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lobelsteve said:
Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
Click to expand...

Ditto for steroids.
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no offense, but this is a position paper, not a study.

its a bunch of guys getting on their soapbox.

and btw,

"While this study is a step in the right direction, numerous other factors remain elusive and warrant comprehensive investigation. Different PRP compositions, absolute platelet counts as one important factor, and many other physiological and demographic variables will influence effectiveness.

Ultimately, the definition of PRP, whether leukocyte rich or poor, whether it should be activated or not, how often it should be injected, the ideal dose and how it should be prepared remains elusive. "
 
lobelsteve said:
Yet, aspects like the definition of PRP, whether activation is necessary, the frequency of injections, the optimal dosage, and the preparation method remain unclear.
Click to expand...

Ditto for steroids.
Ducttape said:
no offense, but this is a position paper, not a study.

its a bunch of guys getting on their soapbox.

and btw,

"While this study is a step in the right direction, numerous other factors remain elusive and warrant comprehensive investigation. Different PRP compositions, absolute platelet counts as one important factor, and many other physiological and demographic variables will influence effectiveness.

Ultimately, the definition of PRP, whether leukocyte rich or poor, whether it should be activated or not, how often it should be injected, the ideal dose and how it should be prepared remains elusive. "
Click to expand...

That's how science works. There is no Truth with a capital T. Just what we agree it is.
 
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Any good training courses come up this year?
 
on how to spin blood and make into a pin cushion?
 
Agast said:
He’s a total hack!

Jk

What happened to the ARMI course? @oreosandsake
Click to expand...

re-structuring...

new teachers and leaders, also focus on traditional orthopedic surgery and the overlap between what we can do with our Interventional pain skillset. added some new talent to the leadership including Ariana DeMers the former IOF president
 
oreosandsake said:
re-structuring...

new teachers and leaders, also focus on traditional orthopedic surgery and the overlap between what we can do with our Interventional pain skillset. added some new talent to the leadership including Ariana DeMers the former IOF president
Click to expand...

DeMers is good.
 
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Not sure if this was posted already……

www.mdpi.com

Angiogenesis and Tissue Repair Depend on Platelet Dosing and Bioformulation Strategies Following Orthobiological Platelet-Rich Plasma Procedures: A Narrative Review

Angiogenesis is the formation of new blood vessel from existing vessels and is a critical first step in tissue repair following chronic disturbances in healing and degenerative tissues. Chronic pathoanatomic tissues are characterized by a high number of inflammatory cells; an overexpression of...
www.mdpi.com www.mdpi.com
 
BMC Musculoskelet Disord. 2024 May 18;25(1):392.
doi: 10.1186/s12891-024-07519-6.

Percutaneous bone marrow concentrate and platelet products versus exercise therapy for the treatment of rotator cuff tears: a randomized controlled, crossover trial with 2-year follow-up​

Christopher J Centeno 1 2, Zachary Fausel 2, Ehren Dodson 3, Dustin R Berger 2, Neven J Steinmetz 2
Affiliations expand

Abstract​

Background: Surgical repair is recommended for the treatment of high-grade partial and full thickness rotator cuff tears, although evidence shows surgery is not necessarily superior to non-surgical therapy. The purpose of this study was to compare percutaneous orthobiologic treatment to a home exercise therapy program for supraspinatus tears.

Methods: In this randomized-controlled, crossover design, participants with a torn supraspinatus tendon received either 'BMC treatment', consisting of a combination of autologous bone marrow concentrate (BMC) and platelet products, or underwent a home exercise therapy program. After three months, patients randomized to exercise therapy could crossover to receive BMC treatment if not satisfied with shoulder progression. Patient-reported outcomes of Numeric Pain Scale (NPS), Disabilities of the Arm, Shoulder, and Hand, (DASH), and a modified Single Assessment Numeric Evaluation (SANE) were collected at 1, 3, 6, 12, and 24 months. Pre- and post-treatment MRI were assessed using the Snyder Classification system.

Results: Fifty-one patients were enrolled and randomized to the BMC treatment group (n = 34) or the exercise therapy group (n = 17). Significantly greater improvement in median ΔDASH, ΔNPS, and SANE scores were reported by the BMC treatment group compared to the exercise therapy group (-11.7 vs -3.8, P = 0.01; -2.0 vs 0.5, P = 0.004; and 50.0 vs 0.0, P < 0.001; respectively) after three months. Patient-reported outcomes continued to progress through the study's two-year follow-up period without a serious adverse event. Of patients with both pre- and post-treatment MRIs, a majority (73%) showed evidence of healing post-BMC treatment.

Conclusions: Patients reported significantly greater changes in function, pain, and overall improvement following BMC treatment compared to exercise therapy for high grade partial and full thickness supraspinatus tears.

Trial registration: This protocol was registered with www.

Clinicaltrials: gov (NCT01788683; 11/02/2013).

Keywords: Autologous orthobiologics; Bone marrow concentrate (BMC); Cell therapy; Exercise therapy; Musculoskeletal pain; Platelet-rich plasma (PRP); Rotator cuff tears; Shoulder.
© 2024. The Author(s).

1716219278304.png


  • BMC Treatment provided better outcomes compared to exercise therapy in terms of shoulder function, pain reduction, and overall improvement, especially at the 3-month follow-up.
  • Long-term Improvements: BMC treatment led to continued improvements in shoulder function and pain relief up to 24 months, while the exercise group did not show significant long-term benefits.
  • Statistical Significance: The improvements in the BMC group were statistically significant for all measured outcomes at the 3-month follow-up, highlighting BMC as a more effective treatment for shoulder injuries compared to exercise therapy.
 
Last edited:
Orthop J Sports Med. 2024 May 14;12(5):23259671241249123.
doi: 10.1177/23259671241249123. eCollection 2024 May.

Ultrasound-Guided Subfascial Platelet-Rich Plasma Injections Versus Enthesis Needling for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial​

Leire Atilano 1 2, Nerea Martin 1 3, Jose Ignacio Martin 1 2, Gotzon Iglesias 1 2, Josu Mendiola 1 2, Paola Bully 4, Ayoola Aiyegbusi 5, Jose Manuel Rodriguez-Palomo 1 3, Isabel Andia 1
Affiliations expand

Abstract​

Background: Greater trochanteric pain syndrome (GTPS) is characterized by gluteal enthesopathy involving the peritrochanteric space and associated with chronic pain and functional impairment. A corticosteroid injection in the trochanteric bursa is the usual palliative treatment for pain. However, it is important to investigate treatment options that will relieve pain in the peritrochanteric space.

Purpose: To compare the clinical efficacy of subfascial platelet-rich plasma (PRP) injection and enthesis needling for GTPS.

Study design: Randomized controlled trial; Level of evidence, 1

Methods: A total of 92 patients (90% women; mean age, 55 years old; mean body mass index, 25.3 kg/m2) were randomly divided into a subfascial PRP injection group and an enthesis needling group. Descriptive data and radiographic measurements of the pelvis-including leg-length difference, pelvic width difference, and pelvic trochanteric index-were recorded. The primary outcome measures were the Hip Outcome Score (HOS) activities of daily living (HOS-ADL) and sports-specific (HOS-SS) subscales and the visual analog scale for pain at 3, 6, and 12 months posttreatment. In addition, we evaluated the presence or absence of ultrasound characteristics (fascia nodules, trochanteric bursa distension, and calcium deposits) over time in response to treatment.

Results: Baseline demographic and radiological characteristics were similar between the groups. The PRP group saw significantly greater improvement from baseline to 12 months posttreatment on the HOS-SS subscore compared with the needling group (32.09 [95% CI, 28.99-40.20] vs 20.52 [95% CI, 11.99-29.05]; P = .048). At 3 months, 60% of patients in the PRP group versus 33.3% in the needling group had a reduction in pain compared with a baseline of >20% (P = .040). After subfascial PRP injection, fewer patients had a fascia nodule over the trochanter and/or bursa distension (P = .006 and P = .004, respectively). The pelvic trochanteric index was predictive of HOS-ADL and HOS-SS outcomes (P = .011 and P = .022, respectively). The interaction between treatment modality and fascia nodule influenced HOS-ADL and HOS-SS outcomes (P = .021 and P = .023) as well as the interactions of treatment modality, fascia nodules, and calcifications (P = .027).

Conclusion: Both subfascial PRP injection and enthesis needling resulted in clinical improvements, but the improvement in the HOS-SS was greater in the PRP group.

Registration: NCT04231357 (ClinicalTrials.gov identifier).

Keywords: enthesis needling; fascia; gluteal tendons; greater trochanteric pain syndrome; platelet-rich plasma; ultrasound.

1716224761432.png


  • PRP treatment generally led to better improvements in daily living activities and sports-specific functions compared to dry needling, especially noticeable at the 12-month mark.
  • Pain reduction was similar between both groups at 6 and 12 months, but PRP showed a greater reduction at the 3-month follow-up.
  • Significance: The improvements in the PRP group were statistically significant for the sports-specific function at 12 months, highlighting PRP as a more effective treatment in this area.
Overall, PRP treatment provided better outcomes in terms of function and pain reduction, particularly over a longer period (12 months).
 
drusso said:
Orthop J Sports Med. 2024 May 14;12(5):23259671241249123.
doi: 10.1177/23259671241249123. eCollection 2024 May.

Ultrasound-Guided Subfascial Platelet-Rich Plasma Injections Versus Enthesis Needling for Greater Trochanteric Pain Syndrome: A Randomized Controlled Trial​

Leire Atilano 1 2, Nerea Martin 1 3, Jose Ignacio Martin 1 2, Gotzon Iglesias 1 2, Josu Mendiola 1 2, Paola Bully 4, Ayoola Aiyegbusi 5, Jose Manuel Rodriguez-Palomo 1 3, Isabel Andia 1
Affiliations expand

Abstract​

Background: Greater trochanteric pain syndrome (GTPS) is characterized by gluteal enthesopathy involving the peritrochanteric space and associated with chronic pain and functional impairment. A corticosteroid injection in the trochanteric bursa is the usual palliative treatment for pain. However, it is important to investigate treatment options that will relieve pain in the peritrochanteric space.

Purpose: To compare the clinical efficacy of subfascial platelet-rich plasma (PRP) injection and enthesis needling for GTPS.

Study design: Randomized controlled trial; Level of evidence, 1

Methods: A total of 92 patients (90% women; mean age, 55 years old; mean body mass index, 25.3 kg/m2) were randomly divided into a subfascial PRP injection group and an enthesis needling group. Descriptive data and radiographic measurements of the pelvis-including leg-length difference, pelvic width difference, and pelvic trochanteric index-were recorded. The primary outcome measures were the Hip Outcome Score (HOS) activities of daily living (HOS-ADL) and sports-specific (HOS-SS) subscales and the visual analog scale for pain at 3, 6, and 12 months posttreatment. In addition, we evaluated the presence or absence of ultrasound characteristics (fascia nodules, trochanteric bursa distension, and calcium deposits) over time in response to treatment.

Results: Baseline demographic and radiological characteristics were similar between the groups. The PRP group saw significantly greater improvement from baseline to 12 months posttreatment on the HOS-SS subscore compared with the needling group (32.09 [95% CI, 28.99-40.20] vs 20.52 [95% CI, 11.99-29.05]; P = .048). At 3 months, 60% of patients in the PRP group versus 33.3% in the needling group had a reduction in pain compared with a baseline of >20% (P = .040). After subfascial PRP injection, fewer patients had a fascia nodule over the trochanter and/or bursa distension (P = .006 and P = .004, respectively). The pelvic trochanteric index was predictive of HOS-ADL and HOS-SS outcomes (P = .011 and P = .022, respectively). The interaction between treatment modality and fascia nodule influenced HOS-ADL and HOS-SS outcomes (P = .021 and P = .023) as well as the interactions of treatment modality, fascia nodules, and calcifications (P = .027).

Conclusion: Both subfascial PRP injection and enthesis needling resulted in clinical improvements, but the improvement in the HOS-SS was greater in the PRP group.

Registration: NCT04231357 (ClinicalTrials.gov identifier).

Keywords: enthesis needling; fascia; gluteal tendons; greater trochanteric pain syndrome; platelet-rich plasma; ultrasound.

View attachment 386992

  • PRP treatment generally led to better improvements in daily living activities and sports-specific functions compared to dry needling, especially noticeable at the 12-month mark.
  • Pain reduction was similar between both groups at 6 and 12 months, but PRP showed a greater reduction at the 3-month follow-up.
  • Significance: The improvements in the PRP group were statistically significant for the sports-specific function at 12 months, highlighting PRP as a more effective treatment in this area.
Overall, PRP treatment provided better outcomes in terms of function and pain reduction, particularly over a longer period (12 months).
Click to expand...
Highlights failure to do better with VAS and HOS-ADL scores. But 1/3 ain't bad in baseball.
 
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