Intratendon delivery of leukocyte‐rich platelet‐rich plasma at early stage promotes tendon repair in a rabbit Achilles tendinopathy model

2020 ◽  
Vol 14 (3) ◽  
pp. 452-463 ◽  
Author(s):  
Sihao Li ◽  
Yifan Wu ◽  
Guangyao Jiang ◽  
Xiulian Tian ◽  
Jianqiao Hong ◽  
...  
Keyword(s):  
Early Stage ◽  
Platelet Rich Plasma ◽  
Tendon Repair ◽  
Achilles Tendinopathy

Comparison of Leukocyte-Rich Platelet-Rich Plasma and Leukocyte-Poor Platelet-Rich Plasma on Achilles Tendinopathy at an Early Stage in a Rabbit Model

2020 ◽  
Vol 48 (5) ◽  
pp. 1189-1199 ◽  
Author(s):  
Guangyao Jiang ◽  
Yifan Wu ◽  
Jiahong Meng ◽  
Fengfeng Wu ◽  
Sihao Li ◽  
...  
Keyword(s):  
Early Stage ◽  
Platelet Rich Plasma ◽  
Biomechanical Testing ◽  
Rabbit Model ◽  
Tendon Repair ◽  
Polymerase Chain Reaction Analysis ◽  
Achilles Tendinopathy ◽  
Cross Sectional ◽  
Collagenase Injection

Background: Tendinopathy is still a great challenge in clinical practice, and the role of platelet-rich plasma (PRP) is controversial. The influence of leukocytes on tendinopathy at an early stage has not been defined so far. Purpose: To compare the effects of leukocyte-rich PRP (Lr-PRP) and leukocyte-poor PRP (Lp-PRP) on Achilles tendinopathy when applied at an early stage. Study Design: Controlled laboratory study. Methods: A rabbit Achilles tendinopathy model was induced by a collagenase injection. A week later, treatments were applied randomly on local Achilles tendon lesions: (1) 200 μL of Lr-PRP (16 legs), (2) 200 μL of Lp-PRP (16 legs), and (3) 200 μL of saline (16 legs). At 3 and 6 weeks after the collagenase injection, outcomes were evaluated by histology, magnetic resonance imaging (MRI), real-time polymerase chain reaction analysis, immunohistochemistry, and transmission electron microscopy (TEM). Results: The Lr-PRP group had a lower T2 signal intensity ( P = .0377) and smaller diameter ( P = .0193) and cross-sectional area ( P = .0194) than the Lp-PRP group on MRI. Histologically, the Lr-PRP group had better scores than the Lp-PRP group ( P = .0284 and P = .0188, respectively). Compared with the Lp-PRP group, higher gene expression and more protein synthesis of collagen I ( P = .0160 and P = .0309, respectively) and CD163 ( P < .0001 and P = .0411, respectively) were found in the Lr-PRP group. Considering TEM and biomechanical testing, the Lr-PRP group demonstrated more mature collagen fibers ( P < .0001), a larger fiber diameter ( P = .0005), a higher failure load ( P = .00417), and higher tensile stress ( P < .0001) than the Lp-PRP group. Conclusion: Lr-PRP had more beneficial effects than Lp-PRP when delivered at an early stage during tendon repair. Clinical Relevance: Here, we showed that tendinopathy influenced the curative effects of PRP in vivo. An early-stage application of Lr-PRP had more benefits for the repair of tendinopathy than Lp-PRP in a rabbit model, which will supplement guidelines of PRP treatment on tendinopathy clinically.

Rehabilitation of tendopathies in human athletes

2013 ◽  
Vol 9 (3-4) ◽  
pp. 153-160 ◽  
Author(s):  
K. Legerlotz
Keyword(s):  
Platelet Rich Plasma ◽  
Treatment Options ◽  
Symptom Relief ◽  
Achilles Tendinopathy ◽  
Basketball Players ◽  
Cross Sectional ◽  
Exercise Treatment ◽  
Recreational Athletes ◽  
Sedentary Population ◽  
Sclerosing Agents

Tendinopathies, chronic tendon disorders characterized by pain and functional impairment, are a common problem particularly in elite and recreational athletes. There is a high prevalence of Achilles tendinopathy in runners, while patellar tendinopathies, also referred to as jumpers knee, are very common amongst volleyball and basketball players. However, tendinopathies also occur in the sedentary population. The syndrome is associated with a variety of morphological, histopathological, biochemical and molecular changes, such as an increase in tendon cross sectional area, loss of fibre organization and infiltration of blood vessels. It has been shown that exercise or mechanical loading plays a role, which is why overuse is suspected to initiate tendinopathies. The exact mechanisms are still poorly understood, which makes the treatment problematic. A variety of treatment options are available, ranging from non-invasive procedures such as exercise treatment, topical nitroglycerin patches or shock wave therapy, over injections of various substances, such as corticosteroids, platelet-rich plasma or sclerosing agents, to surgical debridement. However, most of the treatment options focus solely on symptom relief, and the evidence for their effectiveness is often poor. The effectiveness of a treatment is furthermore likely to depend on the stage of the tendinapathy. In contrast to many therapies, exercise treatment has been relatively well investigated, has been shown to work in the majority of cases and is considered the gold standard.

scholarly journals Platelet-rich plasma as an effective biological therapy in early-stage knee osteoarthritis: One year follow up

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 6
Author(s):  
Deepak Rai ◽  
Jyotsana Singh ◽  
Thimmappa Somashekharappa ◽  
Ajit Singh
Keyword(s):  
Knee Osteoarthritis ◽  
Early Stage ◽  
Platelet Rich Plasma ◽  
Symptomatic Relief ◽  
Womac Questionnaire ◽  
Significant Clinical Improvement ◽  
Bioactive Agents ◽  
One Year ◽  
Early Oa

Objective: PRP is produced by centrifugation of whole blood containing highly concentrated platelets, associated growth factors, and other bioactive agents which has been shown to provide some symptomatic relief in early knee osteoarthritis (OA). The principal objective of our study was to evaluate the effectiveness and safety of standardized intra-articular injection of autologous PRP in early osteoarthritis knee. Methods: A total of 98 eligible symptomatic patients received two injections of standardized PRP 3 weeks apart. Clinical outcomes were evaluated using the VAS and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire before treatment and at 6 weeks, 3 months, 6 months, and 1 year after treatment. Secondary objectives were safety (side effects), and the effect of PRP on the different grades of knee degeneration. Results: There was a statistically significant improvement in mean VAS and WOMAC scores at 6 weeks, 3 months, 6 months, and slight loss of improvement at 1 year follow-up. There was also a correlation between the degree of degeneration and improvement in the mean scores. The decrease in mean pain score is more in grades 1 and 2 (early OA) than in grade 3. The intraarticular injection is safe, with no major complications. Conclusion: PRP is a safe and effective biological regenerative therapy for early OA Knees. It provides a significant clinical improvement in patients with some loss of improvement with time. More studies will be needed to confirm our findings.

scholarly journals Autologous Tenocyte Implantation (ATI) and the Use of Collagen Scaffolds: a Case Report of a Novel Surgical Treatment for Gluteal Tendon Repair

2021 ◽  
pp. 194
Author(s):  
◽  
◽  
◽  
◽  
Keyword(s):  
Platelet Rich Plasma ◽  
Tendon Repair ◽  
Tendon Healing ◽  
Collagen Scaffold ◽  
Gluteus Medius ◽  
Normal Function ◽  
Collagen Scaffolds ◽  
Mri Findings ◽  
Level Of Evidence ◽  
Mri Scans

Background: Ortho-biological therapies such as platelet-rich plasma and autologous tenocyte implantation injections are hypothesized to introduce cellular mediators such as growth factors into tendons, promoting natural healing. Methods: This case introduces a 63-year-old female with an extensive history of lateral hip pain and treatment refractory tendinopathy with tearing. She underwent open surgery to repair the gluteus medius tendon, using supplementary autologous tenocyte implantation (ATI) in conjunction with a Celgro (Orthocell, Perth, Australia) collagen scaffold. Level of evidence: 4 Results: She had normal function in the hip at 12 months. MRI scans post-operatively at 12 months showed a marked reduction in inflammation, an intact tendon and a reduction in atrophic changes in the muscle belly. Conclusion: Surgical repair of a large degenerate tear of the gluteus medius tendon, augmented with autologous tenocyte implantation in a collagen scaffold led to an excellent patient outcome and MRI findings demonstrated tendon healing with improved tendon structure and reduced inflammation.

Extracorporeal Shockwave Therapy Versus Platelet‐rich Plasma for Achilles Tendinopathy

PM&R ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 1169-1176
Author(s):  
Adam Tenforde ◽  
David Robinson ◽  
Joanne Borg‐Stein ◽  
Haylee Borgstrom ◽  
Jaspal Ricky Singh
Keyword(s):  
Platelet Rich Plasma ◽  
Achilles Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy

scholarly journals The Use of Platelet-Rich Plasma for the Treatment of Osteonecrosis of the Femoral Head: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-11 ◽  
Author(s):  
Jun Han ◽  
Fuqiang Gao ◽  
Yajia Li ◽  
Jinhui Ma ◽  
Wei Sun ◽  
...  
Keyword(s):  
Stem Cells ◽  
Femoral Head ◽  
Early Stage ◽  
Platelet Rich Plasma ◽  
Articular Surface ◽  
Experimental Studies ◽  
Core Decompression ◽  
Comprehensive Overview ◽  
Autologous Plasma ◽  
Operation Modes

Background. As a pathological process, osteonecrosis of the femoral head (ONFH) is characterized by the avascularity of the femoral head, cellular necrosis, microfracture, and the collapse of the articular surface. Currently, critical treatment for early-stage ONFH is limited to core decompression. However, the efficacy of core decompression remains controversial. To improve the core decompression efficacy, regenerative techniques such as the use of platelet-rich plasma (PRP) were proposed for early-stage ONFH. As a type of autologous plasma containing concentrations of platelets greater than the baseline, PRP plays an important role in tissue repair, regeneration, and the differentiation of mesenchymal stem cells (MSCs). In this review, we present a comprehensive overview of the operation modes, mechanism, and efficacy of PRP for early-stage ONFH treatment. Methods. We searched for relevant studies in the PubMed, Web of Science, and Embase databases. By searching these electronic databases, the identification of either clinical or experimental studies evaluating PRP, MSC, core decompression, and ONFH was our goal. Results. Seventeen studies of PRP and avascular necrosis of the femoral head were evaluated in our review. Ten studies related to the possible mechanism of PRP for treating ONFH were reviewed. Seven studies of the operation modes of PRP in treating ONFH were identified. We reviewed the efficacy of PRP in treating ONFH systematically and made an attempt to compare the PRP operation modes in 7 studies and other operation modes in past studies for early-stage ONFH treatment. Conclusion. PRP treats ONFH mainly through three mechanisms: inducing angiogenesis and osteogenesis to accelerate bone healing, inhibiting inflammatory reactions in necrotic lesions, and preventing apoptosis induced by glucocorticoids. In addition, as an adjunctive therapy for core decompression, the use of PRP is recommended to improve the treatment of early-stage ONFH patients, especially when combined with stem cells and bone grafts, by inducing osteogenic activity and stimulating the differentiation of stem cells in necrotic lesions.

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