Kale Prathamesh, Patel Hardik, Jaiswal Ankit M
Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jul 29;16(7):e65636. doi: 10.7759/cureus.65636. eCollection 2024 Jul.
Tendinopathy poses a significant clinical challenge characterized by chronic tendon pain, swelling, and impaired function, affecting athletes and the general population. Current treatments often provide limited success, necessitating exploration into regenerative therapies such as platelet-rich plasma (PRP). PRP harnesses the regenerative potential of autologous platelets and growth factors to promote tendon healing. This review aims to comprehensively examine the mechanisms, efficacy, and clinical applications of PRP in tendinopathy. We discuss the pathophysiology of tendinopathy, highlighting collagen disorganization, increased ground substance, and inflammatory changes. PRP's action mechanism involves releasing bioactive molecules that stimulate cellular proliferation, collagen synthesis, and tissue remodeling. Clinical studies and trials evaluating PRP in various tendinopathies, including Achilles, patellar, and rotator cuff tendinopathy, are reviewed to assess its efficacy and effectiveness compared to traditional therapies. Practical aspects, such as preparation methods, injection techniques, and safety considerations, are discussed to provide insights into optimal PRP administration. Challenges, including protocol variability and evidence gaps, are addressed, and future research and clinical practice directions are proposed. By synthesizing current knowledge, this review aims to guide clinicians in enhancing treatment strategies and advancing the field of tendon regenerative medicine.
肌腱病是一个重大的临床挑战,其特征为慢性肌腱疼痛、肿胀和功能受损,影响运动员和普通人群。目前的治疗方法往往效果有限,因此有必要探索诸如富血小板血浆(PRP)等再生疗法。PRP利用自体血小板和生长因子的再生潜力来促进肌腱愈合。本综述旨在全面研究PRP在肌腱病中的作用机制、疗效及临床应用。我们讨论了肌腱病的病理生理学,强调了胶原纤维紊乱、基质增加和炎症变化。PRP的作用机制包括释放生物活性分子,刺激细胞增殖、胶原合成和组织重塑。我们回顾了评估PRP在各种肌腱病(包括跟腱、髌腱和肩袖肌腱病)中的临床研究和试验,以评估其与传统疗法相比的疗效和有效性。还讨论了诸如制备方法、注射技术和安全注意事项等实际问题,以深入了解PRP的最佳应用。文中探讨了包括方案变异性和证据空白在内的挑战,并提出了未来的研究和临床实践方向。通过综合现有知识,本综述旨在指导临床医生改进治疗策略,推动肌腱再生医学领域的发展。