استفاده از پلاسمای خون در تسریع روند بهبود ورزشکاران پس از جراحی

محورهای موضوعی : پلاسما و خون شناسی

دانیال تارمست ^{1 *} , اردشیر ظفری ²

1 - گروه تربیت بدنی و علوم ورزشی، دانشکده علوم انسانی، واحد پرند، دانشگاه آزاد اسلامی، پرند، تهران، ایران.
2 - استادیار فیزیولوژی ورزش، گروه علوم ورزشی، دانشکده علوم انسانی و هنر، واحد زنجان، دانشگاه آزاد اسلامی، زنجان، ایران.

تاریخ دریافت : 1403/06/23 تاریخ پذیرش : 1403/08/14 تاریخ انتشار : 1403/09/24

کلید واژه: پلاسما, پلاکت, PRP, بازسازی بافت, تسریع بهبود در ورزشکاران, آسیب دیدگی ورزشی, جراحی,

چکیده مقاله :

پلاسمای غنی از پلاکت (Platelet-rich plasma-PRP) به عنوان یک روش نوین در پزشکی بازساختی، به ویژه در بهبود بافت‌های آسیب‌دیده در ورزشکاران، مورد توجه بسیاری از محققان و متخصصان قرار گرفته است. در این روش بالینی، که از خون خود بیمار استفاده می‌شود، و حاوی تراکم بالایی از پلاکت‌ها و فاکتورهای رشد است، می‌تواند فرآیندهای ترمیمی را در بافت‌های مختلف تحریک کرده و بهبود زخم‌ها و آسیب‌های ناشی از جراحی را تسریع کند. در روش تهیه PRP به دلیل ویژگی‌های کم‌تهاجمی و ایمنی بالا، به سرعت در میان ورزشکاران حرفه‌ای و آماتور محبوبیت یافته است. در دنیای ورزش حرفه‌ای، آسیب‌های فیزیکی ناشی از تمرینات و رقابت‌های شدید به‌طور مکرر رخ می‌دهد، و استفاده از PRP به عنوان یک ابزار کمکی در جراحی‌های بازسازی‌کننده، نقش مهمی در تسریع بهبود و بازگشت ورزشکاران به میادین ورزشی ایفا کرده است. مقاله حاضر به بررسی کاربردهای مختلف PRP در درمان آسیب‌های رایج ورزشی، نظیر تاندونوپاتی، پارگی رباط‌ها، و آسیب‌های عضلانی و استخوانی می‌پردازد. برای مثال، PRP در درمان تاندونوپاتی آشیل که در میان دوندگان و فوتبالیست‌ها شایع است، نشان داده که می‌تواند فرآیند ترمیم تاندون را تسریع کرده، و زمان بازگشت به تمرینات و مسابقات را کاهش دهد. همچنین، در جراحی‌های بازسازی رباط صلیبی قدامی به عنوان یک درمان مکمل، PRP به بهبود سریع‌تر و کاهش التهاب پس از عمل کمک کرده و بازگشت سریع ورزشکاران به فعالیت‌های ورزشی را تسهیل می‌کند. علاوه بر این، PRP در درمان آسیب‌های عضلانی نظیر پارگی عضلات همسترینگ، که در میان دوندگان و بازیکنان فوتبال رایج است، مؤثر بوده و با تحریک فرآیندهای بازسازی سلولی، زمان بهبود را کاهش داده و خطر عود مجدد آسیب را کم کرده است. همچنین، در درمان شکستگی که در ورزشکاران دو استقامت و ورزش‌های برخوردی شایع است، با تسریع جوش‌خوردگی استخوان، و بازگشت به تمرینات را امکان‌پذیر کرده است.

چکیده انگلیسی:

Platelet-rich plasma (PRP) has emerged as an innovative method in regenerative medicine, garnering significant interest from academics and experts, especially for its efficacy in repairing injured tissues in sports. In this medical procedure, utilizing the patient's autologous blood enriched with a high concentration of platelets and growth factors can accelerate post-surgical incision and injury recovery while stimulating reparative processes across diverse tissue types. Professional and amateur athletes have rapidly adopted PRP due to its minimally invasive nature and exceptional safety profile. Physical injuries resulting from rigorous training and competition are prevalent in professional sports. The PRP has emerged as a valuable instrument in reconstructive procedures, potentially expediting recuperation and facilitating athletes' return to the field.

This review examines the diverse uses of PRP in treating prevalent sports injuries, encompassing tendinopathies, ligament tears, and muscle and bone injuries. For instance, PRP has demonstrated potential in treating Achilles tendinopathy, a condition frequently observed in runners and soccer players. The RPR benefits are achieved by expediting the regeneration of the tendon and significantly reducing the time required to resume training and competition. During ACL reconstruction procedures, PRP has been employed as an adjuvant treatment to expedite recovery and alleviate postoperative inflammation, thereby enabling a prompt return to athletic activities. Furthermore, PRP has successfully treated muscle injuries, including hamstring strains, which are prevalent among runners and football players. These outcomes are attained through promoting tissue regeneration processes, minimizing reinjury risk, and reducing recovery duration. PRP has exhibited efficacy in treating stress fractures, common among endurance runners and contact sports athletes. Its application accelerates bone healing, facilitating a prompt return to training.

 

منابع و مأخذ:

1. Mishra A, Harmon K, Woodall J, Vieira A. Sports medicine applications of platelet rich plasma. Curr Pharm Biotechnol. 2012;13(7):1185-95.
2. Tarmast D. The Critical Role of Nutrition in Acceleration of the Rehabilitation Process in Athletes. Journal of Physiology of Training and Sports Injuries. 2024;2(1):29-39.
3. Raum G, Kenyon C, Bowers R. Platelet-Poor versus Platelet-Rich Plasma for the Treatment of Muscle Injuries. Curr Sports Med Rep. 2024;23(6):222-8.
4. Sourugeon Y, Yonai Y, Berkovich Y, Laver L. Platelet-Rich Plasma Treatment for Muscle Injuries. Musculoskeletal Injections Manual: Basics, Techniques and Injectable Agents. 2024:99-104.
5. Paichitrojjana A, Paichitrojjana A. Platelet Rich Plasma and Its Use in Hair Regrowth: A Review. Drug Des Devel Ther. 2022;16:635-45.
6. Zaki SN, Mardyansyah, Oktarina C, Purwoko RY, Sutanto HU. Platelet-Rich Plasma for the Treatment of Atopic Dermatitis: A Literature Review. J Clin Aesthet Dermatol. 2024;17(7):43-9.
7. Xu J, Gou L, Zhang P, Li H, Qiu S. Platelet-rich plasma and regenerative dentistry. Aust Dent J. 2020;65(2):131-42.
8. Kon E, Filardo G, Di Martino A, Marcacci M. Platelet-rich plasma (PRP) to treat sports injuries: evidence to support its use. Knee Surg Sports Traumatol Arthrosc. 2011;19(4):516-27.
9. Marques LF, Stessuk T, Camargo IC, Sabeh Junior N, dos Santos L, Ribeiro-Paes JT. Platelet-rich plasma (PRP): methodological aspects and clinical applications. Platelets. 2015;26(2):101-13.
10. Tarmast D, Ghosh AK. The Impact of Carbohydrate, Protein, and Combined Carbohydrate-Protein Supplementation on Muscle Damage and Oxidative Stress Markers During Prolonged Cycling Performance in the Heat. Asian Journal of Sports Medicine. 2024;15(2):e144084.
11. Zhu T, Zhou J, Hwang J, Xu X. Effects of Platelet-Rich Plasma on Clinical Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Orthop J Sports Med. 2022;10(1):23259671211061535.
12. Flury M, Rickenbacher D, Schwyzer HK, Jung C, Schneider MM, Stahnke K, et al. Does Pure Platelet-Rich Plasma Affect Postoperative Clinical Outcomes After Arthroscopic Rotator Cuff Repair? A Randomized Controlled Trial. Am J Sports Med. 2016;44(8):2136-46.
13. Manso BA, Rodriguez YBA, Forsberg EC. From Hematopoietic Stem Cells to Platelets: Unifying Differentiation Pathways Identified by Lineage Tracing Mouse Models. Cells. 2024;13(8):704.
14. Malara A, Abbonante V, Zingariello M, Migliaccio A, Balduini A. Megakaryocyte Contribution to Bone Marrow Fibrosis: many Arrows in the Quiver. Mediterr J Hematol Infect Dis. 2018;10(1):e2018068.
15. Psaila B, Lyden D, Roberts I. Megakaryocytes, malignancy and bone marrow vascular niches. J Thromb Haemost. 2012;10(2):177-88.
16. Bates DO, Beazley-Long N, Benest AV, Ye X, Ved N, Hulse RP, et al. Physiological Role of Vascular Endothelial Growth Factors as Homeostatic Regulators. Compr Physiol. 2018;8(3):955-79.
17. Barrientos S, Stojadinovic O, Golinko MS, Brem H, Tomic-Canic M. Growth factors and cytokines in wound healing. Wound Repair Regen. 2008;16(5):585-601.
18. Wee P, Wang Z. Epidermal Growth Factor Receptor Cell Proliferation Signaling Pathways. Cancers (Basel). 2017;9(5):52.
19. Farooq M, Khan AW, Kim MS, Choi S. The Role of Fibroblast Growth Factor (FGF) Signaling in Tissue Repair and Regeneration. Cells. 2021;10(11):3242.
20. Creaney L, Hamilton B. Growth factor delivery methods in the management of sports injuries: the state of play. Br J Sports Med. 2008;42(5):314-20.
21. Andia I, Martin JI, Maffulli N. Advances with platelet rich plasma therapies for tendon regeneration. Expert Opin Biol Ther. 2018;18(4):389-98.
22. Andia I, Maffulli N. Muscle and tendon injuries: the role of biological interventions to promote and assist healing and recovery. Arthroscopy. 2015;31(5):999-1015.
23. Maffulli N, Longo UG, Kadakia A, Spiezia F. Achilles tendinopathy. Foot Ankle Surg. 2020;26(3):240-9.
24. Patil P, Jadhav M, Suvvari TK, Thomas V. Therapeutic uses of platelet-rich plasma (PRP) in sport injuries – A narrative review. Journal of Orthopaedic Reports. 2024;3(2):100287.
25. Yuan T, Zhang CQ, Wang JH. Augmenting tendon and ligament repair with platelet-rich plasma (PRP). Muscles Ligaments Tendons J. 2013;3(3):139-49.
26. Laver L, Solis GS, Gilat R, García-Balletbó M, Lopez-Vidriero E, Cole B, et al. The Role of Orthobiologics for the Management of Ligament and Muscle Injuries in Sports. In: Laver L, Kocaoglu B, Cole B, Arundale AJH, Bytomski J, Amendola A, editors. Basketball Sports Medicine and Science. Berlin, Heidelberg: Springer Berlin Heidelberg; 2020. p. 587-603.
27. Barastegui D, Alentorn-Geli E, Gotecha D, Rius M, Navarro J, Cusco X, et al. Treatment of Partial Posterior Cruciate Ligament Injuries with Platelet-Rich Plasma in Growth Factors (PRGF) Intraligamentous Infiltration and a Specific Knee Brace. Surg J (N Y). 2021;7(1):e30-e4.
28. Jordan M, Spörri J, Taylor J. Injury Prevention and Rehabilitation. In: Pritchard J, Taylor J, editors. The Science of Alpine Ski Racing: Routledge; 2022. p. 113-53.
29. Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther. 2010;40(2):67-81.
30. Herdea A, Struta A, Derihaci RP, Ulici A, Costache A, Furtunescu F, et al. Efficiency of platelet-rich plasma therapy for healing sports injuries in young athletes. Exp Ther Med. 2022;23(3):215.
31. Nguyen RT, Borg-Stein J, McInnis K. Applications of platelet-rich plasma in musculoskeletal and sports medicine: an evidence-based approach. PM R. 2011;3(3):226-50.
32. Weibrich G, Kleis WK, Hafner G. Growth factor levels in the platelet-rich plasma produced by 2 different methods: curasan-type PRP kit versus PCCS PRP system. Int J Oral Maxillofac Implants. 2002;17(2):184-90.
33. Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489-96.
34. Bava ED, Barber FA. Platelet-rich plasma products in sports medicine. Phys Sportsmed. 2011;39(3):94-9.
35. Yu H, Habibi M, Motamedi K, Semirumi DT, Ghorbani A. Utilizing stem cells in reconstructive treatments for sports injuries: An innovative approach. Tissue Cell. 2023;83:102152.
36. Boivin J, Tolsma R, Awad P, Kenter K, Li Y. The Biological Use of Platelet-Rich Plasma in Skeletal Muscle Injury and Repair. Am J Sports Med. 2023;51(5):1347-55.
37. Andia I, Sanchez M, Maffulli N. Tendon healing and platelet-rich plasma therapies. Expert Opin Biol Ther. 2010;10(10):1415-26.
38. Padilla S, Sanchez M, Vaquerizo V, Malanga GA, Fiz N, Azofra J, et al. Platelet-Rich Plasma Applications for Achilles Tendon Repair: A Bridge between Biology and Surgery. Int J Mol Sci. 2021;22(2):824.
39. Le ADK, Enweze L, DeBaun MR, Dragoo JL. Current Clinical Recommendations for Use of Platelet-Rich Plasma. Curr Rev Musculoskelet Med. 2018;11(4):624-34.
40. Laver L, Carmont MR, McConkey MO, Palmanovich E, Yaacobi E, Mann G, et al. Plasma rich in growth factors (PRGF) as a treatment for high ankle sprain in elite athletes: a randomized control trial. Knee Surg Sports Traumatol Arthrosc. 2015;23(11):3383-92.
41. Cavallo C, Roffi A, Grigolo B, Mariani E, Pratelli L, Merli G, et al. Platelet-Rich Plasma: The Choice of Activation Method Affects the Release of Bioactive Molecules. Biomed Res Int. 2016;2016(1):6591717.
42. Patel H, Pundkar A, Shrivastava S, Chandanwale R, Jaiswal AM. A Comprehensive Review on Platelet-Rich Plasma Activation: A Key Player in Accelerating Skin Wound Healing. Cureus. 2023;15(11):e48943.
43. Asker M, Whiteley R. Rehabilitation and Return to Sports After Shoulder Injuries. Orthopaedic Sports Medicine: Springer; 2024. p. 1-23.
44. Murrell WD, Tulpule S, Yurdi NA, Ezekwesili A, Maffulli N, Malanga GA. Orthobiologics for the Treatment of Tennis Elbow. Orthobiologics: Injectable Therapies for the Musculoskeletal System. 2022:191-204.
45. Wong JRY, Toth E, Rajesparan K, Rashid A. The use of platelet-rich plasma therapy in treating tennis elbow: A critical review of randomised control trials. J Clin Orthop Trauma. 2022;32:101965.
46. Miller TL, Kaeding CC, Rodeo SA. Emerging Options for Biologic Enhancement of Stress Fracture Healing in Athletes. J Am Acad Orthop Surg. 2020;28(1):1-9.
47. Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, et al. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med. 2016;44(6):1502-7.
48. Nessler T, Denney L, Sampley J. ACL Injury Prevention: What Does Research Tell Us? Curr Rev Musculoskelet Med. 2017;10(3):281-8.
49. Thomas AC, Villwock M, Wojtys EM, Palmieri-Smith RM. Lower extremity muscle strength after anterior cruciate ligament injury and reconstruction. J Athl Train. 2013;48(5):610-20.
50. Fleming BC, Spindler KP, Palmer MP, Magarian EM, Murray MM. Collagen-platelet composites improve the biomechanical properties of healing anterior cruciate ligament grafts in a porcine model. Am J Sports Med. 2009;37(8):1554-63.
51. Radice F, Yanez R, Gutierrez V, Rosales J, Pinedo M, Coda S. Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy. 2010;26(1):50-7.
52. Lopez-Vidriero E, Olive-Vilas R, Lopez-Capape D, Varela-Sende L, Lopez-Vidriero R, Til-Perez L. Efficacy and Tolerability of Progen, a Nutritional Supplement Based on Innovative Plasma Proteins, in ACL Reconstruction: A Multicenter Randomized Controlled Trial. Orthop J Sports Med. 2019;7(2):2325967119827237.
53. Cervellin M, de Girolamo L, Bait C, Denti M, Volpi P. Autologous platelet-rich plasma gel to reduce donor-site morbidity after patellar tendon graft harvesting for anterior cruciate ligament reconstruction: a randomized, controlled clinical study. Knee Surg Sports Traumatol Arthrosc. 2012;20(1):114-20.
54. Rupreht M, Jevtic V, Sersa I, Vogrin M, Jevsek M. Evaluation of the tibial tunnel after intraoperatively administered platelet-rich plasma gel during anterior cruciate ligament reconstruction using diffusion weighted and dynamic contrast-enhanced MRI. J Magn Reson Imaging. 2013;37(4):928-35.
55. Vogrin M, Rupreht M, Dinevski D, Haspl M, Kuhta M, Jevsek M, et al. Effects of a platelet gel on early graft revascularization after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind, clinical trial. Eur Surg Res. 2010;45(2):77-85.
56. Seijas R, Ares O, Catala J, Alvarez-Diaz P, Cusco X, Cugat R. Magnetic resonance imaging evaluation of patellar tendon graft remodelling after anterior cruciate ligament reconstruction with or without platelet-rich plasma. J Orthop Surg (Hong Kong). 2013;21(1):10-4.
57. Chen W, Cloosterman KLA, Bierma-Zeinstra SMA, van Middelkoop M, de Vos RJ. Epidemiology of insertional and midportion Achilles tendinopathy in runners: A prospective cohort study. J Sport Health Sci. 2024;13(2):256-63.
58. Fares MY, Khachfe HH, Salhab HA, Zbib J, Fares Y, Fares J. Achilles tendinopathy: Exploring injury characteristics and current treatment modalities. Foot (Edinb). 2021;46:101715.
59. Arthur Vithran DT, Xie W, Opoku M, Essien AE, He M, Li Y. The Efficacy of Platelet-Rich Plasma Injection Therapy in the Treatment of Patients with Achilles Tendinopathy: A Systematic Review and Meta-Analysis. J Clin Med. 2023;12(3):995.
60. Weller CD, Gardiner EE, Arthur JF, Southey M, Andrews RK. Autologous platelet-rich plasma for healing chronic venous leg ulcers: Clinical efficacy and potential mechanisms. Int Wound J. 2019;16(3):788-92.
61. Gentile P, Calabrese C, De Angelis B, Dionisi L, Pizzicannella J, Kothari A, et al. Impact of the Different Preparation Methods to Obtain Autologous Non-Activated Platelet-Rich Plasma (A-PRP) and Activated Platelet-Rich Plasma (AA-PRP) in Plastic Surgery: Wound Healing and Hair Regrowth Evaluation. Int J Mol Sci. 2020;21(2):431.
62. Uzun H, Bitik O, Uzun O, Ersoy US, Aktas E. Platelet-rich plasma versus corticosteroid injections for carpal tunnel syndrome. J Plast Surg Hand Surg. 2017;51(5):301-5.
63. Wu YT, Ho TY, Chou YC, Ke MJ, Li TY, Huang GS, et al. Six-month efficacy of platelet-rich plasma for carpal tunnel syndrome: A prospective randomized, single-blind controlled trial. Sci Rep. 2017;7(1):94.
64. Desouza C, Dubey R, Shetty V. Platelet-rich plasma in chronic Achilles tendinopathy. Eur J Orthop Surg Traumatol. 2023;33(8):3255-65.
65. Silbernagel KG, Hanlon S, Sprague A. Current Clinical Concepts: Conservative Management of Achilles Tendinopathy. J Athl Train. 2020;55(5):438-47.
66. Abate M, Di Carlo L, Salini V. To evaluate the outcomes of PRP treatment in Achilles tendinopathy: An intriguing methodological problem. Orthop Traumatol Surg Res. 2021;107(6):102787.
67. Gaweda K, Tarczynska M, Krzyzanowski W. Treatment of Achilles tendinopathy with platelet-rich plasma. Int J Sports Med. 2010;31(8):577-83.
68. Filardo G, Kon E, Di Matteo B, Di Martino A, Tesei G, Pelotti P, et al. Platelet-rich plasma injections for the treatment of refractory Achilles tendinopathy: results at 4 years. Blood Transfus. 2014;12(4):533-40.
69. Iacono V, Natali S, De Berardinis L, Screpis D, Gigante AP, Zorzi C. Return to Sports and Functional Outcomes after Autologous Platelet-Rich Fibrin Matrix (PRFM) and Debridement in Midportion Achilles Tendinopathy: A Case Series with 24-Month Follow-Up. J Clin Med. 2023;12(7):2747.
70. Civitarese D, Downing M, Bazzi M, Flanagan G, Rothenberg J. Platelet-rich Plasma Injection for the Treatment of Partial Achilles Tendon Rupture: A Case Report. Medical Research Archives. 2024;12(1).
71. Karjalainen TV, Silagy M, O'Bryan E, Johnston RV, Cyril S, Buchbinder R. Autologous blood and platelet-rich plasma injection therapy for lateral elbow pain. Cochrane Database Syst Rev. 2021;9(9):CD010951.
72. Yanai K, Tajika T, Arisawa S, Hatori Y, Honda A, Hasegawa S, et al. Prevalence and factors associated with lateral epicondylitis among hospital healthcare workers. JSES Int. 2024;8(3):582-7.
73. Karabinov V, Georgiev GP. Lateral epicondylitis: New trends and challenges in treatment. World J Orthop. 2022;13(4):354-64.
74. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006;34(11):1774-8.
75. Fearon AM, Grimaldi A, Mellor R, Nasser AM, Fitzpatrick J, Ladurner A, et al. ICON 2020-International Scientific Tendinopathy Symposium Consensus: the development of a core outcome set for gluteal tendinopathy. Br J Sports Med. 2024;58(5):245-54.
76. da Silva RT, Heidrich F. Therapy with use of platelet-rich plasma in orthopedics and sports traumatology: Literature review, evidence and personal experience. Platelet-Rich Plasma: Regenerative Medicine: Sports Medicine, Orthopedic, and Recovery of Musculoskeletal Injuries. 2013:153-70.
77. Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010;38(2):255-62.
78. Kim CH, Park YB, Lee JS, Jung HS. Platelet-rich plasma injection vs. operative treatment for lateral elbow tendinosis: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2022;31(2):428-36.
79. Andia I, Sanchez M, Maffulli N. Platelet rich plasma therapies for sports muscle injuries: any evidence behind clinical practice? Expert Opin Biol Ther. 2011;11(4):509-18.
80. Hollabaugh WL, Sin A, Walden RL, Weaver JS, Porras LP, LeClere LE, et al. Outcomes of Activity-Related Lower Extremity Muscle Tears After Application of the British Athletics Muscle Injury Classification: A Systematic Review. Sports Health. 2024;16(5):783-96.
81. Hammond JW, Hinton RY, Curl LA, Muriel JM, Lovering RM. Use of autologous platelet-rich plasma to treat muscle strain injuries. Am J Sports Med. 2009;37(6):1135-42.
82. Bigham-Sadegh A, Oryan A. Basic concepts regarding fracture healing and the current options and future directions in managing bone fractures. Int Wound J. 2015;12(3):238-47.
83. Gan W, Xu Z, Wu C, He J. Effectiveness of platelet-rich plasma in the treatment of anterior cruciate ligament injuries: A Systematic Review and Meta-analysis. 2021.
84. Wright-Carpenter T, Klein P, Schaferhoff P, Appell HJ, Mir LM, Wehling P. Treatment of muscle injuries by local administration of autologous conditioned serum: a pilot study on sportsmen with muscle strains. Int J Sports Med. 2004;25(8):588-93.
85. Antuña S, Barco R, Martinez Diez JM, Sanchez Marquez JM. Platelet-rich fibrin in arthroscopic repair of massive rotator cuff tears: a prospective randomized pilot clinical trial. Acta Orthop Belg. 2013;79(1):25-30.
86. Andrews JR, Elbayar JH, Jordan SE. Partial-Rotator Cuff Tears in Throwing Athletes. Operative Techniques in Sports Medicine. 2021;29(1):150799.
87. Vascellari A, Demeco A, Vittadini F, Gnasso R, Tarantino D, Belviso I, et al. Orthobiologics Injection Therapies in the Treatment of Muscle and Tendon Disorders in Athletes: Fact or Fake? Muscle Ligaments and Tendons Journal. 2024;14(02).
88. Blaga FN, Nutiu AS, Lupsa AO, Ghiurau NA, Vlad SV, Ghitea TC. Exploring Platelet-Rich Plasma Therapy for Knee Osteoarthritis: An In-Depth Analysis. J Funct Biomater. 2024;15(8):221.
89. Syed AN, Landrum K, Ganley TJ. Platelet-rich plasma and other injectables in the young athlete. Journal of the Pediatric Orthopaedic Society of North America. 2024;6:100008.
90. Gharpinde MR, Pundkar A, Shrivastava S, Patel H, Chandanwale R. A Comprehensive Review of Platelet-Rich Plasma and Its Emerging Role in Accelerating Bone Healing. Cureus. 2024;16(2):e54122.
91. Everts PA, van Erp A, DeSimone A, Cohen DS, Gardner RD. Platelet Rich Plasma in Orthopedic Surgical Medicine. Platelets. 2021;32(2):163-74.
92. Kuffler DP. Variables affecting the potential efficacy of PRP in providing chronic pain relief. J Pain Res. 2019;12:109-16.
93. Janocha A, Jerzak A, Hitnarowicz A, Kmak B, Szot A, Pociecha A. Platelet-rich plasma as a new treatment method in orthopedics. Journal of Education, Health and Sport. 2024;67:49195.
94. McCarrel TM, Mall NA, Lee AS, Cole BJ, Butty DC, Fortier LA. Considerations for the use of platelet-rich plasma in orthopedics. Sports Med. 2014;44(8):1025-36.
95. Patil P, Jadhav M, Suvvari TK, Thomas V. Therapeutic uses of platelet-rich plasma (PRP) in sport injuries – A narrative review. Journal of Orthopaedic Reports. 2024;3(2):16-26.
96. Cao Y, Zhu X, Zhou R, He Y, Wu Z, Chen Y. A narrative review of the research progress and clinical application of platelet-rich plasma. Ann Palliat Med. 2021;10(4):4823-9.