Platelet-Rich Plasma: Review of Current Literature on its Use for Tendon and Ligament Pathology

Kia, Cameron; Baldino, Joshua B.; Bell, Ryan; Ramji, Alim F.; Uyeki, Colin L.; Mazzocca, Augustus D.

doi:10.1007/s12178-018-9515-y

Cited by 74 publications

(60 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Injection of PRP in these patients may have reduced the carpal tunnel tendon and MN inflammation present in this cohort, thus benefitting, not only the muscles innervated by the distal branches of the MN, but all the irrigated flexor tendons within the carpal tunnel which are the primarily responsible for transferring tensile loads to hand grip (digitorum profundus and superficialis tendons). In this sense, several in vitro and in vivo studies have shown that PRP has anti-inflammatory effects and improves tendon healing, and have elucidated its molecular mechanism of action in this context [51][52][53][54][55][56][57][58][59][60][61] . Nonetheless, other human studies reported that PRP had no beneficial effects on tendon healing [62][63][64][65][66] , or only found them after longer follow-ups [67][68][69][70] .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial

Trull-Ahuir

Sala

Chismol-Abad

et al. 2020

Sci Rep

View full text Add to dashboard Cite

The purpose of this study is to evaluate the efficiency of local platelet-rich plasma (PRP) injection as an adjuvant treatment after carpal ligament release. We conducted a prospective randomized, tripleblinded, controlled trial. Fifty participants with mild to extreme carpal tunnel syndrome (CTS) were randomly assigned either to the PRP (n = 25) or the platelet-poor plasma (PPP, n = 25) group. After performing open surgical release of the carpal ligament, the inside of the carpal tunnel was irrigated with 3 mL of PRP or PPP according to each participant's group allocation. The primary outcome was hand grip strength (HGS). Secondary outcomes were the time taken off work after surgery (in days) and scores on the Wong-Baker Faces Scale, Boston Carpal Tunnel Questionnaire, and Southampton Wound Assessment Scale. We evaluated patients before treatment and at 6-weeks. As expected, the pain levels, symptom severity, and functional status improved in all the patients after surgery. However, intragroup analysis revealed that only the participants in the PRP group had regained their pre-operative HGS levels at 6-weeks follow-up. These findings indicate that PRP is an effective adjuvant treatment in patients with mild to severe CTS who require surgery. Carpal tunnel syndrome (CTS), which affects approximately 3% of the general adult population 1 , is the most commonly diagnosed upper limb peripheral entrapment neuropathy 2. CTS is characterized by compression of the median nerve (MN) at the wrist as it passes through the carpal tunnel 3 and typical symptoms include numbness, paresthesias, and pain in areas innervated by the MN. In more severe cases, weakness and atrophy of the thenar muscles (innervated by the MN) can occur which in turn, usually affects the work productivity and quality of life of the affected patient 4-6. Depending on the severity of the symptoms, treatments for CTS may be conservative (including the use of medications, a night splint, steroid injections, or physical therapy) or require surgical intervention. Surgical decompression of the carpal tunnel by transection of the transverse carpal ligament is the standard treatment for patients with muscle atrophy, or whose symptoms do not respond to conservative therapies 2,7. Carpal tunnel decompression is a well-established surgical treatment for CTS whose reported success rate and levels of patient satisfaction are high 8. Nonetheless, this technique is not exempt from potential complications including: sensitive scar areas, persistent symptoms, neurovascular injury, wound complications, bleeding, pillar pain (pain adjacent to the ligament release site), and reduced grip strength 9,10. Therefore, adjuvant surgical treatments are worth exploring. Platelet-rich plasma (PRP) is an autologous blood product comprising concentrated platelets and several growth factors (including transforming growth factor-β, platelet-derived growth factor, epidermal growth factor, vascular endothelial growth factor, insulin-like growth factor-1, fibroblast growth factor, hepatoc...

show abstract

Section: Discussionmentioning

confidence: 99%

Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial

Trull-Ahuir

Sala

Chismol-Abad

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Etiology may direct choose the type of PRP, for instance leukocyte-rich versus leukocyte-poor. Acellular pathologies such as lateral epicondylitis may benefit from leukocyte-rich PRP, which may help induce an inflammatory response to stimulate healing (6) . Magalon and colleagues (38) retrospectively applied their proposed classification (DEPA: Dose of injected platelets, Efficiency of production, Purity of the PRP, Activation of the PRP) on twenty PRP preparations -for which biological characteristics were available in the literature-to characterize the injected PRP.…”

Section: Preparation Methodsmentioning

confidence: 99%

“…Platelets are natural source of various growth factors. Upon activation, platelets release the stored intercellular mediators and cytokines from the cytoplasmic pool Table 1: Functions of the growth factors and cytokines in the platelet rich plasma (1,(6)(7)(8)(9) .…”

Section: Functionmentioning

confidence: 99%

Platelet-rich Plasma: Three Decades and Ongoing, Do We Have a Conclusion?

Kamel

2019

Suez Canal University Medical Journal

View full text Add to dashboard Cite

Blood components for non-transfusion uses have been the focus of researches in various clinical fields for the last thirty years. Platelet-rich plasma (PRP) can expedite healing, with minimal side effects. As a biologic autologous product, it is well-tolerated, and safe choice for many physicians and patients. Yet, no consensus has been reached regarding PRP preparation, needed volume, the use of an activator, number of sessions, and the period between the sessions in different clinical scenarios. Thus, further clinical studies are needed with higher level of evidence taking into consideration the optimization of these aspects. Up to date, there are many PRP preparation systems on the market with FDA clearance. Meanwhile, FDA has not attempted to regulate activated PRP. Determining the main bioactive components which are responsible for the clinical effects of PRP and the inter-individual variability of growth factors and cytokines production and the synergy of platelets count and growth factors will remain as major obstacles to achieve standardization of PRP. PRP is yet to become the standard of care; nevertheless, more clinical studies with longer periods of follow up to understand the best candidate and to determine the best ways to use it to improve healing; it may be an approved practice in the future.

show abstract

“…Walters et al recently conducted a randomized control trial on the use of PRP to augment patellar tendon autograft ACL reconstruction with minimal success. While the lack of high‐level clinical evidence remains a concern, PRP remains a viable conservative treatment with a low risk of complications or adverse reactions . The primary drawback for clinical use is the out‐of‐pocket costs to patients, as insurance seldom covers the cost of PRP treatment.…”

Section: Therapeutic Approaches To Augment Healing In Tendon and Ligamentioning

confidence: 99%

Tendon and Ligament Healing and Current Approaches to Tendon and Ligament Regeneration

Leong

Kator

Clemens

et al. 2019

Journal Orthopaedic Research

138

115

View full text Add to dashboard Cite

Ligament and tendon injuries are common problems in orthopedics. There is a need for treatments that can expedite nonoperative healing or improve the efficacy of surgical repair or reconstruction of ligaments and tendons. Successful biologically‐based attempts at repair and reconstruction would require a thorough understanding of normal tendon and ligament healing. The inflammatory, proliferative, and remodeling phases, and the cells involved in tendon and ligament healing will be reviewed. Then, current research efforts focusing on biologically‐based treatments of ligament and tendon injuries will be summarized, with a focus on stem cells endogenous to tendons and ligaments. Statement of clinical significance: This paper details mechanisms of ligament and tendon healing, as well as attempts to apply stem cells to ligament and tendon healing. Understanding of these topics could lead to more efficacious therapies to treat ligament and tendon injuries. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 38:7–12, 2020

show abstract

Platelet-Rich Plasma: Review of Current Literature on its Use for Tendon and Ligament Pathology

Cited by 74 publications

References 67 publications

Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial

Efficacy of platelet-rich plasma as an adjuvant to surgical carpal ligament release: a prospective, randomized controlled clinical trial

Platelet-rich Plasma: Three Decades and Ongoing, Do We Have a Conclusion?

Tendon and Ligament Healing and Current Approaches to Tendon and Ligament Regeneration

Contact Info

Product

Resources

About