PRP combined with  ultra-pulsed fractional CO₂ laser had a synergistic effect on PRP therapy for facial rejuvination (Hui et al, 2007). Combined application:

1. Effectively reduces facial wrinkles
2. Significantly improves skin texture and elasticity
3. Relieves coarse pores, pigmentation, and erythema caused by laser therapy.

Other clinical studies have demonstrated that PRP induces the proliferation of new fibroblasts within the first few hours. PRP treatment  resulted in notable increased rates of fibroblast migration and also induces the synthesis of collagen fibres that are of higher density and quality.

Early results are promising that PRP placed in the preparation site of a dental implant will promote and accelerate osteointegration. This may be beneficial in the maxilla, in areas of previous failures, in type IV bone, in osteoporotic women, etc.

Platelet Rich Plasma (PRP) is often used to treat a variety of chronic tendon, acute ligament and muscle injuries as well as other conditions such as arthritis and osteoporosis pain.

Sports

Athletes of all competition levels are early adopters of novel treatment methods. They are driven to find less invasive methods of injury management and faster means of returning to their sports.

Ligament, muscle and tendon tears are often slow to heal due to inadequate blood supply to these areas. Although PRP can be injected on any muscle or tendon, the following areas are the most common sites:

• Shoulder (rotator cuff)
• Elbow (Lateral or medial Epicondylitis; aka tennis or golfer’s elbow)
• Knee (patellar tendon; aka Jumper’s knee)
• Ankle (Achilles Tendon)

PRP can also be used during surgery to augment healing for ACL reconstruction and rotator cuff repair.

Connective tissues such as ligaments and tendons heal by filling in with scar tissue, which in turn, doesn’t support the pressure of large loads effectively and increases the risk of re-injury. Chronic tendon injuries are related to degeneration of the tendon tissue. Traditional forms of therapy do not necessarily improve the tendon’s ability to create new tissue and heal in the same way PRP does.

Platelets release bioactive proteins and growth factors which enhance tissue regeneration and healing. New tendon cells called tenocytes start to develop in the treated area. Cartilage cells called chondrocytes form when PRP is injected into damaged cartilage. There is also an increase in the number of growth factors in the treated area as well as a build-up of Type 1 collagen fibers, which constitute the base structure of tendon tissue. PRP has been demonstrated to shorten recovery time, decrease pain and improve performance in the injured area

• Many high-profile athletes are also taking advantage of the benefits that PRP offers:
• Kobe Bryant of the LA Lakers received more than three treatments on his knee in the past few years and was able to make a full comeback after serious injury
• Alex Rodrigues of the New York Yankees received multiple PRP treatments for both his left shoulder and right knee
• Peyton Manning (quarterback of the Denver Broncos) had several treatments to help repair ligaments, tissues and alleviate pain in his neck
• Tiger Woods received PRP treatments for his Achilles tendon and both knees after a knee surgery to repair injury.

http://www.nbcnewyork.com/on-air/as-seen-on/New_Knee_Procedure_Gets_Athletes_Back_on_Track_New_York-106741583.html

(News coverage of PRP usage in athletes)

http://www.nytimes.com/2009/02/17/sports/17blood.html?pagewanted=all&_r=0

(Pittsburgh Steelers athletes use PRP as an innovative injury treatment)

Orthopedics

Some common orthopedic indications for which PRP is used are listed below:

• Tendinopathies (refers to a degenerative condition of tendons characterized by the chronic loss of collagen, stability, strength and tissue integrity possibly  caused by natural aging, injury, repetitive stress, and/or neural, vascular and hormonal inputs)
• Ligament Sprains
• Muscle Strains
• Joints (i.e. osteoarthritis; a chronic degenerative disease of hyaline cartilage)

PRP can be effective for many cases of osteoarthritis as repairing the damage has posed a great challenge due to its regenerative limitations. Platelets and other elements within the blood help tendons and ligaments heal by stimulating a repair and growth response that accelerates the process of developing new tissue. However, the tendons and ligaments do not receive a rich blood supply containing these factors which is why they often take a significant amount of time to heal. PRP stimulates healing of cartilage and reduces pain and disability by delivering these factors directly to the site of injury. Areas of treatment can include knee, hip, shoulder and ankle.

With age, the cartilage lining the joints can shrink and wear thin causing friction between the bones. Bone spurs and inflammation can gradually enlarge the joint leading to the pain and dysfunction of arthritis.

Damages to the cartilage have been treated by cortisone and HA injections, micro fracture, debridement and grafting procedures. The results obtained by these techniques are so far unsatisfactory and in most cases, result in the formation of fibrous connective tissue with minimal mechanical strength at the affected area.

Not only does PRP stimulate cellular activity and the process of regeneration and repair, it also improves bone and cartilage recovery, as well as reduce inflammation and pain which could potentially inhibit the deteriorating effects of age and slow the progression of arthritis.

The primary goal of PRP is to resolve pain through healing, therefore, it could prove to have lasting results. Initial improvement may be seen within a few weeks and gradually increase as healing progresses. Research studies and clinical practice have demonstrated PRP injections to be very effective at relieving pain and returning patients to their normal lives.

Ultrasound and MRI imaging have both shown definitive tissue repair after PRP therapy thereby confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissues before the damage progresses to an irreversible condition.

Platelet rich plasma contains the bioactive proteins which act as the catalyst for accelerating the wound healing process. With the increased level of growth factors present in PRP, the tissue maturation phase is accelerated and the overall healing process is significantly improved in terms of post-operative pain, swelling, infection and establishment of tissue texture, colour and contour. PRP’s cohesive nature and its hemostatic properties also allow for minimal bleeding.

Growth factors found in PRP permit accelerated tissue regeneration. It can be used to treat corneal lesions and dystrophy, superficial punctuate keratitis, severe dry eye-related ocular surface disorders, ocular GvHD, recurrent erosion syndrome, neurotrophic keratopathy, keratopathy with loss of epithelial-stromal tissue resulting from chemical or physical traumas, sicca syndrome and/or Sjögren’s syndrome.

It also provides nutritional factors necessary to maintain cellular feasibility in the epithelial repair process while reducing the risk of contamination and infection.