Objective To investigate the interleukin-17 (IL-17) levels changes in both synovial fluid and venous plasma of patients with primary knee osteoarthritis (OA) after intra-articular injection of platelet-rich plasma (PRP). Methods Between January 2015 and January 2016, 30 patients with primary knee OA were treated by intra-articular injection of PRP once a week for 3 weeks (trial group). Thirty healthy individuals were recruited into the study as control. There was no significant difference in gender, age, and body mass index between 2 groups (P>0.05). Visual analogue scale (VAS) score and Knee Society Score (KSS) were used to evaluate pain level and function of the knee for patients with OA. The IL-17 levels in both venous plasma and synovial fluid were measured before injection and at 1, 3, 6, and 12 months after injection in trial group and the IL-17 levels in venous plasma were measured in control group. The levels were determined using ELISA method. Results There was no knee joint swelling, fever, local infection, or other uncomfortable symptoms for all patients in process of PRP injection. All patients were followed up 13.5 months on average (range, 12-15 months). In trial group, the VAS scores at different time points after injection were significantly lower than that before injection (P<0.05). And the KSS scores at different time points after injection were significantly higher than that before injection (P<0.05). There was no significant difference in VAS and KSS scores between different time points after injection (P>0.05). The IL-17 levels in venous plasma before and after injection in trial group were significantly higher than that in control group (P<0.05). The IL-17 levels in venous plasma at each time point after injection were significantly lower than that before injection (P<0.05). There was no significant difference in IL-17 levels in both venous plasma and synovial fluid between different time points after injection (P>0.05). Conclusion Intra-articular injection of PRP can significantly release the pain symptoms, improve joint function, and reduce IL-17 levels in both synovial fluid and venous plasma of the patients with knee OA, but IL-17 levels can not reduce to normal level.
Objective Platelet-rich plasma (PRP) secretes many growth factors, including transforming growth factor β1 (TGF-β1), platelet derived growth factor, vascular endothl ial growth factor, insul in-l ike growth factor 1, and so on, which can promote cell prol iferation, chemotaxis, and collagen synthesis in wound heal ing. To investigate the effects of PRPon the tendon heal ing, and to explore the mechanism of action so as to provide the experimental basis for the tissue engineered tendons. Methods Forty healthy New Zealand white rabbits, weighing 2.5-3.0 kg and male or female, were randomly divided into the experimental group (n=20) and the control group (n=20). PRP was prepared from arterial blood of rabbit’s ears through twice centrifugation method of Landesberg. The platelet concentrations of whole blood and PRP were determined. The right achilles tendons of the rabbits were transected to make rupture models. In experimental group, the tendon was sutured after PRP (0.5 mL) was immediately appl ied at repair site. In control group, the tendon was sutured directly after transection. At 1, 2, 4, and 6 weeks after operation, the tendons of 5 rabbits in each group were harvested for morphological, histological, and immunohistochemical observations; the fibroblast counting, the content of collagen fibers, and the expression of TGF-β1 were detected. Results The concentration of platelet of PRP was 4.03 times of whole blood. All the animals survived till the end of the experiment, and the incision healed well. No death, infection, and other compl ications occurred. With time, the tendons almost healed in 2 groups, and the fibrous tissue at anastomosis site was more remarkable in control group than in experimental group. The histological observation showed significant differences in fibroblast counting at 1, 2, and 4 weeks after operation between 2 groups (P lt; 0.05), while no significant difference at 6 weeks (P gt; 0.05). The contents of collagen fibers in the parenchyma at repair site in experimental group were significantly higher than those in control group at each time point (P lt; 0.05). Immunohistochemistry staining showed the expression of TGF-β1 in experimental group was upregulated at 1 week and 2 weeks and reached the peak at the 2nd week, and subsequently downregulated at 4 and 6 weeks in comparison with the control group, showing signficant differences between 2 groups at each time point (P lt; 0.05). Conclusion PRP can facil itate rabbit’ s tendons heal ing and significantly improve the heal ing qual ity, which may be associated with its advancing the peak time of the TGF-β1 expression in tendon.
This paper describes the latest definition, connotation, content and working mode of orthopedic rehabilitation. It points out that the main contents of orthopedic rehabilitation should include the rehabilitation of patients with orthopedic diseases after surgery and non-surgical treatment. The research progress of stem cells, especially mesenchymal stem cells, in the treatment of osteoarthritis and lumbar intervertebral disc degeneration are reviewed. The latest progress of platelet-rich plasma in the treatment of injury of articular cartilage, ligament and tendon injuries are also reviewed.
Objective To introduce the effect of platelet-rich plasma (PRP) in the treatment of chronic tissue lesions. Methods The latest research papers concerning the relevant subject were reviewed and analyzed. Results In PRP, the platelets and cytokines, the interaction of them in the same proportion as they were in the body fluid, played promoting role in repairing the chronic damage of tissues. However, there was still way to go before PRP was appl ied for cl inical use in a widerrange. Conclusion PRP has quite a bright outlook in the treatment of chronic tissue lesions.
Objective To study the effect of serum rich in growth factors (SRGF) derived from plateletrich plasma (PRP) on the biological function of human and rat osteoblast.Methods PRP and platelet-poor plasma (PPP) obtained from healthy human and SD rat were activated by thrombin toget SRGF and serum poor in growth factors (SPGF). The level of TGFβ1 and PDGF-AB in human-SRGF and SPGF were assayed by enzyme-linked immunoassay(ELISA). Rat and human osteoblast were cultured and identified. Rat osteoblasts were treated with 5% rat-SRGF, 5% rat-SPGF and serumfree F12 medium, respectively. And human osteoblast were treated with 5% human-SRGF, 5% human-SPGF and serumfree DMEM. Cellular mitogenic activity was evaluated by thiazoly blue (MTT) colorimetric assay at 24, 48, 72 and 96hours.Results The level of TGF-β1 in human-SRGF was 307.67±35.57 ng/ml, and that of PDGF-AB was 52.76±7.89 ng/ml. The proliferation of rat and human osteoblast were promoted after treated with rat-SRGFand human-SRGF, respectively. In rat osteoblast groups, there were significant differences in absorbency between ratSPGF group and rat-SRGF group at 48 and 96 hours(Plt;0.05). In human osteoblast groups, the differences between human-SPGF group and human-SRGF group were significant at 48, 72 and 96 hours(Plt;0.05). The proliferation of these two kinds of osteoblasts almost stopped in serum-free medium, and the differences in absorbency , compared with othergroups，were significant (Plt;0.05). Conclusion High quality of PRP can be achieved by the improved method and SRGF is capable of up-regulating the proliferation of rat osteoblast and human osteoblast.
Objective To study the effect of platelet-rich plasma (PRP) on repairing chronic wounds of lower l imbs. Methods From May 2007 to November 2007, 47 patients suffering from chronic wounds of lower l imbs were treated. There were 41 males and 6 females, aged from 15 to 68 years (43.2 years on average). The disease was caused by tibiofibulafracture in 20 cases, calcaneus fracture in 4 cases, metatarsal fracture in 1 case, multiple open fracture of lower l imbs in 3 cases, tibia osteomyel itis in 10 cases, femur osteomyel itis in 1 case, soft tissue injury of ankle in 4 cases, infection after amputation in 2 cases, infection after foot orthomorphia in 1 case, and infection after calcaneus tendon neoplasty in 1 case. Their chronic wounds did not healed after 2 to 4 months of therapy. Among them, chronic wounds compl icated with fracture nonunion in 23 cases and positive bacterial culture result in 38 cases. Debridement and autogenous PRP gel injection were appl ied every 2 months and for twice. Results The patients were followed up for 4 months after the first PRP injection. Two months after the first PRP injection, chronic wounds contracted significantly in 34 patients with purulence and necrosis tissue cleaned up, circulation of soft tissue improved and exposed bone or muscle tissue covered by neogenetic granulation. No patient was completely cured. Two months after the second PRP injection, the average coverage rate was 79.3% ± 18.0%, the total cure rate was 29.8%. The volume of the chronic wounds decreased by (9.3 ± 4.9) mL after PRP therapy (2.5 ± 2.7) mL when compared with (11.8 ± 5.6) mL of before therapy, showing significant difference (P lt; 0.05). X-ray photograph showed that among the 23 cases of fracture nonunion, fracture healed completely in 9 cases; bony callus formation increased obviously in 12 cases; no significant change was observed in 2 cases. No aggravated sign of osteomyel itis was notified. Positive results of bacterial culture reduced to 15 cases. Conclusion PRP efficiently enhances the recovery of soft tissue defect and speeds up the chronic wounds heal ing oflower l imbs.
Platelet-rich plasma (PRP) is a platelet-rich plasma protein concentrate extracted from autologous peripheral blood, which contains a variety of blood-derived growth factors and cytokines. As an autologous blood product, PRP is widely used in many fields such as tissue repair and regeneration because of its minimally invasive process, simple preparation process and good biological properties. The acquisition of PRP is mainly achieved by collecting peripheral blood through density gradient centrifugation. Various growth factors and cytokines in PRP can repair various tissues. With the deepening of PRP research, it is now gradually applied to rotator cuff injury, lateral epicondylitis of humerus, carpal tunnel syndrome, knee joint injury, gluteal muscle tendinopathy, achilles tendinopathy, plantar fasciitis, and other soft tissue injuries, and some progress has been made. This article reviews the progress on clinical applications of PRP in chronic soft tissue injuries to provide a theoretical basis.
Cardiopulmonary bypass(CPB) is associated with thrombocytopenia and platelet dysfunction. The primary cause of acquired platelet defect is thought to be activation and release of alpha granules during CPB. Before CPB, platelet-rich plasma (PRP) was prepared by obtaining the required amount of patient’s whole blood by autologous plateletpheresis. PRP could be reinfused after operation in order to protect the function and quantities of the platelets. On the other hand, PRP could be made into autologous platelet gel (APG). APG contains supraphysiologic amounts of growth factors, and has adequate tensile strength and adhesive ability. Therefore, it can be used for hemostasis in operation, sealing wound and enhancing incision or dehiscent sternal wounds healing.
Objective The use of autologous platelet-rich gel (APG) is a relatively new technology and a promising treatment method for infections, which is currently being used by a variety of surgical specialties. The mechanism of antibacterialeffect of APG is not yet fully discovered. Subsequent evidence suggests that platelets have multi ple functional attributes inantimicrobial host defense (including the capacity to generate antimicrobial oxygen metabol ites and the antimicrobial peptides) and interact directly with microorganisms, contribute to clearance of pathogens from the blood. To investigate the bacteriostasis of APG against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa in vitro. Methods Platelet-rich plasma (PRP) and platelet-poor plasma (PPP) were obtained from whole blood of 17 healthy donors. APG was prepared by mixing PRP with bovine thrombin in a 10% calcium gluconate solution or bovine thrombin in a 10% calcium gluconate solution and apocynin (APG-APO). Antibacterial effects of APG, PRP, and APG-APO on Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa were evaluated by bacteriostasis assay. Results The culture results showed apparent decrease in the number of Staphylococcus aureus for both APG and APG-APO, which was maximal at first 4 hours and lasted to 24 hours and 8 hours, respectively; showing significant difference (P lt; 0.05) when compared APG with PRP and PPP, however no significant difference at first 8 hours (P gt; 0.05) and significant difference at 12 and 24 hours (P lt; 0.05) when compared APG with APG-APO; showing significant difference at first 4 hours (P lt; 0.05), no significant difference at 6, 8, 12, and 24 hours when compared APG-APO with PRP and PPP (P gt; 0.05). The bacteriostasis rates of APG and APG-APO were 27.36%-52.97% and 18.82%-51.52% against Escherichia coli, respectively; showing no significant difference (P gt; 0.05) when compared with PRP. The bacteriostasis rates of APG and APG-APO were less than 35% against Pseudomonas aeruginosa, showing no significant difference (P gt; 0.05) when compared with PRP; the bacteriostasis rates of PRP were less than 15% against Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. Conclusion APG may have potential bacteriostatic effect against Staphylococcus aureus by platelet mediating. Either APG or APG-APO has no obvious bacteriostatic effect against Escherichia coli or Pseudomonas aeruginosa. PRP has no antibacterial activity against Staphylococcus aureus, Escherichia coli or Pseudomonas aeruginosa.
Objective To investigate the effectiveness of autogenous platelet-rich plasma (PRP) gel with acellular xenogeneic dermal matrix in the treatment of deep II degree burns. Methods From January 2007 to December 2009, 30 cases of deep II degree burns were treated. There were 19 males and 11 females with an average age of 42.5 years (range, 32-57 years).The burn area was 10% to 48% of total body surface area. The time from burn to hospitalization was 30 minutes to 8 hours. All patients were treated with tangential excision surgery, one side of the wounds were covered with autogenous PRP gel and acellular xenogeneic dermal matrix (PRP group), the other side of the wounds were covered with acellular xenogeneic dermal matrix only (control group). The heal ing rate, heal ing time, infection condition, and scar formation were observed. Results At 7 days after operation, the infection rate in PRP group (6.7%, 2/30) was significantly lower than that in control group (16.7%, 5/30, P lt; 0.05). The healing times were (18 ± 4) days and (22 ± 4) days respectively in PRP group and control group, showing significant difference (P lt; 0.05). The healing rates at 14 days and 21 days were 75% ± 7% and 88% ± 5% in PRP group, were 62% ± 15% and 73% ± 7% in control group, showing significant difference (P lt; 0.05). RPR group was superior to control group in elasticity, color, appearance, softness, scar formation, and heal ing qual ity. Conclusion Autogenous PRP gel with acellular xenogeneic dermal matrix can accelerate the wound healing of deep II degree burns as well as alleviate the scar proliferation.