scholarly journals Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP

2019 ◽  
Vol Volume 11 ◽  
pp. 55-60 ◽  
Author(s):  
Klaus Hanisch ◽  
Niels Wedderkopp
Keyword(s):  
Platelet Rich Plasma ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Significant Difference

A Single Platelet-Rich Plasma Injection for Chronic Midsubstance Achilles Tendinopathy

2014 ◽  
Vol 7 (5) ◽  
pp. 372-376 ◽  
Author(s):  
Christopher D. Murawski ◽  
Niall A. Smyth ◽  
Hunter Newman ◽  
John G. Kennedy
Keyword(s):  
Platelet Rich Plasma ◽  
Short Form ◽  
General Health Questionnaire ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Therapeutic Level ◽  
Retrospective Case ◽  
Plasma Injection ◽  
Open Debridement

The purpose of this study was to evaluate a series of patients undergoing a single platelet-rich plasma (PRP) injection for the treatment of chronic midsubstance Achilles tendinopathy, in whom conservative treatment had failed. Thirty-two patients underwent a single PRP injection for the treatment of chronic midsubstance Achilles tendinopathy and were evaluated at a 6-month final follow-up using the Foot and Ankle Outcome Score and Short Form 12 general health questionnaire. Magnetic resonance imaging was performed on all patients prior to and 6 months after injection. Twenty-five of 32 patients (78%) reported that they were asymptomatic at the 6-month follow-up visit and were able to participate in their respective sports and daily activities. The remaining 7 patients (22%) who reported symptoms that did not improve after 6 months ultimately required surgery. Four patients went on to have an Achilles tendoscopy, while the other 3 had an open debridement via a tendon splitting approach. A retrospective evaluation of patients receiving a single PRP injection for chronic midsubstance Achilles tendinopathy revealed that 78% had experienced clinical improvement and had avoided surgical intervention at 6-month follow-up. Levels of Evidence: Therapeutic, Level IV: Retrospective case series

scholarly journals Efficacy of Autologous Platelet Rich Plasma in the Treatment of Male Androgenetic Alopecia

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Nadia Naeem ◽  
Saadiya Siddiqui ◽  
Atif Shehzad ◽  
Kehkshan Tahir ◽  
Marrium Manzoor
Keyword(s):  
Platelet Rich Plasma ◽  
Case Series ◽  
Data Entry ◽  
Stage Iv ◽  
Androgenetic Alopecia ◽  
Case Series Study ◽  
Significant Difference ◽  
Autologous Platelet Rich Plasma ◽  
Male Patients ◽  
Autologous Platelet

Objective: To assess the outcome of autologous platelet rich plasma(PRP) for the treatment of androgenetic alopecia in male patients. Methods: A total of 61 male patients from Department of Dermatology, Lahore General Hospital Lahore with ages between 18-60 years were included in the study during a period of 6 months. PRP was prepared by double spin method and CaCl2 was used to activate platelets. PRP was injected, with a 30-G needle using Nappage technique. This descriptive case series study was carefully monitored. Protocol included three treatment sessions with an interval of four weeks. Number of hairs, and hair strength was assessed by dermoscopy and hair pull test. SPSS Version-21 was used for data entry and analysis. Results: The mean age of patients was 42.67±8.63 years. Mean number of hair was 21.50±4.57 per dermatoscopic field, Post treatment number of hair was 78.10±16.24. Mean duration of disease was 10.25±3.52 months. Majority of patients were in stage iv 19(31.1%) and in stage ii 16(26.2%). There was significant difference in number of hair before and after treatment. Conclusion: PRP is an effective method to treat the patients with androgen alopecia. Key Words: Autologus platelet rich plasma, Androgen alopecia. How to Cite: Naeem N, Siddiqui S, Shehzad A, Tahir K, Manzoor M. Efficacy of autologous platelet rich plasma in the treatment of male androgenetic alopecia. Esculapio.2020;16(04):41-45.

scholarly journals Platelet-Rich Plasma Is an Equal Alternative to Surgery in the Treatment of Type 1 Medial Epicondylitis

2020 ◽  
Vol 8 (3) ◽  
pp. 232596712090895 ◽  
Author(s):  
Hunter L. Bohlen ◽  
Zachary E. Schwartz ◽  
Victor J. Wu ◽  
Stephen G. Thon ◽  
Zachary J. Finley ◽  
...  
Keyword(s):  
Platelet Rich Plasma ◽  
Full Range ◽  
Case Series ◽  
Surgery Outcome ◽  
Significant Difference ◽  
Medial Epicondylitis ◽  
Successful Outcomes ◽  
Free Status

Background: Medial epicondylitis (ME) is characterized as an overuse injury resulting in pathological alterations of the common flexor tendon at the elbow. Platelet-rich plasma (PRP) has recently become of interest in the treatment of musculoskeletal conditions as an alternative to operative management. Purpose: To compare the outcomes of recalcitrant type 1 ME after treatment with either PRP or surgery. Study Design: Cohort study; Level of evidence, 3. Methods: To compare the 2 methods of treatment, we performed a retrospective review of 33 patients diagnosed with type 1 ME from 2006 to 2016 with a minimum clinical follow-up of 1 year who had failed an initial nonoperative treatment program of injections, medication, topical creams, and/or physical therapy. Overall, 15 patients were treated with a series of 2 leukocyte-rich PRP injections, and 18 patients were treated with surgery. Outcome measures included time to pain-free status, time to full range of motion (ROM), the Mayo Elbow Performance Score (MEPS), and the Oxford Elbow Score (OES). Each patient had at least 1-year follow-up. They were then contacted by telephone to determine final scores at a minimum 2-year follow-up. Unsuccessful outcomes were determined by the Nirschl grading system and failure to reach pain-free status, achieve baseline ROM, or return to previous activity. Results: The mean final follow-up was 3.9 years. A statistically significant improvement was noted in both time to full ROM (42.3 days for PRP vs 96.1 days for surgery; P < .01) and time to pain-free status (56.2 days for PRP vs 108.0 days for surgery; P < .01). Successful outcomes were observed in 80% of patients treated with PRP and 94% of those treated operatively ( P = .37). No significant difference was found in return-to-activity rates, overall successful outcomes, MEPS scores, or OES scores. Conclusion: In this case series, the use of PRP showed clinically similar outcomes to those of surgery in recalcitrant type 1 ME. PRP can be considered as an alternative to surgery in the treatment of recurrent ME, with an earlier time to full ROM and time to pain-free status compared with surgery.

Utilisation du Plasma Riche en Plaquettes pour le traitement des tendinopathies rotuliennes et achilléennes

2015 ◽  
Vol 63 (2) ◽  
Keyword(s):  
Functional Ability ◽  
Scientific Literature ◽  
Platelet Rich Plasma ◽  
Achilles Tendinopathy ◽  
Patellar Tendinopathy ◽  
Functional Improvement ◽  
Plasma Injection ◽  
Significant Difference ◽  
Positive Effect ◽  
Significant Functional Improvement

The purpose of this study was to retrospectively evaluate the effectiveness of Platelet-Rich Plasma Injection (PRP) for Achilles and patellar tendinopathy refractory to conventional conservative treatments. For this, we compared the data from 34 patients treated with one or two injections of PRP. Pain, functional ability, athletic recovery and satisfaction of patients were evaluated. The results show a significant reduction in pain after the PRP injection treatment, as a significant functional improvement and better sports recovery, without any significant difference according to the affected tendon or the sports. Patients are, on average, satisfied. The PRP is not the miracle treatment but can be however considered in cases of refractory tendinopathy as a possible chance of improvement. Despite the potentially positive effect of PRP injection therapy on patellar and Achilles tendinopathy, there is still not enough scientific literature of high methodological quality about it.

Meta-analysis of Noninsertional Achilles Tendinopathy

2020 ◽  
Vol 41 (6) ◽  
pp. 744-754 ◽  
Author(s):  
Ian Jarin ◽  
Henrik C. Bäcker ◽  
J. Turner Vosseller
Keyword(s):  
Platelet Rich Plasma ◽  
Operative Procedure ◽  
Case Series ◽  
Achilles Tendinopathy ◽  
Current Evidence ◽  
Flexor Hallucis Longus ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Optimal Method ◽  
Treatment Methods

Background: Achilles tendinopathy is a common clinical problem that can be either insertional or noninsertional. A variety of treatment methods have been described, although little consensus exists on an optimal method or methods. We sought to investigate the current evidence on different treatment methods for noninsertional Achilles tendinopathy, with a focus on functional outcomes. Methods: We performed a review of the available literature in PubMed and the Cochrane Central Register of Controlled Trials. Data from included studies were categorized according to treatment method and analyzed with respect to functional outcome and complication rate. Results: In total, 1420 abstracts were reviewed, of which 72 articles containing 3523 patients met inclusion criteria. Within the 72 studies included, 6 operative techniques and 19 nonoperative treatments were evaluated. Conclusion: A wide variety of treatments are available for noninsertional Achilles tendinopathy, although newer treatments and most operative methods lack high-level evidence. Eccentric exercise is the most thoroughly studied and supported nonoperative treatment, while tenotomy and debridement is the operative procedure with the most evidence of efficacy. Platelet-rich plasma injections and extracorporeal shockwave therapy have proven to be viable second-line nonoperative treatments. Gastrocnemius recession and flexor hallucis longus transfer have shown benefit in case series. Level of Evidence: Level II, systematic review.

Criteria positive and criteria negative anaphylaxis, with a focus on undifferentiated somatoform idiopathic anaphylaxis: A review and case series

2020 ◽  
Vol 41 (6) ◽  
pp. 436-441 ◽  
Author(s):  
Daniel A. Rosloff ◽  
Kunal Patel ◽  
Paul J. Feustel ◽  
Jocelyn Celestin
Keyword(s):  
Diagnostic Criteria ◽  
Statistical Significance ◽  
Case Series ◽  
Poor Response ◽  
Response To Treatment ◽  
Fisher Exact Test ◽  
Subjective Symptoms ◽  
Significant Difference ◽  
Physical Findings ◽  
Idiopathic Anaphylaxis

Background: Undifferentiated somatoform (US) idiopathic anaphylaxis (IA) is considered a psychogenic disorder characterized by a lack of observable physical findings and poor response to treatment. Although failure to diagnose true anaphylaxis can have disastrous consequences, identification of US-IA is crucial to limit unnecessary expenses and use of health care resources. Objective: To better define the presentation and understand the potential relationship between US-IA and underlying psychiatric comorbidities. Methods: We retrospectively reviewed 110 visits by 107 patients to our institution for evaluation and management of anaphylaxis over a 1-year period. The patients were classified as having either criteria positive (CP) or criteria negative (CN) anaphylaxis based on whether they met Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium criteria for the clinical diagnosis of anaphylaxis. Patient characteristics, including objective and subjective signs and symptoms, and the presence of psychiatric diagnoses were collected and analyzed. Statistical significance was assessed by using the Fisher exact test. A literature review of US-IA and other psychogenic forms of anaphylaxis was performed. Results: Patients with CP anaphylaxis were more likely to present with hypotension, wheezing, urticaria, and vomiting than were patients with CN anaphylaxis. The patients with CN anaphylaxis were more likely to present with subjective symptoms of sensory throat tightness or swelling compared with patients with CP anaphylaxis. No significant difference was detected in the prevalence of psychiatric conditions between the two groups. Conclusion: Patients who met previously established diagnostic criteria for anaphylaxis were more likely to present with objective physical findings than those who did not meet criteria for true anaphylaxis. CN patients who presented for treatment of anaphylaxis were more likely to present with subjective symptoms. Formal diagnostic criteria should be used by clinicians when evaluating patients with suspected anaphylaxis.

Introduction of intraoperative neuromonitoring does not necessarily improve overall long-term outcome in elective aneurysm clipping

2020 ◽  
Vol 132 (4) ◽  
pp. 1188-1196 ◽  
Author(s):  
Tobias Greve ◽  
Veit M. Stoecklein ◽  
Franziska Dorn ◽  
Sophia Laskowski ◽  
Niklas Thon ◽  
...  
Keyword(s):  
Evoked Potentials ◽  
Predictive Value ◽  
Neurological Outcome ◽  
Positive Impact ◽  
Case Series ◽  
Intraoperative Neuromonitoring ◽  
Neurosurgical Procedures ◽  
Long Term Outcome ◽  
Unruptured Intracranial Aneurysms ◽  
Significant Difference

OBJECTIVEIntraoperative neuromonitoring (IOM), particularly of somatosensory-evoked potentials (SSEPs) and motor-evoked potentials (MEPs), evolved as standard of care in a variety of neurosurgical procedures. Case series report a positive impact of IOM for elective microsurgical clipping of unruptured intracranial aneurysms (ECUIA), whereas systematic evaluation of its predictive value is lacking. Therefore, the authors analyzed the neurological outcome of patients undergoing ECUIA before and after IOM introduction to this procedure.METHODSThe dates of inclusion in the study were 2007–2014. In this period, ECUIA procedures before (n = 136, NIOM-group; 2007–2010) and after introduction of IOM (n = 138, IOM-group; 2011–2014) were included. The cutoff value for SSEP/MEP abnormality was chosen as an amplitude reduction ≥ 50%. SSEP/MEP changes were correlated with neurological outcome. IOM-undetectable deficits (bulbar, vision, ataxia) were not included in risk stratification.RESULTSThere was no significant difference in sex distribution, follow-up period, subarachnoid hemorrhage risk factors, aneurysm diameter, complexity, and location. Age was higher in the IOM-group (57 vs 54 years, p = 0.012). In the IOM group, there were 18 new postoperative deficits (13.0%, 5.8% permanent), 9 hemisyndromes, 2 comas, 4 bulbar symptoms, and 3 visual deficits. In the NIOM group there were 18 new deficits (13.2%; 7.3% permanent, including 7 hemisyndromes). The groups did not significantly differ in the number or nature of postoperative deficits, nor in their recovery rate. In the IOM group, SSEPs and MEPs were available in 99% of cases. Significant changes were noted in 18 cases, 4 of which exhibited postoperative hemisyndrome, and 1 suffered from prolonged comatose state (5 true-positive cases). Twelve patients showed no new detectable deficits (false positives), however 2 of these cases showed asymptomatic infarction. Five patients with new hemisyndrome and 1 comatose patient did not show significant SSEP/MEP alterations (false negatives). Overall sensitivity of SSEP/MEP monitoring was 45.5%, specificity 89.8%, positive predictive value 27.8%, and negative predictive value 95.0%.CONCLUSIONSThe assumed positive impact of introducing SSEP/MEP monitoring on overall neurological outcome in ECUIA did not reach significance. This study suggests that from a medicolegal point of view, IOM is not stringently required in all neurovascular procedures. However, future studies should carefully address high-risk patients with complex procedures who might benefit more clearly from IOM than others.

Treating Knee Osteoarthritis With Platelet-Rich Plasma and Hyaluronic Acid Combination Therapy: A Systematic Review

2021 ◽  
pp. 036354652199801
Author(s):  
Michael R. Baria ◽  
W. Kelton Vasileff ◽  
James Borchers ◽  
Alex DiBartola ◽  
David C. Flanigan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Combination Therapy ◽  
Knee Osteoarthritis ◽  
Platelet Rich Plasma ◽  
Case Series ◽  
Final Analysis ◽  
Preparation Technique ◽  
Randomized Studies ◽  
Patient Reported

Background: Platelet-rich plasma (PRP) and hyaluronic acid (HA) are injectable treatments for knee osteoarthritis. The focus of previous studies has compared their efficacy against each other as monotherapy. However, a new trend of combining these 2 injections has emerged in an attempt to have a synergistic effect. Purpose: To systematically review the clinical literature examining the combined use of PRP + HA. Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed and Embase. The following search terms were used: knee osteoarthritis AND platelet rich plasma AND hyaluronic acid. The review was performed by 2 independent reviewers who applied the inclusion/exclusion criteria and independently extracted data, including methodologic scoring, PRP preparation technique, HA composition, and patient-reported outcomes (PROs). Results: A total of 431 articles were screened, 12 reviewed in full, and 8 included in the final analysis: 2 case series, 3 comparative, and 3 randomized studies. Average follow-up was 9 months. The modified Coleman Methodology Score was 38.13 ± 13.1 (mean ± SD). Combination therapy resulted in improved PROs in all studies. Of the comparative and randomized studies, 2 demonstrated that combination therapy was superior to HA alone. However, when PRP alone was used as the control arm (4 studies), combination therapy was not superior to PRP alone. Conclusion: Combination therapy with PRP + HA improves PROs and is superior to HA alone but is not superior to PRP alone.

scholarly journals Prediction accuracy of standard and total keratometry by swept-source optical biometer for multifocal intraocular lens power calculation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hun Lee ◽  
Jae Lim Chung ◽  
Young Jun Kim ◽  
Jae Yong Kim ◽  
Hungwon Tchah
Keyword(s):  
Cataract Surgery ◽  
Case Series ◽  
Intraocular Lenses ◽  
Power Calculation ◽  
Neutral Position ◽  
Swept Source ◽  
Refractive Outcomes ◽  
Case Series Study ◽  
Significant Difference ◽  
Optical Biometer

AbstractWe aimed to compare the refractive outcomes of cataract surgery with diffractive multifocal intraocular lenses (IOLs) using standard keratometry (K) and total keratometry (TK). In this retrospective observational case series study, a total of 302 patients who underwent cataract surgery with multifocal IOL implantation were included. Predicted refractive outcomes were calculated based on the current standard formulas and a new formula developed for TK using K and TK, which were obtained from a swept-source optical biometer. At 2-month postoperatively, median absolute prediction errors (MedAEs) and proportion of eyes within ± 0.50 diopters (D) of predicted postoperative spherical equivalent (SE) refraction were analyzed. There was no significant difference between MedAEs or proportion of eyes within ± 0.50D of predicted refraction from K and TK in each formula. In TFNT00 and 839MP IOL cases, there was no difference between MedAEs from K and TK using any formula. In 829MP IOL cases, MedAE from TK was significantly larger than that from K in Barrett Universal II/Barrett TK Universal II (P = 0.033). In 677MY IOL cases, MedAE from TK was significantly larger than that from K in Haigis (P = 0.020) and Holladay 2 (P = 0.006) formulas. In the subgroup analysis for IOL, there was no difference between the proportion of eyes within ± 0.50 D of predicted refraction from K and TK using any formula. TFNT00 and 839MP IOLs were favorable with TK, with 677MY IOL with K and 829MP IOL being in a neutral position, which necessitates the study that investigates the accuracy of the new TK technology.

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