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      Rectus femoris myotendinous lesion treated with PRP: a case report

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          Abstract

          Background and aim of work: Musculoskeletal injuries are the most common cause of severe, chronic pain and physical disability for the majority of all sport-related injuries. Platelet-rich plasma is being used more frequently to promote healing of muscle injuries. We report a case of 39 years old non professional soccer player who came to our attention for a quadriceps muscle pain onset after kicking the ball during a match. Methods: Clinical and instrumental evaluation revealed a myotendinous junction rupture of the rectus femoris with retraction of 1.5 cm from the anterior inferior iliac spine. We decided to treat the patient with PRP ultrasound guided injections and a specific rehabilitation protocol. Results: Clinical evaluation 45 days following the end of the treatment showed the resolution of the pain and the full recovery of strength and range of motion. Muscle healing was documented by magnetic resonance imaging. Conclusions: Even if the role of PRP in muscle injury is not still clear, the result observed confirms that it could be used in the treatment of muscle lesions. (www.actabiomedica.it)

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          Autologous platelets as a source of proteins for healing and tissue regeneration.

          Platelets are known for their role in haemostasis where they help prevent blood loss at sites of vascular injury. To do this, they adhere, aggregate and form a procoagulant surface leading to thrombin generation and fibrin formation. Platelets also release substances that promote tissue repair and influence the reactivity of vascular and other blood cells in angiogenesis and inflammation. They contain storage pools of growth factors including PDGF, TGF-beta?and VEGF as well as cytokines including proteins such as PF4 and CD40L. Chemokines and newly synthesised active metabolites are also released. The fact that platelets secrete growth factors and active metabolites means that their applied use can have a positive influence in clinical situations requiring rapid healing and tissue regeneration. Their administration in fibrin clot or fibrin glue provides an adhesive support that can confine secretion to a chosen site. Additionally,the presentation of growth factors attached to platelets and/or fibrin may result in enhanced activity over recombinant proteins. Dental implant surgery with guided bone regeneration is one situation where an autologous platelet-rich clot clearly accelerates ossification after tooth extraction and/or around titanium implants. The end result is both marked reductions in the time required for implant stabilisation and an improved success rate. Orthopaedic surgery, muscle and/or tendon repair, reversal of skin ulcers, hole repair in eye surgery and cosmetic surgery are other situations where autologous plate-lets accelerate healing. Our aim is to review these advances and discuss the ways in which platelets may provide such unexpected beneficial therapeutic effects.
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            The biology of platelet-rich plasma and its application in trauma and orthopaedic surgery: a review of the literature.

            Although mechanical stabilisation has been a hallmark of orthopaedic surgical management, orthobiologics are now playing an increasing role. Platelet-rich plasma (PRP) is a volume of plasma fraction of autologous blood having platelet concentrations above baseline. The platelet alpha granules are rich in growth factors that play an essential role in tissue healing, such as transforming growth factor-beta, vascular endothelial growth factor, and platelet-derived growth factor. PRP is used in various surgical fields to enhance bone and soft-tissue healing by placing supraphysiological concentrations of autologous platelets at the site of tissue damage. The easily obtainable PRP and its possible beneficial outcome hold promise for new regenerative treatment approaches. The aim of this literature review was to describe the bioactivities of PRP, to elucidate the different techniques for PRP preparation, to review animal and human studies, to evaluate the evidence regarding the use of PRP in trauma and orthopaedic surgery, to clarify risks, and to provide guidance for future research.
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              Platelet-rich plasma injections in acute muscle injury.

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                Author and article information

                Journal
                Acta Biomed
                Acta Biomed
                Acta Bio Medica : Atenei Parmensis
                Mattioli 1885 (Italy )
                0392-4203
                2531-6745
                2020
                06 March 2020
                : 90
                : Suppl 12
                : 178-183
                Affiliations
                [1 ] Orthopaedics and Traumatology Clinic, Department of Medicine and Surgery, University of Parma, Parma (Italy)
                [2 ] Orthopaedic Unit, Oglio Po Hospital, Vicomoscano (CR), Italy
                [3 ] Immunohaematology and Transfusion Centre, Department of Laboratory Medicine and Pathology, University Hospital of Parma, Parma (Italy)
                [4 ] Radiology Unit, University Hospital of Parma, Parma (Italy)
                Author notes
                Correspondence: Francesco Pogliacomi Orthopaedics and Traumatology Clinic Department of Medicine and Surgery, University of Parma Via Gramsci 14 - 43126 Parma (Italy) E-mail: francesco.pogliacomi@ 123456unipr.it
                Article
                ACTA-90-178
                10.23750/abm.v90i12-S.8932
                7233700
                31821305
                424e4c64-ebb0-4be0-ad5b-77eba7a75cd2
                Copyright: © 2019 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA

                This work is licensed under a Creative Commons Attribution 4.0 International License

                History
                : 01 October 2019
                : 03 November 2019
                Categories
                Case Report

                rectus femoris,rupture,injury,prp,muscle
                rectus femoris, rupture, injury, prp, muscle

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