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See detailCHRONIC TENDINOPATHIES AND PLATELET-RICH PLASMA TREATMENT: HOW TO IMPROVE THE EFFICIENCY?
Kaux, Jean-François ULiege; Emonds-Alt, Thibault ULiege

in ISPRM 2018 (2018, July)

Introduction/Background Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is ... [more ▼]

Introduction/Background Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications. Material and Method In a literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery. Results Analysis of the 59 studies shows that a majority use ACD-A as an anticoagulant during sampling. The best results have been obtained in studies which use no platelet activator. In terms of the speed of centrifugation, analysis of all these studies appears to confirm the existence of a great number of protocols in the literature. It is difficult to draw any conclusions when these different variables are unknown (volume of initial sample, equipment used to obtain the PRP). Although it would appear inadvisable to administer a local anesthetic Finally, it appears to be advisable to carry out infiltration under ultrasound guidance. Conclusion Our study helped identify features of PRP recommended a platelet concentration lower than 5 times the baseline (from 3 to 4), and avoiding leukocytes and erythrocytes. We recommend leveraging this information about PRP for future studies. [less ▲]

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See detailThe use of platelet-rich plasma (PRP) to treat chronic tendinopathies: a technical analysis
Kaux, Jean-François ULiege; Emonds-Alt, Thibault ULiege

in 23rd Annual Congress of the ECSS (2018, July)

Introduction: Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in ... [more ▼]

Introduction: Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications. Although highly popular with athletes, the use of PRP for the treatment of tendinopathies remains scientifically controversial, particularly due to the diversity of products that go by the name of "PRP." Purpose:To optimize its use, it is important to look at the various stages of obtaining PRP. Methods:In this literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery. Conclusion. There is a lack of standardization in PRP preparation technique for tendinopathies. However it appears that the use of a platelet concentration lower than 5 times the baseline, and avoidance of leukocytes should be preferred. [less ▲]

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See detailThe use of platelet-rich plasma (PRP) to treat chronic tendinopathies: a technical analysis
Kaux, Jean-François ULiege; Emonds-Alt, Thibault ULiege

in Abstract Book - 21st European Congress of Physical and Rehabilitation Medicine (2018, May)

Introduction: Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in ... [more ▼]

Introduction: Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications. Although highly popular with athletes, the use of PRP for the treatment of tendinopathies remains scientifically controversial, particularly due to the diversity of products that go by the name of "PRP." Purpose:To optimize its use, it is important to look at the various stages of obtaining PRP. Methods:In this literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery. Conclusion. There is a lack of standardization in PRP preparation technique for tendinopathies. However it appears that the use of a platelet concentration lower than 5 times the baseline, and avoidance of leukocytes should be preferred. [less ▲]

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See detailThe use of platelet-rich plasma to treat chronic tendinopathies: A technical analysis
Kaux, Jean-François ULiege; Emonds-Alt, Thibault ULiege

in Platelets (2018), 9(3), 213-227

Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various ... [more ▼]

Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications. Although highly popular with athletes, the use of PRP for the treatment of tendinopathies remains scientifically controversial, particularly due to the diversity of products that go by the name of “PRP.” To optimize its use, it is important to look at the various stages of obtaining PRP. In this literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery. [less ▲]

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See detailCHRONIC TENDINOPATHIES AND PLATELET-RICH PLASMA TREATMENT: HOW TO IMPROVE THE EFFICIENCY?
Kaux, Jean-François ULiege; Emonds-Alt, Thibault ULiege

in Osteoporosis International (2018, April), 29(Supplement 1), 380-381

Introduction: Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in ... [more ▼]

Introduction: Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications. Although highly popular with athletes, the use of PRP for the treatment of tendinopathies remains scientifically controversial, particularly due to the diversity of products that go by the name of “PRP”. This may partly explain the disparity of results obtained in the literature. Purpose: The objective of this study was to evaluate the similarities and differences between the variety of PRP formulations, preparation, and uses of this techniques in literature and to try to determine characteristics of the PRP which tend to give the best responses for the treatment of knee osteoarthritis. Methods: In a literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery. Results: Analysis of the 59 studies shows that a majority use ACDA as an anticoagulant during sampling. A platelet activator (calcium chloride) is only used in a few studies. However, the best results have been obtained in studies which use no platelet activator. In terms of the speed of centrifugation, analysis of all these studies appears to confirm the existence of a great number of protocols in the literature. It is difficult to draw any conclusions when these different variables are unknown (volume of initial sample, equipment used to obtain the PRP). Currently, no studies have been carried out neither on the use of a “buffer” product to neutralize the acidity caused by the anticoagulant nor on the optimal volume of PRP to be injected. Although it would appear inadvisable to administer a local anesthetic because the anesthetic may reduce the local pH and lead to the inhibition, reduction, or absence of platelet degranulation, the literature shows that the majority use a local anesthetic. They do not, however, obtain better results than those not using a local anesthetic. Finally, it appears to be advisable to carry out infiltration under ultrasound guidance, even if PRP diffusion is observed after injection. This all aims to show that there is still a need for high quality studies, with standardized collection protocols and the use of PRP in the context of tendinopathies, in order to better scientifically understand the real effectiveness. Conclusion: There is a lack of standardization in PRP preparation technique for chronic tendinopathies. However, our study helped identify features of PRP recommended a platelet concentration lower than 5 times the baseline (from 3 to 4), and avoiding leukocytes and erythrocytes. We recommend leveraging this information about PRP for future studies. [less ▲]

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See detailQuel « PRP » pour traiter les tendinopathies chroniques ?
Kaux, Jean-François ULiege; Emonds-Alt, Thibault ULiege

in Journal de Traumatologie du Sport (2017), 34(1), 76-90

Plasma rich platelets (PRP) consist of blood plasma with a high concentration of platelets autologous constituting a huge reservoir of growthfactors. The clinical use of the PRP is widespread in various ... [more ▼]

Plasma rich platelets (PRP) consist of blood plasma with a high concentration of platelets autologous constituting a huge reservoir of growthfactors. The clinical use of the PRP is widespread in various medical applications. Even it is very popular with athletes, the use of PRP intendinopathies is still scientifically discussed, particularly related to a disparity in the products called PRP. In order to optimize employment, itshould be interested in the different stages of obtaining of the PRP. In this literature review, we analyzed in particular 8 parameters that can influencethe quality of the PRP: (1) anticoagulants used to preserve the best feature of platelet; (2) centrifuge speeds used in order to extract platelets; (3)platelet concentrations and the presence of leukocytes and erythrocytes in the PRP; (4) the platelet activators for the mast of platelets and thus therelease of growth factors; (5) use of local anesthetics to achieve infiltration, in addition to these parameters, it might be interesting to analyze othervariables like: (6) employment or not of buffer to neutralize the acidity caused by anticoagulants; (7) injection under US guidance or not; and (8)volume of PRP injected to determine their influence on the healing potential. [less ▲]

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