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

الموضوعات :

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.

تاريخ الإرسال : 10 الجمعة , ربيع الأول, 1446 تاريخ التأكيد : 02 الإثنين , جمادى الأولى, 1446 تاريخ الإصدار : 13 السبت , جمادى الثانية, 1446

الکلمات المفتاحية: پلاسما, پلاکت, PRP, بازسازی بافت, تسریع بهبود در ورزشکاران, آسیب دیدگی ورزشی, جراحی,

ملخص المقالة :

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.

المصادر:

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.