Platelet Rich Plasma in Musculoskeletal Practice

256 Pages·2016·3.095 MB·English

by  Nicola Maffulli (eds.)

Nicola Maffulli
Editor
Platelet Rich Plasma
in Musculoskeletal
Practice
123
Platelet Rich Plasma
in Musculoskeletal Practice

Nicola Maffulli
Editor
Platelet Rich Plasma
in Musculoskeletal
Practice
Editor
Nicola Maffulli
Department of Musculoskeletal Disorders
Faculty of Medicine, Surgery and Dentistry
University of Salerno
Salerno
Italy
ISBN 978-1-4471-7270-3 ISBN 978-1-4471-7271-0 (eBook)
DOI 10.1007/978-1-4471-7271-0
Library of Congress Control Number: 2016947466
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Pref ace
I n the near future, most Western countries will have to cope
with the economic implications of the demands imposed by
the growing rate of musculoskeletal ailments. Therefore, there
is a real need to develop further research and novel therapies.
Osteoarticular conditions and tendinopathies affect both the
elderly and young adults, are common, and cause severe long-
term pain and chronic impairment. These impact negatively
on the quality of life and induce sedentarism.
The problem is worsening, as there is an increased inci-
dence of the risk factors, including ageing, traumatic sports
injuries, and metabolic diseases. Morbidity and financial
costs are of great consequence. Critical progress on novel
biological interventions could meet pressing health needs,
reduce costs, and enable patients to resume an active healthy
lifestyle.
Over the past decade, the concept that chronic musculo-
skeletal conditions such as osteoarthritis and tendinopathy
are linked to deficient healing by failure of one or several of
the cellular/molecular processes involved has gained ground.
The economic and social burden of musculoskeletal disor-
ders is challenging, and biological interventions in their pres-
ent form cannot meet the clinical demand for long-lasting
treatment.
Novel technologies are making it possible to deal with the
intrinsic complexity of regenerative mechanism. However,
technologies aimed at this are still expensive and limited.
In this context, the use of platelet rich plasma (PRP) and
its derivatives is encouraging. Blood and its products are
v
vi Preface
appealing: blood contains biologically active factors, and it
is responsible for haemostasis, synthesis of new connective
tissue, and revascularization. Growth factors, and the induc-
tion of further release of growth factors, seem to improve
the healing process in chronic injuries and accelerate repair
in acute and chronic lesions. PRP can be used to enhance
articular and soft tissue healing and is often recommended
as best practice for management of musculoskeletal injuries.
T here are still many unanswered questions about the most
appropriate volume and frequency of the injections, the ideal
period between multiple injections, and the mechanism by
which the beneficial effect would be harnessed. In this con-
text, this book offers some insights in the use of PRP in this
field. It is not exhaustive and is written by enthusiasts who
have performed much research on the topic. Above all, all
the authors acknowledge that we are at the beginning of a
long road ahead of us. We still do not know why PRP works,
when it is contraindicated, and why some patients respond to
it wonderfully well, or not at all. We have to start, however,
and this is the first step.
Salerno, Italy Nicola Maffulli
London, UK
About the Editor
Nicola Maffulli Department of Musculoskeletal Disorders,
Faculty of Medicine, Surgery and Dentistry , University of
Salerno , Salerno , Italy
C entre for Sports and Exercise Medicine, B arts and London
School of Medicine and Dentistry, Queen Mary University of
London , London , UK
vii

Contents
1 Contents and Formulations of Platelet
Rich Plasma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Amy S. Wasterlain , Hillary J. Braun ,
and Jason L. Dragoo
2 Platelet-Rich Plasma in Pain Medicine . . . . . . . . . . . 31
José Fábio Santos Duarte Lana ,
Eduardo Fonseca Vicente , Adam Weglein ,
William Dias Belangero , Fabrício Dias Assis ,
and André Marques Mansano
3 PRP: Tips for Application
in the Musculoskeletal System. . . . . . . . . . . . . . . . . . . 63
Steven Sampson , Ken Mautner , Alessio Giai Via ,
and Angie Botto-van Bemden
4 PRP in Tendons and Other Non-bone Tissues . . . . . 93
Sebastiano Vasta , Rocco Papalia ,
Vincenzo Denaro , and Nicola Maffulli
5 Platelet Rich Plasma in Articular
Cartilage Lesions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Elizaveta Kon , Giuseppe Filardo ,
Berardo Di Matteo , Giulia Venieri ,
and Maurilio Marcacci
6 Platelet-Rich Plasma in Knee Osteoarthritis
in the Athlete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Mary Alexis Iaccarino and Joanne Borg-Stein
7 Platelet Rich Plasma in Foot and Ankle Surgery . . . 147
Catie Cunningham , Amit Sood , and Sheldon Lin
ix