What do you think about utility of platelet rich plasma (PRP) in treatment of tendon and ligament injuries?
What is your experience with this method and your preferred preparation methods.
Would you expect benefit of such treatment in heamophilia patients?
Look at the questions I have put here for some info
PRP works well in my opinion for ligament injuries, where you are trying to repair an acute process. it is unclear whether it works for arthritis.
I cannot see why it should not work with haemophilia patients with tendon injuries. It is possible that the activation of the platelets is less intense because of the clotting deficiency. However platelets are also activated by the direct action of contact with collagen
Prolotherapy short for Proliferative Therapy has been shown to help heal tendon and ligament injuries with injection with PRP being more effective than Dextrose injection. However, PRP is much more costly. I have attached an article which is a review of Prolotherapy with an algorithm for treatment.
For Hemophilia patients, there was a study performed by Buda et al using Bone Marrow-Derived Cells (which is in the continuum of proliferative therapy) infused in the joint during Arthroscopic surgery which showed regeneration and stabilization of joint degeneration. See reference below:
Cartilage. 2015 Jul; 6(3): 150-5.
Up till now there is no a double blind blacebo controlled study to prove safety, efficacy and the number of PRP injections needed for which type of injuries whatever Articular or peri Articular (early, late ;miled, moderate or sever ;acute, subacute or chronic... ).
Anybody catching this data, please let us know and I'll be the first one to use this modalities.
If no we have to start a scientific trustable work OR we have to respect the patient's rights,
In a previous study with a very simple experimental design (only 16 patients), we found some significant negative correlations between GOT, GPT and Gamma-GP in blood and the healing index. Also, we found some significant positive correlation between healing index and blood concentration of PDGF-AB. We did not found any other significant correlation with other blood biomarkers and human gait parameters.
Although they were just preliminary results, they would allow to think that only in some cases with specific blood biomarker conditions could obtain encouraging healing results.
Thanks a lot for your efforts, but I would like to ask about the pre and post PRP comparative study regarding the biological biomarkers of the Cartilage (as in case of Osteoarthritis) also is there any work regarding Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) to show the GAGs changees before and after the PRP injections
On the whole, the beneficial effects of PRP in clinical application remain doubtful. No appropriate clinical investigations that meet all modern quality criteria have been conducted up to now.
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