Ultrasound-guided platelet-rich plasma injection and multimodality ultrasound examination of peripheral nerve crush injury

Abstract

Ultrasound-guided platelet-rich plasma (PRP) injection is able to make up for the limitations of applying a single growth factor. The goal of this study was to investigate the effects of serial ultrasound-guided PRP injections of the appropriate concentration on the treatment of sciatic nerve crush injury, and explore the value of multimodality ultrasound techniques in evaluating the prognosis of crushed peripheral nerve. In vitro, optimal concentration of PRP (from 150%, 250%, 450%, and 650%) was screened due for its maximal effect on proliferation and neurotrophic function of Schwann cells (SCs). In vivo, ninety rabbits were equally and randomly divided into normal control, model, PRP-2.5×, PRP-4.5×, and PRP-6.5× groups. The neurological function and electrophysiological recovery evaluation, and the comparison of the multimodality ultrasound evaluation with the histological results of sciatic nerve crush injury were performed to investigate the regenerative effects of PRP at different concentrations on the sciatic nerve crush injury. Our results showed that the PRP with a 4.5-fold concentration of whole blood platelets could significantly stimulate the proliferation and secretion of SCs and nerve repair. The changes in stiffness and blood perfusion were positively correlated with the collagen area percentage and VEGF expression in the injured nerve, respectively. Thus, serial ultrasound-guided PRP injections at an appropriate concentration accelerates the recovery of axonal function. Multimodality ultrasound techniques provide a clinical reference for prognosis by allowing the stiffness and microcirculation perfusion of crush-injured peripheral nerves to be quantitatively evaluated.

Platelet-rich plasma loaded nerve guidance conduit as implantable biocompatible materials for recurrent laryngeal nerve regeneration

“…On the other hand, platelet-rich plasma (PRP) has been reported to have healing effects on tendons, ligaments, muscle, bone, and on the regeneration of peripheral nerves, which have been ascribed to the various GFs it contains 18 , 19 . Although the effects of these GFs on nerve regeneration have been studied 20 , little is known about the biological effects of PRP on Schwann cells (SCs) 17 , 21 .…”

Can platelet-rich plasma injections provide better pain relief and functional outcomes in persons with common shoulder diseases: a meta-analysis of randomized controlled trials

“…The medium-term follow-up results from eight RCTs (12 groups) [ 6 , 9 - 12 , 15 , 22 , 23 ] showed greater pain relief with PRP injection compared with the control interventions (MD, 1.00 cm; 95% CI, 0.35–1.65; I 2 =93%, p=0.002) ( Fig. 3 ).…”

“…PRP has anti-nociceptive [ 5 ], anti-inflammatory [ 6 ], and regenerative properties [ 7 ]. Recent studies have demonstrated the use of PRP in many kinds of pathologies, from fracture-healing [ 8 ] to nerve repair [ 9 ]. Some trials have reported the superiority of PRP for pain-relief and tissue healing compared with other interventions.…”

Tacrolimus-Induced Neurotrophic Differentiation of Adipose-Derived Stem Cells as Novel Therapeutic Method for Peripheral Nerve Injury

“…In this study, we conducted our electrophysiological analysis via a bipolar stimulation electrode. As reported previously ( Rodríguez Sánchez et al, 2019 ; Zhu et al, 2020 ), one electrode was positioned at the proximal and distal end of the sciatic nerve for electricity transduction. Another electrode, was inserted in the belly of the gastrocnemius muscle to record the NCV and DCMAP.…”