Platelet-rich Plasma in Orthopaedic Applications: Evidence-based Recommendations for Treatment

Hsu, Wellington K.; Mishra, Allan; Rodeo, Scott; Fu, Freddie H.; Terry, Michael A.; Randelli, Pietro; Canale, Terry S.; Kelly, Frank B.

doi:10.5435/00124635-201312000-00004

Cited by 88 publications

(48 citation statements)

References 54 publications

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“…Additionally, there have been several articles discussing different preparation types of PRP. 57,58 A formal discussion of this is beyond the scope of this review; however, special attention should be paid to this aspect of preparation as it differs greatly in the literature. Examples of classification include the amount of white blood cell concentration and the presence or absence of exogenous activation.…”

Section: Case Seriesmentioning

confidence: 99%

The Effects of Platelet-Rich Plasma in the Treatment of Large-Joint Osteoarthritis: A Systematic Review

Tietze¹,

Geissler²,

Borchers

2014

The Physician and Sportsmedicine

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Section: Case Seriesmentioning

confidence: 99%

The Effects of Platelet-Rich Plasma in the Treatment of Large-Joint Osteoarthritis: A Systematic Review

Tietze¹,

Geissler²,

Borchers

2014

The Physician and Sportsmedicine

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“…Platelet rich plasma (PRP) is receiving tremendous attention along with increasing use for treatment of many different musculoskeletal disorders . There is now convincing evidence for the safety and efficacy of PRP as an intra‐articular injection for the treatment of osteoarthritis . PRP—alone or with a scaffold—has also been used intra‐articularly in an attempt to augment ACL healing after primary repair or reconstruction .…”

mentioning

confidence: 99%

“…With respect to the meniscus, PRP incorporated in a hydrogel showed positive effects on meniscal defect healing in a rabbit model . In addition, PRP has chemotactic, anabolic, anti‐inflammatory, and anti‐degradative effects, which also may be beneficial for meniscal healing and/or preservation of its integrity and function . Similar to the ACL, direct effects of PRP on meniscal healing are likely dependent upon sustained local delivery of bioactive factors to the repair site .…”

mentioning

confidence: 99%

“…Encompassed within the goals for treatment of ACL and meniscal pathology is the overriding objective for preservation of whole‐joint health and prevention or retardation of the development and progression of OA. In leukoreduced forms, PRP has consistently been reported to have beneficial effects when used for treatment of knee OA . These beneficial effects occur via direct and indirect mechanisms, including stimulation of tissue anabolism, amelioration of tissue catabolism, anti‐inflammatory effects, analgesia, and enhancement of viscoelastic properties .…”

mentioning

confidence: 99%

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Multiple injections of leukoreduced platelet rich plasma reduce pain and functional impairment in a canine model of ACL and meniscal deficiency

Cook

Smith

Bozynski

et al. 2015

Journal Orthopaedic Research

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Platelet rich plasma (PRP) is used to treat many musculoskeletal disorders. We used a canine model to determine the effects of multiple intra-articular injections of leukoreduced PRP (ACP) on anterior cruciate ligament healing, meniscal healing, and progression of osteoarthritis (OA). With Animal Care and Use Committee (ACUC) approval, 12 dogs underwent partial ACL transection and meniscal release in one knee. At weeks 1, 2, 3, 6, and 8 after insult, dogs were treated with intra-articular injections (2 ml) of either ACP (n ¼ 6) or saline (n ¼ 6). Dogs were assessed over 6 months to determine comfortable range of motion (CROM), lameness, pain, effusion, kinetics, and radiographic and arthroscopic assessments. At 6-month endpoint, dogs were assessed for ACL material properties and histopathology. Saline-treated dogs had significantly (p < 0.04) more CROM loss, significantly (p < 0.01) more pain, significantly (p < 0.05) more severe lameness, significantly (p < 0.05) lower function, and significantly (p < 0.05) lower %Total Pressure Index in affected hindlimbs compared to ACP-treated dogs. Radiographic OA increased significantly (p < 0.01) over time within each group. Arthroscopically, saline-treated knees showed moderate to severe synovitis, further ACL disruption, and medial compartment cartilage loss, and ACP-treated knees showed evidence of ACL repair and less severe synovitis. ACL material properties in ACP-treated knees were closer to normal than in saline-treated knees, however, the differences were not statistically significant. ACL histopathology was significantly (p< 0.05) less severe in ACP-treated knees compared to saline-treated knees. Five intra-articular injections of leukoreduced PRP had beneficial effects for ACL healing, improved range of motion, decreased pain, and improved limb function for up to 6 months in this model. ß

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“…37,38 The authors' experience with PRP for MET suggest it is a safe option, but at this time no published data are available. It may be more common than presently reported because there are no specific tests for the disorder.…”

Section: Future Considerationsmentioning

confidence: 99%

Treatment of Medial Epicondylar Tendinopathy in Athletes

Mishra

Pirolo

Gosens

2014

Sports Medicine and Arthroscopy Review

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Medial epicondylar tendinopathy, also known as golfer's elbow, is less common than lateral elbow tendinopathy. Overhead throwing athletes and those participating in sports that require repeated forearm pronation and wrist flexion are most commonly affected by this disorder. This problem predominates in amateur as opposed to professional athletes and is also seen more commonly in patients over 40 years of age. This review will begin by outlining the incidence, history, and physical examination of medial epicondylar tendinopathy, including a new clinical test. Imaging modalities, nonoperative, and operative treatments will then be outlined. Finally, future directions will be explored including emerging biological therapies.

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Platelet-rich Plasma in Orthopaedic Applications: Evidence-based Recommendations for Treatment

Cited by 88 publications

References 54 publications

The Effects of Platelet-Rich Plasma in the Treatment of Large-Joint Osteoarthritis: A Systematic Review

The Effects of Platelet-Rich Plasma in the Treatment of Large-Joint Osteoarthritis: A Systematic Review

Multiple injections of leukoreduced platelet rich plasma reduce pain and functional impairment in a canine model of ACL and meniscal deficiency

Treatment of Medial Epicondylar Tendinopathy in Athletes

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