Err.. gonna repost my PRP comment here, instead of the “tennis elbow rehab article” thread.
Didn’t know about this thread that specifically discusses PRP.
**PRP evidence**
> found a paucity of evidence from unbiased trials
Comparative Effectiveness of Injection Therapies in Lateral Epicondylitis
doi:10.1177/0363546512458237. PMID 22972856. Epub 2012 Sep 12.
> but the apparent benefit of PRP dissipates over time
Platelet-Rich Plasma as a Treatment for Patellar Tendinopathy
A Double-Blind, Randomized Controlled Trial. January 30, 2014
ajs.sagepub/com/content/early/2014/01/29/0363546513518416.abstract
**Nonbulbar dermal sheath cells**
Yahoo sports did an article a few months ago on the tendinosis (usually starts as tendinitis before becoming chronic) in soccer star Cristiano Ronaldo's patellar region/knees.
The Yahoo journalist interviewed the CEO of a Vancouver company called RepliCel.
They are working on a tendon treatment that will involve taking fibroblasts isolated from nonbulbar dermal sheath cells of a patient's own hair follicles, and injecting it into the damaged area.
sports.yahoo/com/news/cristiano-ronaldo-s-obscure-injury-could-open-door-for-u-s-031401309-soccer.html
> “Having spent much of his career researching treatments for tendinosis, Dr. Jack Taunton, professor at the University of British Columbia faculty of medicine’s CCV sports medicine division, says regenerative therapy holds great promise when dealing with chronic, long-term injuries.
> “We’ve dealt with a number of these types of injuries caused by overuse or
repetitive strain in thousands of patients.
> Typically treatments have included physiotherapy, ice, anti-inflammatory’s, dextrose and **PRP [platelet-rich plasma]** injections.
> Yet, we still have a significant population of patients that do not get better.”
> He is hopeful that the upcoming RepliCel trials will improve those numbers given that hair follicle fibroblasts produce the amount of Type 1 collagen needed for fundamental repair of the tendon.
business.financialpost/com/2014/09/09/new-technology-puts-your-own-cells-to-work-to-repair-and-rejuvenate-your-body/
PRP might have a purpose, but once you have damaged tissue, or scar tissue, I don't think that supposed increased blood circulation is going to all of a sudden convert the scar tissue (e.g. for tendons, type 3 collagen) into healthy tissue (for tendons, type 1 collagen).
>Replicel will initiate a Phase 1/2 clinical trial investigating the use of RCT-01 to treat patients suffering from chronic Achilles tendinosis.
>NBDS cells are rich in of collagen-producing dermal fibroblasts necessary for tendon healing.
>Chronic Achilles tendinosis is a degenerative disease of the tendon caused by a cycle of injury, improper healing and re-injury resulting in ongoing pain and loss of function.
>Healthy functioning tendon is comprised largely of highly structured type 1 collagen wherein resident fibroblasts play a significant role in repair and maintenance.
>In chronic tendinosis, it is believed that the resident fibroblast population is insufficient to complete the healing cycle.
>These particular fibroblasts are easily isolated and expanded and are highly expressive of type 1 collagen and other extracellular proteins which are needed to reignite the healing process and support the regeneration of tendon for patients suffering from chronic tendinosis.
Obaid, H.; Clarke, A.; Rosenfeld, P.; Leach, C.; Connell, D. (2012). "Skin-Derived Fibroblasts for the Treatment of Refractory Achilles Tendinosis: Preliminary Short-Term Results". The Journal of Bone & Joint Surgery 94 (3): 193–200. doi:10.2106/JBJS.J.00781. ISSN 0021-9355. Jbjs/org/content/94/3/193
**EchoSoft ultrasound software, and reevaluating platelet-rich plasma**
There's now a new ultrasound technology and software from the University of Wisconsin-Madison (Wisconsin Alumni Research Foundation), and Echometrix that not only uses waves for vision (conventional B-mode ultrasound), but the waves give quantitative data about functional characteristics, like stiffness (acoustoelasticity).
echo-metrix/com/products.php
It’s like looking at those heat maps on the Weather Channel.
> Called EchoSoft, that technology analyzes previously unused information carried by ultrasound waves to **quantify** the extent of muscle and ligament injuries or a patient's progress in the healing process.
> This technology applies the theory of acoustoelasticity to measure biological materials.
> “EchoSoft is the first ultrasound-based product to provide a **quantitative analysis** of ligaments, tendons, and muscles as they naturally function,’” says Sam Adams, chief executive officer of Echometrix.
> “The result is a clear, quantitative measurement that surpasses the diagnostic capabilities of a traditional ultrasound image.
New Products". Journal of Orthopaedic & Sports Physical Therapy 40 (9): 598–601. 2010. doi:10.2519/jospt.2010.40.9.598. ISSN 0190-6011.
While waiting for RepliCel, I might consider PRP for my tennis elbow (lateral epicondylitis) and wrist tendinosis if they do a proper trial with the Echosoft ultrasound software.
No subjective reporting.
I’d like to see data with numbers.