Online ISSN: 2515-8260

Keywords : Platelet rich plasma


Evaluation of clinico-radiological outcomes in patients with lumbar degenerative disc diseases treated with intradiscal PRP versus steroids: A prospective double blinded randomized controlled trial

Dr. Bhupinder Singh Brar, Dr. Vivek Jha, Dr. Guncha Kalia, Dr. Bhandari Vaibhav, Dr. Neelam Gupta, Dr. Mandeep Kaur Nanda, Dr. Monika Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1079-1088

Context: To evaluate clinico-radiological outcomes in patients with lumbar degenerative disc
diseases treated with intradiscal PRP versus steroids.
Design: Prospective double blinded randomized controlled trial.
Aims: The aim of the study was to compare and assess radiological changes and clinical
outcome in patients with degenerative disc diseases when treated with intradiscal platelet rich
plasma and intradiscal steroid.
Objectives: To compare clinical outcome in PRP and steroid treated patients, to compare
radiological changes in PRP and steroid treated patients, to assess clinical outcome in PRP
and steroid treated patients at subsequent follow ups, to assess radiological changes in PRP
and steroid treated patients at subsequent follow up.
Settings and Design: Prospective double blinded randomized controlled trial.
Methods and Material: Adults (18-50 years) with chronic low back ache (> 6 months) nonradiating
who were unresponsive to conservative treatment. A total 40 patients were
randomized to receive intradiscal PRP (Group A) or steroid (Group B) after provocative
discography in the department of Orthopaedics in Maharishi Markandeshwar Medical
College and Hospital, Solan between the time period of November 2019 to September 2021
based on inclusion and exclusion criteria were enrolled for platelet rich plasma and steroid
infiltration in a randomized manner. Pain relief as assessed by change in VAS score,
functional assessment using change in Modified oswestry disability index (MODI). Pfirrman
and MSU grades as assessed by MRI.

Clinico-radiological outcomes of platelet rich plasma versus steroid via epidural route in patients with lumbar degenerative disc disease: A prospective triple blinded randomized control study

Nikunj Gupta, Vivek Jha, Bhupinder Singh Brar, Omeshwar Singh, Mandeep Kaur Nanda, Naveen Kakkar .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 2, Pages 1280-1289

Abstract
Introduction: Low back pain is one of the leading causes of physical disability in both old and younger age group. It has enormous effects on socioeconomic status and health of people. Inter vertebral disc degeneration is an active process which involve changes in cellular microenvironment and tissue that eventually leads to structural breakdown and impairment of inter vertebral disc function. These changes cause back pain. Epidural steroid injection is a well-established modality in providing pain relief and is widely practiced. PRP (Platelet rich plasma) is a new upcoming modality with promising regenerative effects. In recent literature its use in treatment of back pain is being encouragingly promoted and is under evaluation.
Aim:
 To evaluate clinical outcomes of Platelet rich plasma in patients of degenerative disc disease with predominant radicular pain.
 Subjective and objective comparison of effects of platelet rich plasma and dexamethasone with bupivacaine.
 To evaluate evolution of MRI changes post P-PRP/Epidural steroid injections.
Methods: Patients of radiating low back pain were included after 6 weeks of failed conservative management. They were divided into two groups A and B of 15 each. Group A were given epidural P-PRP (pure-PRP) (8ml) injection in epidural space and group B were given dexamethasone 2ml + bupivacaine 0.5% 2ml + 4ml Normal saline. Groups were evaluated on basis of VAS lower back, VAS leg pain, MODI score and Pfirrmann grade in MRI

PLATELET RICH PLASMA IN ORAL AND MAXILLOFACIAL SURGERY

Dr. Vijay Ebenezer; Dr. Balakrishnan Ramalingam

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 1948-1950

Platelet-rich plasma, or PRP, is now widey used in wound healing in the field of dentistry. Following any surgical procedure , blood clots initiate the healing and regeneration of hard and soft tissues. Several studies are being carried out to investigate the use of PRP in dentistry as a way to enhance the body’s natural wound-healing mechanisms.

Efficacy of Intra-Articular Injection of Platelet Rich Plasma and Hyaluronic Acid in Early Knee Osteoarthritis – Case Series

Krishnaiah Kurapati; Sanjay Tapadia; Madhusudhan Rao; Kavitha Anbarasu; Vinod Kumar Verma; Syed Sultan Beevi

European Journal of Molecular & Clinical Medicine, 2018, Volume 5, Issue 1, Pages 30-36

Higher prevalence and growing burden of knee Osteoarthritis (OA) combined with recent safety concerns about pharmacological interventions has increased demand for new effective technologies for its management. Need of the hour is an innovative treatment alternative which may repair cartilage damage rather than just reduce symptoms of pain. Hyaluronic acid (HA) and PRP has been shown to relieve pain and symptoms as well as slow the progression of disease as stand-alone therapy. Treatment combining these modalities could be particularly hopeful owing to their positive and diverse interaction among themselves. Combinational treatment using both PRP and HA was performed on a series of 12 patients with early stage primary knee OA who fulfilled all the designated inclusion and exclusion criteria. All the patients were evaluated before and after treatment (1, 3, 6 and 12 months) by physical examination, assessment of VAS for pain, WOMAC, IKDC, KOOS and OKS to record the patient-reported improvement in pain, functionality and quality of life (QOL). 2-tailed Mann Whitney U Test was performed to assess the effect of treatment at different follow-up times of all the clinical scores. Whereas, Pearson correlation coefficient was done to evaluate the correlation between different clinical scores. For all tests, p < 0.05 was considered significant. All patients showed statistically significant improvement in all orthopedics scores evaluated. VAS score was improved significantly from 3.00 ± 0.49 at baseline to 1.57 ± 0.41 (p = 0.031) in Grade I and 3.60 ± 0.51 at baseline to 2.10 ± 0.29 (p = 0.031) in Grade II patients at 6 months’ follow-up respectively. Other scores followed similar trends with statistically significant improvement at 6 months’ follow-up which maintained throughout till end of the study period. All patients treated experienced strong functional improvement and substantial gains in pain relief, functionality and QOL. Hence our preliminary findings suggest that combined PRP and HA procedure is safe and potentially efficacious, which merits further investigation in large clinical settings and also in controlled clinical trials with long-term follow-ups. Focal Points Bench side: Platelet Rich Plasma (PRP) deliver a large pool of signalling proteins including growth factors and cytokines to the local milieu driving the tissue regeneration and repair mechanisms which when combined with high molecular weight cross-linked hyaluronan could bestow greater viscoelastic properties and alleviate the symptoms of osteoarthritis. Bedside: Osteoarthritis (OA) is a chronic degenerative disease and there is no cure for OA except medical management and partial/total knee replacement in advanced stage. PRP along with HA could have the therapeutic potential to promote cartilage regeneration and inhibit inflammation synergistically by decreasing the friction coefficient and minimizing wear. Community: The burden of OA on quality of life, disability and health care utilization is quite high. Combined PRP and HA could be an effective single-dose treatment modality restoring the functional activities and considerably reducing effective cost of the treatment. Governments and regulatory agencies: The technology to obtain PRP is FDA-approved and its safety and efficacy has been well established through several clinical studies. Regulatory agencies should consider the evidences put forth by the researchers and sanction grants to investigate in larger clinical settings and also in controlled trials with different ethnicities with long-term follow-ups.