A Comprehensive Review on Platelet-Rich Plasma Activation: A Key Player in Accelerating Skin Wound Healing

Re-Evaluating Platelet-Rich Plasma Dosing Strategies in Sports Medicine: The Role of the "10 Billion Platelet Dose" in Optimizing Therapeutic Outcomes-A Narrative Review

Platelet-rich plasma (PRP) therapy is increasingly recognized as a promising treatment for musculoskeletal disorders, including osteoarthritis (OA), tendinopathy, and muscle injuries. This narrative review synthesizes the current literature to evaluate the efficacy of PRP, with a focus on platelet dosing strategies, leukocyte composition, and preparation protocols. Evidence suggests that optimal therapeutic outcomes are achieved when platelet doses exceed 3.5 billion per injection, with cumulative doses of 10-12 billion across multiple treatments. In intra-articular applications, leukocyte-poor PRP (LP-PRP), characterized by reduced neutrophil content, demonstrates superior efficacy compared to leukocyte-rich PRP (LR-PRP). However, its effectiveness in tendon and muscle regeneration remains a subject of debate. Preliminary data suggest that the inclusion of peripheral blood mononuclear cells (PBMNCs) may enhance PRP efficacy, though robust clinical trials are required to confirm these findings. Furthermore, red blood cell contamination and pre-activation have been identified as detrimental to PRP effectiveness, highlighting the need for standardized preparation protocols. This review emphasizes the importance of tailoring PRP formulations to patient-specific factors and musculoskeletal conditions. Future research should focus on refining PRP preparation techniques, identifying optimal leukocyte compositions, and establishing standardized guidelines to enhance clinical outcomes.

Comparison of clinical efficacy between tibial cortex transverse transport and platelet-rich plasma treatment for severe diabetic foot ulcers

Objective

This study aims to compare the effects of tibial cortex transverse transport (TTT) and platelet-rich plasma (PRP) on the healing of severe diabetic foot ulcers, evaluate the clinical efficacy of TTT, and explore its potential impact on lower limb circulation.

Methods

A retrospective analysis was conducted on two patient groups treated at our hospital between July 2019 and June 2022. One group underwent TTT, while the other received PRP therapy. Both groups had Wagner level 3 or higher ulcers. An 18-month follow-up was performed for both groups, during which we documented wound healing progress and healing times to assess clinical efficacy. To investigate lower limb blood flow recovery, lower limb arterial ultrasound was used to measure blood flow velocities in the affected popliteal and dorsalis pedis arteries. Additionally, ELISA was employed to measure the stromal cell-derived factor-1 (SDF-1) levels of angiogenic factors in peripheral blood.

Results

A total of 60 diabetic foot ulcers (DFUs) patients were enrolled in our study, with 30 patients in each group: TTT-treated and PRP-treated. During the 18-month follow-up, the wound healing rate in the TTT-treated group was significantly higher than in the PRP-treated group [96.67% (29/30) vs. 80% (24/30), p < 0.05]. Furthermore, the healing time in the TTT-treated group was shorter (3.02 ± 0.84 vs. 6.04 ± 0.85 months, p < 0.001). The amputation rate [3.33% (1/30) vs. 20% (6/30), p < 0.05] and recurrence rate [6.67% (2/30) vs. 26.67% (8/30), p < 0.05] in the TTT-treated group were lower than those in the PRP-treated group. After 1 month and 18 months of treatment, the flow velocities in the popliteal artery (68.93 ± 2.69 vs. 58.14 ± 2.48 cm/s, p < 0.001; 55.68 ± 3.43 vs. 46.07 ± 3.02 cm/s, p < 0.001) and dorsalis pedis artery (46.45 ± 2.77 vs. 36.46 ± 2.83 cm/s, p < 0.001; 38.63 ± 2.40 vs. 29.82 ± 2.15 cm/s, p < 0.001) in the TTT-treated group were significantly higher than in the PRP-treated group. Additionally, the TTT-treated group showed higher levels of SDF-1 expression (375.36 ± 13.52 vs. 251.93 ± 9.82 pg/ml, p < 0.001; 256.62 ± 13.19 vs. 239.96 ± 10.78 pg/ml, p < 0.001).

Conclusion

Our results suggest that TTT treatment is more clinically effective than PRP for treating severe DFUs. This increased efficacy may be attributed to enhanced lower limb blood flow, which is potentially driven by elevated SDF-1 levels.

A novel surgical technique for cranial cruciate ligament repair in dogs using autologous lateral digital extensor muscle tendon graft combined with platelet-rich plasma: A preliminary experimental study

Background and Aim

Cranial cruciate ligament (CrCL) injuries are a prevalent orthopedic issue in dogs, typically managed through surgical interventions such as tibial plateau leveling osteotomy and tibial tuberosity advancement. However, these techniques have limitations, including high costs and extended recovery periods. This study introduces an innovative CrCL repair method employing an autologous lateral digital extensor muscle tendon graft and evaluates the effects of platelet-rich plasma (PRP) on tissue healing.

Materials and Methods

Twenty-four healthy, male, local-breed dogs were divided into two groups. Group A underwent the surgical procedure without PRP, while Group B received intra-articular PRP during surgery. Outcomes were evaluated through clinical assessments of lameness, post-operative complications, and histological analysis over 10, 20, 30, and 40 days.

Results

The PRP-treated group demonstrated statistically significant improvements in post-operative complication scores (p = 0.0025) and histological outcomes (p = 0.0002). However, graft maturation was unaffected by PRP treatment but improved over time (p = 0.0013). PRP-treated dogs exhibited faster recovery and enhanced tissue regeneration, with reduced inflammation and improved graft-bone attachment.

Conclusion

This novel surgical approach demonstrates significant potential for improving outcomes in CrCL repair by combining autologous tendon grafting with PRP. The technique offers reduced complications and enhanced healing, providing a promising alternative to traditional methods. Further studies are recommended to validate its efficacy in clinical settings.

Could CH3-M6P Be a Potential Dual-Functioning Candidate for Bone Regeneration?

Background: CI-RM6P has different binding sites with affinities for both M6P and IGF2, plays a role in the regulation of the TGF-β and IGF pathways that is important for controlling cell growth and differentiation. We hypothesize that previously synthesised derivative of M6P could be an alternative candidate for bone tissue regeneration in terms of higher binding affinity, stability in human serum, low cost and temporal delivery. Methods: CH3-M6P is synthesised based on previously described protocol; mesenchymal origin of isolated DPSCs was assessed by flow cytometry and AR staining prior to alkaline phosphatase (ALP) activity test, qPCR to evaluate differentiation specific marker expression, immunofluoresence, and SEM/EDS to evaluate organic and inorganic matrix formation; and rat aortic ring model to evaluate angiogenic effect of molecule. Results: CH3-M6P upregulated ALP activity, the expression of the ALP, Col1, RunX2, Mef2C, TGFβ1, TGFβ1R, TGFβ2, and Smad3 genes under osteogenic conditions. The results of immunofluorescence and SEM/EDS studies did not show enhancing effect on matrix formation. As we observed, the induction effect of CH3-M6P on the expression of angiogenic genes such as SMAD3 and TGFβ1R, even under osteogenic conditions, within the scope of research, we checked the angiogenic effect of the molecule and compared it to VEGF, showing that the CH3-M6P is really angiogenic. Conclusions: Our findings provide an important clue for the further exploration of the molecule, which can be necessary to enhance the capability of the commonly used osteomedium, possibly leading to the development of bone-forming drugs and has the potential to be a dual-functioning molecule for bone tissue engineering.

Platelet-Rich Plasma With an Activator: A New Approach for Treating Thin Endometriums of Women Suffering From Infertility

This case study reflects the primary infertility treatment which was in vitro fertilization (IVF) that lasted for four years. This case study involves a 37-year-old female who underwent intrauterine insemination (IUI), recurrent implantation failure, and frozen embryo transfers with a focus on platelet-rich plasma (PRP) for receptor endometrial thickness. The patient's report revealed a hormonal imbalance and a thin endometrium measuring 5 mm, while her husband's semen analysis findings were normal. Activation with calcium chloride PRP therapy successfully helped to achieve an endometrial thickness of 7.1 millimeters, and then, on the second day of the menstrual cycle, gonadotropin-releasing hormone (GnRH) was given. Six oocytes were retrieved, and after intracytoplasmic sperm injection (ICSI), a good-quality blastocyst was developed. On day 21 of the cycle, an embryo of 4AB grade was transferred. Serum beta-human chorionic gonadotropin (β-hCG) was positive, which confirmed pregnancy 14 days after the process of embryo transfer. The patient was advised to take regular check-ups during pregnancy. Recurrent implantation failure and thin endometrium are critical issues in this case, demonstrating that PRP can be used to augment the endometrial thickness to improve the pregnancy rate.

Impact of Hysteroscopic Instillation of Autologous Platelet-Rich Plasma on Pregnancy Outcomes in Patient With Recurrent Implantation Failure: A Case Report

Recent advancements in assisted reproductive technology (ART) have enabled couples to achieve pregnancy, who were previously unable to conceive. However, recurrent implantation failure (RIF) remains a significant challenge. This case study exhibits the effective use of hysteroscopic-guided platelet-rich plasma (PRP) instillation in the treatment of a female patient aged 33 who was nulliparous and diagnosed with RIF and a thin endometrium, which resulted in primary infertility. The couple had a history of 10 years of infertility and had previously undergone ART procedures, including intrauterine insemination (IUI) and intracytoplasmic sperm injection (ICSI), which failed. The female partner was diagnosed with a thin endometrium (<7 mm) and underwent hysteroscopy, revealing no other significant intrauterine pathologies. Following hormonal treatment and ovum pick-up, hysteroscopic PRP was administered, resulting in improved endometrial thickness (ET) and successful embryo implantation, as evidenced by a positive serum β-hCG level of 1470 mIU/mL. This case demonstrates the hysteroscopic injection of PRP's potential for increasing endometrial receptivity and enhancing ART outcomes in women with RIF due to thin endometrium, making it a promising alternative to conventional therapies.

Efficacy of Intra-articular Super-dose Platelet-Rich Plasma Injection in Improving Pain in a Middle-Aged Sedentary Female With Meniscal Tear: A Case Report

This case study explores the use of super-dose platelet-rich plasma (PRP) in managing a meniscal tear in a 43-year-old woman with left knee pain. The patient was diagnosed with a vertical longitudinal tear of the body and posterior horn medial meniscus, confirmed through magnetic resonance imaging. Super-dose PRP, characterized by a higher platelet volume (8 ml), was administered intra-articular. Post-injection, the patient reported initial discomfort for a few days, but significant improvements in pain and range of motion (ROM) were observed within the first week. Over 12 weeks, her visual analog scale pain score decreased from 8/10 during activity to 2/10, and her ROM returned to full functionality. The case supports the hypothesis that super-dose PRP may enhance the healing process in meniscal injuries by promoting tissue healing and regeneration through the release of growth factors, angiogenesis, collagen synthesis, and inflammation modulation. This case highlights PRP's potential as a non-surgical treatment for meniscal tears. Further large-scale studies and randomized controlled trials are needed to validate these results, optimize dosing strategies, and determine which patient populations will benefit most from this innovative treatment approach.

Platelet-Rich Plasma Therapy for Rotator Cuff Injuries: A Comprehensive Review of Current Evidence and Future Directions

Rotator cuff injuries are a prevalent cause of shoulder pain and disability, significantly impacting daily activities and quality of life. Platelet-rich plasma (PRP) therapy has emerged as a potential treatment for these injuries, aiming to enhance healing by delivering concentrated platelets and growth factors. This review comprehensively evaluates the current evidence regarding PRP therapy for rotator cuff injuries. It examines clinical trial data, comparing PRP therapy with conventional treatments such as physical therapy and surgical intervention. The review also explores the biological mechanisms of PRP, including its role in promoting tendon repair and regeneration through growth factors and cytokines. In addition, it addresses variables that may affect PRP therapy outcomes, including preparation techniques, injection methods, and patient-specific factors. The review highlights the need for standardized protocols and further research to optimize PRP therapy and address existing gaps in knowledge. Future directions include exploring combined treatment approaches and assessing long-term outcomes to refine PRP therapy's role in rotator cuff injury management. This review aims to provide valuable insights into the effectiveness of PRP therapy, contributing to improved treatment strategies and enhanced patient outcomes.

Exploring the applications of platelet-rich plasma in tissue engineering and regenerative medicine: evidence from goat and sheep experimental research

Platelet-rich plasma (PRP) has emerged as a promising therapeutic approach in regenerative medicine. It contains various growth factors and bioactive molecules that play pivotal roles in tissue repair, regeneration, and inflammation modulation. This comprehensive narrative review delves into the therapeutic potential of PRP in experimental goat and sheep research, exploring recent advancements, challenges, and future prospects in the field. PRP has been explored for its application in musculoskeletal injuries, wound healing, and orthopedic conditions. Studies have demonstrated the ability of PRP to accelerate tissue healing, reduce inflammation, and improve the overall quality of healing. Recent advancements in PRP technology have led to the development of novel formulations and delivery methods to enhance its therapeutic efficacy. PRP has shown promise in tendon and ligament injuries, osteoarthritis, and bone fractures in experimental goat and sheep research. Despite these advancements, several challenges and opportunities exist to harness the full therapeutic potential of PRP in regenerative medicine. Standardizing PRP preparation protocols, including blood collection techniques, centrifugation parameters, and activation methods, is essential to ensure consistency and reproducibility of the findings. Moreover, further research is needed to elucidate the optimal dosing, frequency, and timing of PRP administration for different clinical indications. Research conducted in goat and sheep models provides evidence supporting the translational potential of PRP in tissue engineering and regenerative medicine. By harnessing the regenerative properties of PRP and leveraging insights from preclinical studies, researchers can develop innovative therapeutic strategies to address unmet clinical needs and improve patient outcomes in diverse medical specialties.

The Role of Platelet-Rich Plasma in the Management of Sensorineural Hearing Loss: Current Evidence and Emerging Trends

Sensorineural hearing loss (SNHL) is a common form of hearing impairment characterized by damage to the inner ear or auditory nerve, resulting in significant communication difficulties and reduced quality of life. Current treatment options, including hearing aids, cochlear implants, and corticosteroids, primarily focus on symptom management and do not address the underlying pathophysiological damage. Platelet-rich plasma (PRP), an autologous concentrate rich in platelets and growth factors, has emerged as a potential regenerative therapy due to its ability to promote tissue repair and cellular regeneration. This review provides a comprehensive overview of the role of PRP in the management of SNHL, examining the current evidence from preclinical and clinical studies. We discuss the mechanisms through which PRP may promote auditory tissue regeneration and repair, analyze its efficacy and safety profile, and explore innovative approaches and future directions in its application for SNHL. Despite promising preliminary findings, further research is needed to optimize PRP protocols, establish standardized treatment guidelines, and conduct large-scale randomized controlled trials to validate efficacy. This review aims to highlight the potential of PRP as a novel therapeutic strategy in treating SNHL and its possible integration into current clinical practices, offering new hope for patients with this debilitating condition.

Microneedling in Dermatology: A Comprehensive Review of Applications, Techniques, and Outcomes

Microneedling, also known as collagen induction therapy, is a minimally invasive dermatological procedure that has gained widespread popularity for treating various skin conditions, including acne scars, wrinkles, hyperpigmentation, and stretch marks. By creating controlled micro-injuries in the skin, microneedling stimulates the body's natural healing processes, resulting in increased collagen and elastin production, essential for maintaining skin elasticity and firmness. Over the past few decades, microneedling has evolved significantly, with advancements such as automated devices, radiofrequency microneedling, and combination therapies enhancing its effectiveness and safety profile. This comprehensive review explores the mechanisms of action, various techniques, and clinical applications of microneedling, highlighting its advantages over other skin rejuvenation methods. The review also examines patient satisfaction, safety considerations, and potential complications, providing a balanced perspective on its clinical utility. Furthermore, the discussion includes future directions in microneedling technology and research, focusing on emerging innovations and potential new applications. As the field advances, microneedling is poised to play an increasingly important role in aesthetic medicine, offering a reliable and effective solution for skin rejuvenation and beyond. This review is a valuable resource for healthcare professionals, guiding the optimization of microneedling practices and informing future research efforts.

Mechanisms, Efficacy, and Clinical Applications of Platelet-Rich Plasma in Tendinopathy: A Comprehensive Review

Tendinopathy poses a significant clinical challenge characterized by chronic tendon pain, swelling, and impaired function, affecting athletes and the general population. Current treatments often provide limited success, necessitating exploration into regenerative therapies such as platelet-rich plasma (PRP). PRP harnesses the regenerative potential of autologous platelets and growth factors to promote tendon healing. This review aims to comprehensively examine the mechanisms, efficacy, and clinical applications of PRP in tendinopathy. We discuss the pathophysiology of tendinopathy, highlighting collagen disorganization, increased ground substance, and inflammatory changes. PRP's action mechanism involves releasing bioactive molecules that stimulate cellular proliferation, collagen synthesis, and tissue remodeling. Clinical studies and trials evaluating PRP in various tendinopathies, including Achilles, patellar, and rotator cuff tendinopathy, are reviewed to assess its efficacy and effectiveness compared to traditional therapies. Practical aspects, such as preparation methods, injection techniques, and safety considerations, are discussed to provide insights into optimal PRP administration. Challenges, including protocol variability and evidence gaps, are addressed, and future research and clinical practice directions are proposed. By synthesizing current knowledge, this review aims to guide clinicians in enhancing treatment strategies and advancing the field of tendon regenerative medicine.

Therapeutic Potential of Platelet-Rich Plasma in Fracture Healing: A Comprehensive Review

Fracture healing is a dynamic process essential for the restoration of bone integrity and function. However, factors such as patient age, comorbidities, and the severity of the fracture can impede this process, leading to delayed healing or nonunion. Platelet-rich plasma (PRP) has emerged as a promising therapeutic option for enhancing fracture healing. PRP is an autologous blood product containing a concentrated mixture of platelets, growth factors, and cytokines known to promote tissue regeneration and repair. This comprehensive review provides an overview of the fracture healing process, emphasizing the importance of timely and efficient bone repair. We discuss the mechanisms underlying the purported efficacy of PRP in fracture healing, drawing upon both preclinical and clinical evidence. Preclinical studies in animal models have demonstrated the ability of PRP to accelerate fracture healing, stimulate osteogenesis, and enhance bone regeneration. Clinical studies have yielded mixed results, with some reporting positive outcomes in terms of accelerated healing and improved functional outcomes, while others have shown no significant benefits over standard treatments. Factors influencing the efficacy of PRP, such as timing of administration, PRP concentration, and patient-specific variables, are also examined. Furthermore, safety considerations and potential adverse effects associated with PRP therapy are discussed. Despite the promising preclinical findings, challenges remain in standardizing PRP formulations, optimizing administration protocols, and addressing unanswered questions regarding its long-term efficacy and safety. This review aims to provide insights into the therapeutic potential of PRP in fracture healing, informing future research directions and guiding clinical practice.

A Comprehensive Review of Platelet-Rich Plasma and Its Emerging Role in Accelerating Bone Healing

This comprehensive review delves into the emerging role of platelet-rich plasma (PRP) in accelerating bone healing. PRP, a blood-derived product rich in platelets and growth factors, has garnered attention for its regenerative potential. The review begins by defining PRP and providing a historical background, highlighting its significance in expediting bone healing. PRP's composition and preparation methods, including centrifugation techniques and commercial kits, are explored. Mechanistically, PRP operates by releasing growth factors, chemotaxis, and angiogenesis, elucidating its cellular effects. Applications in fracture healing and orthopaedic surgeries, such as joint arthroplasty and spinal fusion, are discussed, emphasising the promising outcomes in clinical trials. Safety considerations, patient selection criteria, and the need for PRP preparation and application standardisation are underscored. The review outlines ongoing research trends, potential technological advancements, and unexplored areas in paediatric applications and inflammatory bone disorders. The implications for clinical practice involve informed decision-making, optimised protocols, and interdisciplinary collaboration. In conclusion, the future of PRP in bone healing holds exciting prospects, with the potential for precision medicine, integration with emerging therapies, expanded applications, and enhanced technological innovations shaping its trajectory in orthopaedics and regenerative medicine.

Navigating the Therapeutic Landscape: A Comprehensive Review of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate in Knee Osteoarthritis

This comprehensive review provides an in-depth analysis of platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC) as potential treatments for knee osteoarthritis. It explores their mechanisms of action, clinical efficacy, safety considerations, and the importance of personalised treatment approaches. The review highlights promising findings regarding the ability of PRP and BMAC to alleviate symptoms, improve joint function, and potentially slow disease progression. It emphasises the need for further research into long-term outcomes, direct comparative studies, protocol standardisation, biomarker identification, and cost-effectiveness assessments to enhance clinical practice. While the review does not directly compare PRP and BMAC, it provides valuable insights into their respective roles in knee osteoarthritis management. The review aims to contribute to evidence-based advancements in regenerative therapies for knee osteoarthritis by addressing critical research priorities and refining treatment strategies.