Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Abstract

Open Access Short communicationof extrinsinc factors include unadapted material, bad training planification, or usage of some drugs (quinolones, corticoids,…) [4]. Some patients are refractory to the traditional treatments (including physiotherapy, shockwaves, deep transverse massage, etc.) and thus need another option. Less invasive than surgery, Platelet-Rich Plasma (PRP) injection has become more and more popular over the last decades, particularly in sports medicine [5][6][7]. In this paper, in addition of presenting the data asserting the effectiveness of injections of reproducible PRP collected from an apheresis machine on different tendinopathies, we introduce another original contribution : the investigation of the possible correlation between several biomarkers and healing evolution to determine the factors of good prognosis, if any. Material and MethodsForty-eight patients (mean age = 49 y.o +/-10 y.o, min = 26 y.o, max = 77 y.o. ; 15 women and 33 men) afflicted with different pathologies participated in this study after they gave their informed consent (lateral epicondylitis (n=20), medial epicondylitis (n=3), tendinopathy of the gluteus medius (n=1), patellar tendinopathy (n=6), calcaneal tendinopathy (n=14), and plantar fasciitis (n=4)). To be recruited, the patients have had to suffer from a chronic tendinopathy for more than 3 months and be refractory to the following classical treatments : non steroidal anti inflammatory drugs, electrotherapy, deep transverse massage, eccentric revalidation and shockwaves therapy. A clinical examination was carried out to confirm the diagnosis and to exclude any other pathology, including metabolic disease. After this first step, a blood sample was drawn and analyzed to quantify the presence of various metabolic biomarkers (glycemia, thyroid hormons, cholesterolemia, uricemia) which are considered to be risk factors of tendinopathies. The initial pain assessment was made using a Visual Analogic Scale (VAS) of pain and a pressure algometer (Commander Algometer, Tech Medical) prior to the PRP collection. The PRP collection and injection protocol used has already been described in previous AbstractBackground : The aims of this study were to evaluate the effect of a single PRP injection followed by a standardized reeducation protocol among patients suffering from different tendinopathies, but otherwise healthy, and to determine the biomarkers that constitute good prognosis factors, if any.