Wednesday, March 26, 2008

Platelet Rich Plasma Basic Science

This is a video produced by Dr. Allan Mishra discussing the basic science of PRP. Future videos will discuss cell culture, animal and human studies. For more information, please visit either Total Tendon or ApexPRP.

Sunday, March 16, 2008

More Evidence that PRP may heal Tendons

In this study the authors found that PRP releasate stimulated cell proliferation and total collagen production. It is an interesting article that adds to the growing body of PRP knowledge.


Total Tendon

ApexPRP

Can Platelet-Rich Plasma Enhance Tendon Repair? A Cell Culture Study.

BACKGROUND: Autologous platelet-rich plasma (PRP) application appears to improve tendon healing in traumatic tendon injuries, but basic knowledge of how PRP promotes tendon repair is needed. HYPOTHESIS: Platelet-rich plasma has a positive effect on cell proliferation and collagen production and induces the production of matrix-degrading enzymes and endogenous growth factors by human tenocytes. STUDY DESIGN: Controlled laboratory study. METHODS: Human tenocytes were cultured 14 days in 2% fetal calf serum medium complemented with 0%, 10%, or 20% vol/vol platelet-rich clot releasate ([PRCR] the active releasate of PRP) or platelet-poor clot releasate (PPCR). At day 4, 7, and 14, cell amount, total collagen, and gene expression of collagen Ialpha1 (COL1) and IIIalpha1 (COL3), matrix metalloproteinases ([MMPs] MMP1, MMP3, and MMP13), vascular endothelial-derived growth factor (VEGF)-A, and transforming growth factor (TGF)-beta1 were analyzed. RESULTS: Platelet numbers in PRP increased to 2.55 times baseline. Growth-factor concentrations of VEGF and platelet-derived growth factor (PDGF)-BB were higher in PRCR than PPCR. Both PRCR and PPCR increased cell number and total collagen, whereas they decreased gene expression of COL1 and COL3 without affecting the COL3/COL1 ratio. PRCR, but not PPCR, showed upregulation of MMP1 and MMP3 expression. Matrix metalloproteinase 13 expression was not altered by either treatment. PRCR increased VEGF-A expression at all time points and TGF-beta1 expression at day 4. CONCLUSION: In human tenocyte cultures, PRCR, but also PPCR, stimulates cell proliferation and total collagen production. PRCR, but not PPCR, slightly increases the expression of matrix-degrading enzymes and endogenous growth factors. CLINICAL RELEVANCE: In vivo use of PRP, but also of PPP to a certain extent, in tendon injuries might accelerate the catabolic demarcation of traumatically injured tendon matrices and promote angiogenesis and formation of a fibrovascular callus. Whether this will also be beneficial for degenerative tendinopathies remains to be elucidated. Am J Sports Med. 2008 Mar 7

Sunday, March 02, 2008

Platelet Rich Plasma Wins!

In our informal survey of best names, "Platelet Rich Plasma" won with 61% of the vote with "PRP" taking 22%, "Platelet Gel" 8% and "Platelet Enriched Plasma and Growth Factors" 4% each. With a total of 83% of the votes, Platelet Rich Plasma/PRP wins in a landslide.

I propose we end the argument of what to name it and begin to define it in studies moving forward. The landscape of PRP is scattered at best. In order to figure out how best to use this important tool, we must agree on what we are talking about. Please see the post below for a definition that is published in the literature.

I am repeating the survey of what machine producing the best PRP. I'll post the results in a month.

Total Tendon

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