Emerging Techniques in Orthopaedics

Abstract

Platelet-rich plasma (PRP), a portion of autologous blood containing concentrated platelets above baseline values, has gained recent popularity in the field of orthopaedics. Many orthopaedic surgeons feel that PRP plays an influential role in enhancing the healing process following soft-issue injuries in patients who have failed conservative management or in patients requiring surgical intervention. Platelet-rich plasma is currently being used to treat acute and chronic tendinopathies in the clinical and surgical settings. For clinicians to fully understand the role of PRP, it is imperative that they have a general understanding of the body's healing process. Clinicians should also be aware of the various commercial systems available that may be utilized to produce PRP and the basis behind the performance of these systems. The presence of PRP provides additional treatment options when managing and treating soft-tissue injuries. However, clinicians must realize that little clinical evidence exists supporting the efficacy of PRP and more well-designed, controlled, clinical trials are needed.

Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial

“…Lateral elbow epicondylar tendinosis or tennis elbow is a common condition occurring at the common extensor tendon that originates from the lateral epicondyle in patients whose activities require strong gripping or repetitive wrist movements [1,2]. It causes pain and functional impairment in daily activities [1-3].…”

“…Histologic findings in chronic cases confirm that tendinosis is not an acute inflammatory condition but rather a failure of the normal tendon repair mechanism associated with angiofibroblastic degeneration [1-3]. Current research has produced several biological hypotheses regarding the cause of tendinosis based on histopathological, biochemical, and clinical findings that show cell apoptosis, angiofibroblastic features, or abnormal biochemical adaptations, largely suggesting that a failed healing response underlies the condition [4].…”

“…However, these traditional therapies do not alter the tendon’s poor healing properties secondary to poor vascularization [6]. Given the inherent nature of the tendon, new treatment options including Platelets Rich Plasma (PRP), autologous blood, prolotherapy, and extracorporeal shockwave therapy are aimed at inducing inflammation rather than suppressing it [1,7,8]. …”

Platelet-rich Plasma: Applications in Sports Medicine

“…Lateral elbow epicondylar tendinosis, or tennis elbow, is a common condition occurring at the common extensor tendon that originates from the lateral epicondyle, in patients whose activities require strong gripping or repetitive wrist movements [36,41]. It causes pain and functional impairment in daily activities [7].…”

Effects of intralesional platelet-rich plasma in the patients with lateral epicondylitis of elbow

“…9 New treatment options include local injection of platelet-rich plasma, autologous blood, prolotherapy and extracorporeal shock wave therapy. [10][11][12] Platelet-rich plasma is a concentrate of platelets derived from the patient's own blood. Platelets in platelet-rich plasma contain numerous growth factors and build-up reparative processes.…”