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I'd love to see a cogent argument for how PRP or other 'therapies' are supposed to promote healing. Who believes that a magic potion of 'factors' 'jump starts healing' (quote one major US medical centre website). It is well recognised that tissue healing requires an accurate balance of certain proteins (including cytokines and growth factors). The 'factor' composition of autologous blook and PRP is not known. The doses of 'factors' required for tissue healing are likely to differ at various stages after injury.
As Professor Maffulli states in his editorial, there are major commercial interests at play. At present there is no biological rationale, or high quality clinical evidence to support injecting PRP or autologous blood as tendinopathy treatment.
There are systematic reviews that support the role of exercise therapy for tendinopathy and the biological rationale is well established. http://tiny.cc/alhcxw
Competing interests:
No competing interests
20 May 2013
Karim Khan
Professor & BJSM Editor
University of British Columbia (UBC) and Aspetar Hospital: Qatar
It is difficult, after going thro this piece, to resist classifying "autologous blood products" in musculoskeletal medicine as the perfect 'placebo'
What may be equally interesting though is longterm consequence of blood or blood products on teno-synovial integrity; just as there are growth or proliferative agents in blood, there are also lytic and adhesion agents that may play counter-repair roles
on tissues under stress.
Blood or blood products in ectopic environments may not be physiologic or therapeutic guests after all.
Competing interests:
No competing interests
11 May 2013
basil b basil fadipe
surgeon. former clinical professor of anatomy and surgery RUSM
Re: Autologous blood products in musculoskeletal medicine
I'd love to see a cogent argument for how PRP or other 'therapies' are supposed to promote healing. Who believes that a magic potion of 'factors' 'jump starts healing' (quote one major US medical centre website). It is well recognised that tissue healing requires an accurate balance of certain proteins (including cytokines and growth factors). The 'factor' composition of autologous blook and PRP is not known. The doses of 'factors' required for tissue healing are likely to differ at various stages after injury.
As Professor Maffulli states in his editorial, there are major commercial interests at play. At present there is no biological rationale, or high quality clinical evidence to support injecting PRP or autologous blood as tendinopathy treatment.
There are systematic reviews that support the role of exercise therapy for tendinopathy and the biological rationale is well established. http://tiny.cc/alhcxw
Competing interests: No competing interests