Platelet rich plasma: traitement des tendinopathies chroniques? Revue de la littérature

Abstract

RésuméIntroduction. -Certaines tendinopathies se chronifient malgré une thérapeutique adéquate. Un traitement novateur par injection de plaquettes (platelet rich plasma ou PRP) permettrait d'éviter une intervention chirurgicale.Éphémèse. -Nous avons réalisé une revue de la littérature concernant l'administration de PRP. Son efficacité serait liée aux différents facteurs plaquettaires de croissance qui, après préparation adéquate, deviennent 3 à 50 fois plus concentrées que dans le sang complet. Le PRP, utilisé avec succès dans différentes disciplines médicales, a démontré in vitro une activité tendineuse réparatrice. Cependant, une seule étude clinique rapporte l'efficacité du PRP dans le traitement des épicondylites.Conclusion. -Le PRP pourrait théoriquement constituer un traitement séduisant des tendinopathies chroniques mais la seule étude clinique ne permet pas encore d'établir sa réelle efficacité. AbstractIntroduction. -Some tendinopathies become chronic in spite of an appropriate treatment. Further treatment with an injection of platelet rich plasma (PRP) can avoid surgical intervention.Ephemesis. -We have made a review of literature concerning the PRP. Its efficacy is due to growth factors contained in platelets which are from 3 to 50 times more concentrated after preparation than in blood. The use of PRP has good results in different medical disciplines and can heal tendons in vitro studies. However, only one clinical study reports a good efficacy of PRP in the treatment of epicondylitis.Conclusion. -PRP is an interesting technique to treat chronic tendinopathies but there are not enough studies to determine its real efficacy.

Comparison of the platelet concentrations obtained in platelet-rich plasma (PRP) between the GPS™ II and GPS™ III systems

“…These growth factors "accelerate" and enhance the healing of different tissues such as bones, skin and tendons. These properties have already been demonstrated in several fundamental or clinical studies on the regeneration of tissue following local injections of platelet concentrates (platelet-rich plasma or PRP) [1][2][3]. In fact, this technique is already used on a regular basis in maxillofacial and orthopaedic surgery in order to improve bone graft incorporation, in dermatology to treat varicose ulcers in diabetics and, more recently, in sports medicine when treating various chronic tendinopathies [1,[3][4][5][6][7].…”

“…Blood platelets contain numerous growth factors such as PDGF (platelet-derived growth factor), TGF-β (transforming growth factor-β), IGF-1 (insulin-like growth factor-1), VEGF (vascular endothelial growth factor) and FGF (fibroblast growth factor) [1][2][3]. They are stored in the α-granules and released when the platelets are activated [1][2][3].…”

“…They are stored in the α-granules and released when the platelets are activated [1][2][3]. These growth factors "accelerate" and enhance the healing of different tissues such as bones, skin and tendons.…”

“…HIV) [3]. However, there is a theoretical risk of infection when the blood is handled in the preparation of the PRP.…”

“…However, there is a theoretical risk of infection when the blood is handled in the preparation of the PRP. Blood must not be taken at the level of any perfusion due to the risk of dilution which is likely to lead to a lower platelet concentration and, as a result, a reduction in its effectiveness [3].…”