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SPORTS MEDICINE

Achilles Tendinosis

Pain of the Achilles tendon is among the most frequent causes of pain among patients seen at foot and ankle practices. The common cause, chronic Achilles tendinosis, is the result of poor vascularization and of microtears in the collagen fibers due to repetitive overuse. In such cases, PRP has a strong theoretical potential. Healing of hard and soft tissue is mediated by the expression and proliferation of an array of growth factors, which are released with the activation of platelets. PRP is the plasma portion of whole blood that contains a higher level of platelet and growth factors than baseline. In studies, the growth factors released during coagulation have been shown to increase the survival, proliferation, and angiogenesis process of human tendon cells.

Anterior Cruciate Ligaments Injuries / ACL Injuries

An anterior cruciate ligament injury is the over-stretching or tearing of the anterior cruciate ligament in the knee. A tear may be partial or complete. ACL injury more commonly causes knee instability than injury to other knee ligaments. Injuries of the ACL range from mild such as small tears to severe when the ligament is completely torn. The future of PRP techniques in ACL surgery is in the field of primary repairs. The possibility of augmenting and enhancing the biological environment for repair with PRP may open another door to less invasive procedures to achieve stability in the acute ACL-deficient knee.

References - Orthopedic - Sports Medicine/Injection Therapy

Menetrey, J, et al, Growth Factors Improve Muscle Healing In Vivo, The Journal of Bone & Joint Surgery (Br), 2000; 82-B:131-137

Aspenberg, P, P, et al, Platelet Concentrate Injection Improves Achilles Tendon Repair in Rats, Acta Orthop Scand, 2004; 1:93-99

Yasuda, K, et al, The Effect of Growth Factors on Biomechanical Properties of the Bone-Patellar Tendon-Bone Graft after Anterior Cruciate Ligament Reconstruction, American Journal of Sports Medicine, 2004, 32:870-880

Anitua, E, et al, Autologous Preparations Rich in Growth Factors Promote Proliferation and Induce VEGF and HGF Production by Human Tendon Cells in Culture, Journal of Orthopaedic Research, 2005, 23:281-286

Murray, M, et al, Use of a Collagen-Platelet Rich Plasma Scaffold to Stimulate Healing of a Central Defect in the Canine ACL, Journal of Orthopaedic Research, 2006, 24:820-830

Schnabel, L, et al, Platelet Rich Plasma (PRP) Enhances Anabolic Gene Expression Patterns in Flexor Digitorum Superficialis Tendons, Journal of Orthopaedic Research, 2006

Sanchez, M, et al, Plasma Rich in Growth Factors to Treat Articular Cartilage Avulsion: A Case Report, Medicine & Science in Sports & Exercise, 2003, 1648-1652

Sanchez, M, et al, Application of Autologous Growth Factors on Skeletal Muscle Healing, 2nd World Congress on Regenerative Medicine Podium Presentation, May, 2005

Ventura, A, et al, Use of Growth Factors in ACL Surgery: Preliminary Study, Journal of Orthopaedic Traumatology, 2005, 6:76-79

Mishra, A, et al, Treatment of Chronic Elbow Tendinosis with Buffered Platelet-Rich Plasma, American Journal of Sports Medicine, May 30, 2006

W Weiler, A, et al, The Influence of Locally Applied Platelet-Derived Growth Factor-BB on Free Tendon Graft Remodeling after Anterior Cruciate Ligament Reconstruction, American Journal of Sports Medicine, 2006; 32:881-891

Wu, W, et al, Autologous Injectable Tissue-Engineered Cartilage by Using Plate-Rich Plasma: Experimental Study in a Rabbit Model, Journal of Oral Maxillofacial Surgery, 2007; 65:1951-1957

Murray, M, et al, Collagen-Platelet Rich Plasma Hydrogel Enhances Primary Repair of the Porcine Anterior Cruciate Ligament, Journal of Orthopaedic Research, 2007, 25:81-91

Sanchez, M, et al, Comparison of Surgically Repaired Achilles Tendon Tears Using Platelet Rich Fibrin Matrices, The American Journal of Sports Medicine, 2007, 35:245-251

Tortland, P, Regenerative Injection Therapy, Valley Sports Physicians & Orthopedic Medicine, www.jockdoctors.com

Adelson, H, Platelet Rich Plasma for Treating Chronic Pain, The Chinese Association for the Study of Pain Podium Presentation, 2007, March 17

Zavadil, D, et al, Autologous Platelet Gel and Platelet Poor Plasma Reduce Pain with Total Shoulder Arthroplasty, Journal of Extracorporeal Technology, 2007; 39:177-182

Schultheiss, H, Tendinoraphy in the Foot Utilizing Concentrated Autologous Platelet Grafting: Two Case Studies, 2007

Scarpone, M, Chronic Medial Collateral High-Grade Tear: Treatment with Autologous Platelet Concentrate Injection with Ultrasound Guidance: A Case Report, 2008

Scarpone, M, Non-Surgical Repair of High Grade Achilles Tendon Tear by Autologous Platelet Graft Placement: A Case Report, 2008

de Mos, M, et al, Can Platelet-Rich Plasma Enhance Tendon Repair? A Cell Culture Study, American Journal Sports Medicine, 2008