Which works better for osteoarthritis of the knee? Find out next…
Efficacy Of Platelet-Rich Plasma In The Treatment Of Knee Osteoarthritis: A Meta-Analysis Of Randomized Controlled Trials.
Dr. Jack Cush writing in Rheumnow reported on a large study evaluating the use of platelet rich plasma (PRP) vs other therapies. The analysis showed that at 6 months postinjection, PRP and hyaluronic acid (HA) had similar effects with respect to pain relief. At 12 months postinjection, however, PRP was associated with significantly better pain relief than HA. The researchers also noted that PRP did not increase the risk of adverse events compared with HA and saline.
Current evidence indicates that, compared with HA, intra-articular PRP injection may have more benefit in pain relief and functional improvement in patients with symptomatic knee OA at 1 year postinjection.
Comment: PRP is definitely an effective treatment modality for OIA of the knee. It must be administered via US though for best results.
The shoulder is a complex joint consisting of three bones (the scapula, the humerus, and the clavicle) and held together by an arrangement of ligaments, tendons, muscles, and bursae. Shoulder pain is a common complaint. It’s important to separate shoulder pain from referred pain coming from the neck. Most primary shoulder pain is due to degeneration occurring in the rotator cuff or biceps tendons. The term tendonitis is incorrect since there is very little inflammation. The problem is tendon degeneration. Accurate diagnosis is important. Examination with history, physical, and imaging procedures can establish the correct diagnosis. Treatment involves the use of rest, ice, physical therapy, stretching and strengthening exercises. More aggressive measures include steroid injection, needle tenotomy with platelet rich plasma, and Tenex.
Tennis elbow, also known as lateral epicondylitis, is a common form of painful tendon disorder involving the outside part of the elbow. Interestingly, very few people who suffer from tennis elbow actually play tennis.
Risk factors for tennis elbow include aging, repetitive motion, excessive load on the arm, and trauma.
The diagnosis is made by history, physical examination, and imaging procedures such as magnetic resonance imaging and diagnostic ultrasound.
The treatment for this disorder consists of physical therapy, stretching and strengthening exercises, nonsteroidal anti-inflammatory drugs, a tennis elbow band, and avoidance of those activities that brought the disorder on in the first place.
Extracorporeal shock wave therapy has shown some promise. The treatment of choice today is platelet rich plasma, and ultra concentrate of blood, that contains a large number of platelets. Platelets are cells that are packed with growth and healing factors. Platelet rich plasma is administered using ultrasound guidance. A more recent treatment is Tenex. This is the device that uses at an oscillating needle along with irrigation and suction to vacuum out debris. This also uses ultrasound guidance. At our institution. We use a combination of 10 ask and platelet rich plasma with excellent results. I want to stress that cortisone should not be used for tennis elbow. While it may provide short-term relief, it causes long-term tendon degeneration.
PRP Injections Help Young Athletes With UCL Tears.
John Gever writing in MedPage Today reports, “Young athletes with torn elbow ligaments, where rest and physical therapy were ineffective, quickly returned to play after receiving platelet-rich plasma (PRP) injections, a researcher said” during “the American Orthopaedic Society for Sports Medicine’s Specialty Day, part of the American Academy of Orthopaedic Surgeons’ annual meeting.” Researcher Scott Crow, MD found that “16 of 17 teenage and young adult patients with partial ulnar collateral ligament (UCL) tears were able to return to regular play within 15 weeks of receiving PRP injection.”