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Osteoarthritis and platelet rich plasma treatment.

Alessandro Di Martino, Berardo Di Matteo, Tiziana Papio, Francesco Tentoni, Filippo Selleri, Annarita Cenacchi, Elizaveta Kon, Giuseppe Filardo
BACKGROUND: Platelet-rich plasma (PRP) injections have been proposed as a new conservative option for knee degeneration to provide symptomatic relief and delay surgical intervention. Although the current literature provides some evidence on the benefits of this technique compared with viscosupplementation, no studies have been performed to compare their long-term effects. PURPOSE: To compare the long-term clinical outcomes provided by intra-articular injections of either PRP or hyaluronic acid (HA) to treat knee degenerative disease...
December 13, 2018: American Journal of Sports Medicine
Jose C Alcerro, Carlos J Lavernia
INTRODUCTION: The use of stem cell therapy (SCT) and platelet-rich plasma (PRP) injection for knee osteoarthritis (OA) is extremely controversial and at best experimental stage. These treatments are being offered across the nation for "cash-only payments." Our objectives were to determine (1) what proportion of board-certified orthopedic surgeons in Miami-Dade County offer SCT or PRP and (2) how much do practices charge for these services. METHODS: All board-certified orthopedic surgeons' offices in Miami-Dade County were identified by their American Academy of Orthopaedic Surgeons active membership...
November 28, 2018: Journal of the American Academy of Orthopaedic Surgeons
Ian A Jones, Ryan Togashi, Melissa L Wilson, Nathanael Heckmann, C Thomas Vangsness
Intra-articular drug delivery has a number of advantages over systemic administration; however, for the past 20 years, intra-articular treatment options for the management of knee osteoarthritis (OA) have been limited to analgesics, glucocorticoids, hyaluronic acid (HA) and a small number of unproven alternative therapies. Although HA and glucocorticoids can provide clinically meaningful benefits to an appreciable number of patients, emerging evidence indicates that the apparent effectiveness of these treatments is largely a result of other factors, including the placebo effect...
November 29, 2018: Nature Reviews. Rheumatology
J A Annaniemi, J Pere, S Giordano
BACKGROUND AND AIMS: Intra-articular injections of viscosupplements have been an option in the treatment of knee osteoarthritis. Platelet-rich plasma is an experimental treatment in osteoarthritis. Previous studies have shown that platelet-rich plasma reduces osteoarthritis symptoms in similar proportions as viscosupplements. The aim of this study was to compare platelet-rich plasma versus viscosupplements in terms of symptoms' relief and time to arthroplasty. MATERIAL AND METHODS: A total of 190 patients included in this retrospective study received either intra-articular injections of platelet-rich plasma (94 patients) or hyaluronic acid (86 patients) between January 2014 and October 2017...
November 25, 2018: Scandinavian Journal of Surgery: SJS
Taylor M Southworth, Neal B Naveen, Benedict U Nwachukwu, Brian J Cole, Rachel M Frank
Focal chondral defects of the knee are extremely common and often result in pain, dysfunction, joint deterioration, and, ultimately, the development of osteoarthritis. Due to the limitations of conventional treatments for focal chondral defects of the knee, orthobiologics have recently become an area of interest. Orthobiologics used for cartilage defects include (but are not limited to) bone marrow aspirate concentrate, adipose-derived mesenchymal stem cells, platelet-rich plasma, and micronized allogeneic cartilage...
January 2019: Clinics in Sports Medicine
Bahar Dernek, Fatma Nur Kesiktas
BACKGROUND: Osteoarthritis (OA) is a chronic disease most often occurring in knee joints, leading to pain of varying severity and deterioration in daily living activities. OBJECTIVE: To compare efficacy of platelet-rich-plasma (PRP) versus PRP in combination with ozone gas injection in patients with early stage knee OA. METHODS: Retrospective data of patients who received PRP alone (n= 45) or combined treatment (PRP + ozone, n= 35) injection was analyzed...
November 2, 2018: Journal of Back and Musculoskeletal Rehabilitation
Chih-Hao Chiu, Rei Higashikawa, Wen-Ling Yeh, Kin Fong Lei, Alvin Chao-Yu Chen
The platelet-rich plasma (PRP) has become an attractive topic for soft tissue healing therapy recently. While some clinical reports revealed the effective treatments for knee osteoarthritis, lateral epicondylitis, and rotator cuff tears, other case studies showed that there was no statistically significant healing improvement. The efficacy of the PRP therapy is still unclear clinically. Thus, a significant amount of basic studies should be conducted to optimize the preparation procedure and the platelet concentration of the PRP...
September 7, 2018: Micromachines
Taylor M Southworth, Neal B Naveen, Tracy M Tauro, Natalie L Leong, Brian J Cole
With average life expectancy and the rising prevalence of obesity, osteoarthritis (OA) is creating an increasingly large financial and physical burden on the U.S. population today. As the body ages and experiences trauma, articular cartilage surfaces in joints are gradually worn away, leading to OA. Traditionally, treatment options have included lifestyle modifications, pain management, and corticosteroid injections, with joint replacement reserved for those who have exhausted nonsurgical measures. More recently, hyaluronic acid, micronized dehydrated human amniotic/chorionic membrane tissue, and platelet-rich plasma (PRP) injections have started to gain traction...
November 13, 2018: Journal of Knee Surgery
Yan-Hong Han, He-Tao Huang, Jian-Ke Pan, Jiong-Tong Lin, Ling-Feng Zeng, Gui-Hong Liang, Wei-Yi Yang, Jun Liu
BACKGROUND: Knee osteoarthritis (KOA) is a progressive joint disease involving intraarticular and periarticular structures. In recent years, there has been increasing interest in the use of autologous growth factors, such as intraarticular injections of platelet-rich plasma (PRP), to treat KOA. It is necessary to update the research and reevaluate the efficacy and safety of PRP to provide up-to-date evidence for KOA management. Therefore, we provide a protocol for a systematic review of PRP for KOA...
November 2018: Medicine (Baltimore)
Alice Roffi, Norimasa Nakamura, Mikel Sanchez, Magali Cucchiarini, Giuseppe Filardo
Stem cell-based therapy is a promising approach to treat cartilage lesions and clinical benefits have been reported in a number of studies. However, the efficacy of cell injection procedures may be impaired by cell manipulation and damage as well as by cell dissemination to non-target tissues. To overcome such issues, mesenchymal stromal cell (MSC) delivery may be performed using injectable vehicles as containment systems that further provide a favorable cell microenvironment. The aim of this systematic review was to analyze the preclinical and clinical literature on platelet-rich plasma (PRP), hyaluronic acid (HA), and hydrogels for the delivery of MSCs...
October 25, 2018: International Journal of Molecular Sciences
Şebnem Şahin, Süleyman Ali Tuncel, Kouroush Salimi, Elif Bilgiç, Petek Korkusuz, Feza Korkusuz
Osteoarthritis (OA) is a common form of arthritis, which is characterized by progressive degradation of joint cartilage resulting in pain, joint stiffness, deformity and disability that is also recently related to an increased incidence of mortality. Inhibition of the extracellular matrix (ECM) production by chondrocytes and accumulation of catabolic mediators associated with matrix degradation are the cause of OA. Nonsurgical treatments for OA can be characterised as symptom-modifying or disease-modifying approaches...
2018: Advances in Experimental Medicine and Biology
Adrian D K Le, Lawrence Enweze, Malcolm R DeBaun, Jason L Dragoo
PURPOSE OF REVIEW: This review evaluates current clinical literature on the use of platelet-rich plasma (PRP), including leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP), in order to develop evidence-based recommendations for various musculoskeletal indications. RECENT FINDINGS: Abundant high-quality evidence supports the use of LR-PRP injection for lateral epicondylitis and LP-PRP for osteoarthritis of the knee. Moderate high-quality evidence supports the use of LR-PRP injection for patellar tendinopathy and of PRP injection for plantar fasciitis and donor site pain in patellar tendon graft BTB ACL reconstruction...
December 2018: Current Reviews in Musculoskeletal Medicine
Corey S Cook, Patrick A Smith
PURPOSE OF REVIEW: The purpose of this review is to update the reader on the current applications of platelet-rich plasma (PRP) in the treatment of knee osteoarthritis (KOA). This review will focus on PRP's effect on the osteoarthritic joint, how PRP compares to traditional treatments of KOA, and provide clinical feedback on the use of PRP in an orthopedic and sports medicine practice. RECENT FINDINGS: Recent research into the applications of PRP for KOA has further indicated both the efficacy and safety of PRP treatment...
December 2018: Current Reviews in Musculoskeletal Medicine
Michael-Alexander Malahias, Leonidas Roumeliotis, Vasileios S Nikolaou, Efstathios Chronopoulos, Ioannis Sourlas, Georgios C Babis
Various systematic reviews have recently shown that intra-articular platelet-rich plasma (IA-PRP) can lead to symptomatic relief of knee osteoarthritis for up to 12 months. There exist limited data on its use in small joints, such as the trapeziometacarpal joint (TMJ) or carpometacarpal joint (CMCJ) of the thumb. A prospective, randomized, blind, controlled, clinical trial of 33 patients with clinical and radiographic osteoarthritis of the TMJ (grades: I-III according to the Eaton and Littler classification) was conducted...
October 20, 2018: Cartilage
Constance R Chu, Scott Rodeo, Nidhi Bhutani, Laurie R Goodrich, Johnny Huard, James Irrgang, Robert F LaPrade, Christian Lattermann, Ying Lu, Bert Mandelbaum, Jeremy Mao, Louis McIntyre, Allan Mishra, George F Muschler, Nicolas S Piuzzi, Hollis Potter, Kurt Spindler, John M Tokish, Rocky Tuan, Kenneth Zaslav, William Maloney
Concern that misinformation from direct-to-consumer marketing of largely unproven "biologic" treatments such as platelet-rich plasma and cell-based therapies may erode the public trust and the responsible investment needed to bring legitimate biological therapies to patients have resulted in calls to action from professional organizations and governing bodies. In response to substantial patient demand for biologic treatment of orthopaedic conditions, the American Academy of Orthopaedic Surgeons convened a collaborative symposium and established a consensus framework for improving and accelerating the clinical evaluation, use, and optimization of biologic therapies for musculoskeletal diseases...
October 8, 2018: Journal of the American Academy of Orthopaedic Surgeons
A Martínez-Martínez, F Ruiz-Santiago, J García-Espinosa
Platelet-rich plasma (PRP) is a preparation for therapeutic purposes that is increasingly accepted for various musculoskeletal disorders, due to its theoretical potential to repair tissues with poor healing capacity. Several randomised clinical trials have investigated the capacity of PRP to repair tendons, ligaments, muscles and cartilage, and to date there is level 1a evidence to support its use for lateral epicondylitis, osteoarthritis of the knee, plantar fasciitis and rotator cuff tendinopathy; and level 1b for patellar tendinopathy and osteoarthritis of the hip...
September 28, 2018: Radiología
Peter R Henning, Benjamin J Grear
PURPOSE OF REVIEW: Platelet-rich plasma has become an increasingly popular treatment option within the orthopedic community to biologically enhance and stimulate difficult-to-heal musculoskeletal tissues. This review evaluates the recent literature on platelet-rich plasma use in the treatment of foot and ankle pathologies. RECENT FINDINGS: Recent literature has demonstrated platelet-rich plasma to have a possible benefit in the treatment of Achilles pathology, chronic plantar fasciitis, osteochondral lesions of the talus, ankle osteoarthritis, and diabetic foot ulcers...
December 2018: Current Reviews in Musculoskeletal Medicine
Isabel Andia, Nicola Maffulli
The positive extensive clinical experience with platelet-rich plasma (PRP) in different medical areas has prompted researchers to explore clinical opportunities for optimized PRP therapies. PRP is safe but we have to make it more effective. The growing diversity of formulations and presentations enrich the field of PRP research and offer hope to refine clinical indications. Moving toward targeting the right disease phenotypes with the right PRP formulation or combination product (PRP + cell products) can offer opportunities to change treatment options in osteoarthritis and nonhealing wounds...
September 2018: Regenerative Medicine
Paul S Chirichella, Steven Jow, Stephen Iacono, Hannah E Wey, Gerard A Malanga
The meniscal tear treatment paradigm traditionally begins with conservative measures such as physical therapy with referral for operative management for persistent or mechanical symptoms. As a result, the partial meniscectomy is performed more than any other orthopedic procedure in the United States. This treatment paradigm has shifted because the recent literature has supported the attempt to preserve or repair the meniscus whenever possible given its importance for the structural integrity of the knee joint and the risk of early osteoarthritis associated after meniscus excision...
September 7, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Nicolas S Piuzzi, Mitchell Ng, Ariel Kantor, Kenneth Ng, Stephanie Kha, Michael A Mont, George F Muschler
Platelet-rich plasma (PRP) injections are often used for the treatment of knee osteoarthritis (OA), despite clinical value and cost-effectiveness not being definitely established. PRP injections are considered as a potential means of reducing pain and improving function in patients with knee OA, in the hope of delaying or avoiding the need for surgical intervention. Centers that offer PRP injections usually charge patients out of pocket and directly market services. Therefore, the purpose of this study was to quantify the current (1) prices and (2) marketed clinical efficacy of autologous PRP injections for knee OA...
September 6, 2018: Journal of Knee Surgery
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