Achilles Tendon Tears and Platelet Rich Plasma 2

PRP has been proposed to improve the outcome of achilles tendon repair surgery. Very recently (Sanchez 2007), a study was published that confirmed this hypothesis. If you are having chronic achilles issues or have recently suffered a tear of the tendon, talk to your physician about potentially using platelet rich plasma.

Basic science data also supports its use. As always, review of all treatment options is best done with your treating doctor.

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Platelet Rich Plasma for Rotator Cuff Tears

The use of PRP in shoulder is just beginning to emerge. Dr. Mishra published positive results in patients with chronic elbow tendonitis (AJSM 2006). The shoulder, however, is much more complex than the elbow. Multiple problems can accompany rotator cuff tendonitis including instability, AC arthritis (the joint between the shoulder and collar bone) and even overlapping pinch nerves in the neck from a disc herniation.

So, determining the value of PRP in shoulders will take more time. Basic science and cell cultures do support its use. Several investigators are evaluating it in patients. We look forward to prospective controlled trials to help us determine value.

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Treatment of Iliotibial Band Friction Syndrome with PRP

Several ApexPRP.com readers have asked about the treatment of IT band friction syndrome with PRP. IT Band tendonitis can developed at the knee or hip and can be quite painful. It is usually associated with running or biking long distances. No large studies have been published using PRP for this problem. The results of surgical intervention for IT Band issues, however, are not always predictable. Therefore, an investigation of the use of PRP for chronic, severe patients with this disorder should be initiated.

Treatment of Dry Eye with PRP

Just when you thought you had heard it all....

Here is a published article that suggests platelet rich plasma may be helpful in the treatment of symptomatic dry eye.

Here is the abstract:

Ophthalmic Res. 2007 Mar 19;39(3):124-129 [Epub ahead of print]

Symptomatic Dry Eye Treatment with Autologous Platelet-Rich Plasma.

Alio JL, Colecha JR, Pastor S, Rodriguez A, Artola A.

Corneal and Refractive Surgery Department, Instituto Oftalmologico de Alicante (Vissum), Alicante, Spain.

Background: Autologous platelet-rich plasma (PRP) has been proven to be very effective on tissue regeneration and wound healing. Here we investigate the potential use of PRP in the treatment of symptomatic dry eye. Methods: Eighteen consecutive patients with symptomatic dry eye were treated with topical PRP and followed up for 1 month. Disappearance of subjective symptoms, increase in best corrected visual acuity, tear meniscus, tear breakup time, decrease in inflammation, fluorescein staining and improvement in impression cytology were measured. Results: Symptoms improved significantly in 89% of the patients, 28% improved at least 1 line of best corrected visual acuity. A significant improvement on lachrymal meniscus and conjunctival hyperemia and a decrease or disappearance of corneal fluorescein staining were observed. Impression cytology revealed a significant increase in conjunctival goblet cells. Conclusion: Treatment of patients suffering from significant dry eye symptoms with autologous RPR proved to be very effective, improving both patient symptoms and major clinical signs.

Antibacterial Effects of Platelet Rich Plasma

In this article published in the British Journal of Bone and Joint Surgery, the anti-bacterial effects of PRP are discussed. There results are most interesting and deserve further investigation.

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Here is the abstract:

J Bone Joint Surg Br. 2007 Mar;89(3):417-20.

Antibacterial effect of autologous platelet gel enriched with growth factors and other active substances: AN IN VITRO STUDY.

Bielecki TM, Gazdzik TS, Arendt J, Szczepanski T, Krol W, Wielkoszynski T.

1Department and Clinic of Orthopaedics, Medical University of Silesia, Pl. Medykow 1, 41-200, Sosnowiec, Poland.

Platelet-rich plasma is a new inductive therapy which is being increasingly used for the treatment of the complications of bone healing, such as infection and nonunion. The activator for platelet-rich plasma is a mixture of thrombin and calcium chloride which produces a platelet-rich gel. We analysed the antibacterial effect of platelet-rich gel in vitro by using the platelet-rich plasma samples of 20 volunteers. In vitro laboratory susceptibility to platelet-rich gel was determined by the Kirby-Bauer disc-diffusion method. Baseline antimicrobial activity was assessed by measuring the zones of inhibition on agar plates coated with selected bacterial strains. Zones of inhibition produced by platelet-rich gel ranged between 6 mm and 24 mm (mean 9.83 mm) in diameter. Platelet-rich gel inhibited the growth of Staphylococcus aureus and was also active against Escherichia coli. There was no activity against Klebsiella pneumoniae, Enterococcus faecalis, and Pseudomonas aeruginosa. Moreover, platelet-rich gel seemed to induce the in vitro growth of Ps. aeruginosa, suggesting that it may cause an exacerbation of infections with this organism. We believe that a combination of the inductive and antimicrobial properties of platelet-rich gel can improve the treatment of infected delayed healing and nonunion.

PRP for UCL injuries at the Elbow

The ulnar collateral ligament of the elbow is a major stabilizer that can be injured either acutely or via chronic overuse. Throwers (Pitchers) are especially prone to this type of injuries.

PRP has been proposed as a treatment for strains and partial tears. To date, no one has published or presented their results. It is a treatment to consider but needs more data.

For more PRP info, please visit: ApexPRP.com

PRP for Posterior Tibial Tendonitis

Several readers have asked about the use of PRP for posterior tibial tendonitis. The posterior tibial tendon is located behind the inside part of the ankle and helps support the arch of the foot. Degeneration or tearing of this tendon can lead to foot and ankle pain.

No one to our knowledge has used PRP for this condition yet. There is increasing evidence that PRP is useful for achilles tendon disorders. Discuss the use of PRP for this condition with your physician and keep watching this blog. We'll post any evidence about the use of PRP for this condition as soon as it becomes available.

For more info about PRP, please visit: ApexPRP.com

Carpal Tunnel Syndrome and Platelet Rich Plasma

Several readers have asked about if PRP can treat Carpal Tunnel. To date, there has been no trial using PRP for this disorder. Carpal tunnel is a form of chronic tendonitis in a tight space that leads to nerve compression. Theoretically, PRP may be able to help. Further research both basic science and clinical trials are needed. Dequervain's Tenosynovitis is another form of chronic wrist tendonitis that has yet to be studied.

Keep checking this blog for the latest research on these important problems.

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Steroids and Tennis Elbow and Racquet Grip Size

Researchers find that patients treated with steroids do report decreased symptoms initially. However, in most of the patients, their symptoms recur.

"Leanne Bisset, a PhD candidate, and colleagues found that corticosteroid injections provided significantly better results at 6 weeks, but showed subsequently higher recurrence rates (47 of 65 successes regressed) and poorer outcomes in the long term compared with physiotherapy."

From Ortho SuperSite. Click here to read the full article including more details about Platelet Rich Plasma and racquet grip size.

For more PRP information and research: ApexPRP.com