinical situations, such as diabetic wounds, acute lesions of musculoskeletal system, rotator cuff lesions, tendinopathies, knee and hip osteoarthritis, total knee arthroplasty, allogenic bone graft for dental implants and periodontal intrabony defects. Conclusion:There is low to moderate quality evidence supporting the efficacy of PRP for specific clinical situations. The low quality of the evidence limits the certainty of these findings. Well-planned and well-conducted RCTs are still needed to further assess the efficacy of PRP.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy of platelet‐rich plasma for non‐transfusion use: Overview of systematic reviews

2019

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“…Despite the increasing popularity of PRP use for treatment of muscle injuries, conflicting results on the effect of this biologic on muscle regeneration (Grassi et al, 2018;Sheth et al, 2018) indicate that modifications in present formulations of PRP are needed (Miroshnychenko et al 2017). On the other hand, the use of PPP is more convenient as it can be frozen for prolonged times (Miroshnychenko et al, 2017, Bausset et al 2012.…”

Section: Discussionmentioning

confidence: 99%

“…Muscular injuries cover one-third of sports injuries, leading to muscle fatigue and pain, and sometimes to injury recurrences (Ekstrand et al, 2011;Woods et al, 2004), which are then associated with long absences from training and competition (Maffulli et al, 2015). Besides the established approach of managing sports injuries (protection, rest, ice, compression and elevation (PRICE principle), nonsteroidal antiinflammatory drugs, physical therapy modalities and corticosteroid injections (Sheth et al, 2018), more attention has been recently focused on platelet-derived products.…”

Section: Introductionmentioning

confidence: 99%

Platelet-poor plasma of athletes is a potent inducer of myogenic differentiation of C2C12 myoblasts

et al. 2020

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Introduction. Blood products, i.e. platelet rich plasma (PRP), leukocyte-poor plasma (PRP) and platelet poor plasma (PPP), have previously been used to improve muscle regeneration. In this study, six months? frozen-stored PPP of individuals who practiced different types of physical exercise was analysed; it could steer mouse C2C12 myoblast cells towards proliferation, migration and myogenic differentiation, and it could affect the morphology/shape of myotubes. Materials and Methods. PPP of male Olympic weightlifters, football players and professional folk dancers, aged 15-19, was collected 12 h post-training and stored for 6 months at -20?C. C2C12 cell proliferation was assessed by MTT test, motility by scratch assay, myogenic differentiation by myotube formation and gelatinase activity by gel-zymography. Results and Conclusions. PPP induced proliferation and migration of C2C12 cells. Proliferative capacity was as follows: weightlifters > dancers > football players; mean migratory capacity was: weightlifters = dancers > football players. PPP induced formation of myotubes; significant inter-individual variations were detected: PPP from weightlifters induced formation of round myotubes, and PPP from football players and dancers induced formation of elongated myotubes. The mean myotube area was as follows: football players > dancers > weightlifters. PPP gelatinolytic activity was observed; it was negatively correlated with C2C12 myoblast proliferation. These results provide general but distinct evidence that PPP of individuals practicing certain types of exercise can specifically modify myoblast morphology/function. This is significant for explaining physiological responses and adaptations to exercise. In conclusion, long-term, frozen-stored PPP preserves its potential to modify myoblast morphology and function. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. 175062]

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“…Consequently, reviews over the last few years have consisted of mostly the same small group of articles, some of which are considered to be of poor quality or involve animal studies. [19][20][21][22][23][24] Sheth et al 21 found an apparent significantly shorter time to return to play for grade I and II muscle strains in patients treated with PRP compared with control patients and no differences in reinjury rates up to 6 months between the two groups. However, when they reanalyzed the data using only high-quality studies, no significant difference was found in outcome between the PRP and control groups.…”

Section: Platelet-rich Plasma Injectionsmentioning

confidence: 97%

Biological Basis of Treatments of Acute Muscle Injuries: A Short Review

Beggs¹

2020

Semin Musculoskelet Radiol

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Muscle strains occur frequently in recreational and professional sports. This article considers various treatment options in a biological context and reviews evidence of their efficacy. Treatments reviewed include the PRICE principle (Protection, Rest, Ice, Compression, Elevation), early mobilization, physical therapy, hematoma aspiration, platelet-rich plasma injections, use of nonsteroidal anti-inflammatory drugs, corticosteroids, and local anesthetics, cellular therapies, and surgery.

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Does Platelet-Rich Plasma Lead to Earlier Return to Sport When Compared With Conservative Treatment in Acute Muscle Injuries? A Systematic Review and Meta-analysis

Cited by 47 publications

References 43 publications

Efficacy of platelet‐rich plasma for non‐transfusion use: Overview of systematic reviews

Efficacy of platelet‐rich plasma for non‐transfusion use: Overview of systematic reviews

Platelet-poor plasma of athletes is a potent inducer of myogenic differentiation of C2C12 myoblasts

Biological Basis of Treatments of Acute Muscle Injuries: A Short Review

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