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It is quite difficult to determine both the method and timing of healing of a burn wound in children at the initial stages of treatment and during a visual clinical examination. In the treatment of thermal burns in children, preference is given to conservative methods, although they do not always lead to optimal healing of the burn. The use of PRP (platelet-rich plasma) in the treatment of burn wounds can have a beneficial effect on the timing and quality of healing of burned skin. Also, in certain cases, it allows to avoid surgical intervention in order to restore damaged skin or helps to reduce the volume and number of surgical operations when there is a shortage of donor resources. We present three clinical cases of using allogeneic PRP for the treatment of thermal burns of different etiologies (flame, hot liquid, contact). The use of PRP of the allogeneic type is due to the fact that children with burn injuries have limitations and contraindications to the use of autologous PRP. Allogeneic PRP and its use allow to reduce the time of epithelization of burn wounds of IIIAB degree (2–3 degrees according to ICD-10) and in some cases avoid surgical intervention to restore damaged skin. Its main advantages are good tolerability, relative availability, absence of contraindications and ease of use. Presented clinical examples for the first time clearly demonstrate the high effectiveness of allogeneic PRP in the treatment of thermal burns of different etiologies in children.

Purpose. The aim of the work is to compare the time of epithelization and the change in the thickness of the cornea in the treatment of erosions after corneal burns of 2–3 degrees and ulcers after keratitis with preserved amnion and amnion saturated with autologous PRP lysate. Materials and methods. To compare the effectiveness of preserved amnion and lysate-soaked PRP, 2 groups of patients were identified: the main group (amnion saturated with lysate PRP) and the comparison group (amnion without lysate PRP). Each group included patients with erosions after recent burns with an average area of 60 % of the cornea and ulcers after keratitis with a corneal thickness at the bottom of the ulcer of 382 microns in the experimental group and 393 microns in the comparison group. In the comparison group, ulcers were treated by covering the cornea with an amniotic membrane for 7–14 days, after which the amnion was removed and the condition of the cornea was monitored. An amniotic membrane saturated with PRP lysate was used in the experimental group. PRP lysate was made from autologous blood of patients in the laboratory of cell transplantation and immunotyping of the N.V. Sklifosovsky Research Institute of Emergency Medicine using a patented technology. To do this, platelet-rich plasma (PRP) with a platelet content of over 1000 thousand/ml was isolated from the blood of donors, which was then frozen at -80 °C and thawed at 0–4 °C in order to destroy cell membranes. Assessment of the condition of the cornea was carried out using clinical and instrumental studies, including biomicroscopy with fluorescein staining, photoregistration and OCT on the Heidelberg Engineering “OCT Spectralis” apparatus. Results. The use of an amniotic membrane saturated with PRP lysate led to epithelialization of erosions after recent burns in 1.3 months and a decrease in corneal edema by 247 microns, epithelialization of ulcers after keratitis in 1.3 months and an increase in the thickness of the cornea at the bottom of the ulcer by 62.5 microns. Treatment with conventional preserved amnion took 1.8 months before complete epithelization in recent burns with a decrease in corneal stroma edema by 193 microns, and epithelization of ulcers after keratitis required 1.6 months and ended with an increase in the thickness of the cornea at the site of the ulcer by 42 microns. Conclusion. The study showed that the presented method of treating erosions and ulcers of the cornea of various genesis using an amniotic membrane saturated with autologous PRP lysate allows achieving complete and persistent epithelialization in a shorter time and with fewer amnion coatings, unlike the comparison group. At the same time, patients do not need additional conservative treatment of epitheliopathies.

Background: Meniscus injuries remain the most common indication for orthopedic surgery. Due to advances in magnetic resonance imaging (MRI), the number of patients diagnosed with meniscus injuries that do not extend into the articular surface has increased. Although treatments of complete meniscal tears are defined, treatment of meniscus injuries that do not extend into the articular surface is not clear yet.Objective: To determine the most optimal way of delivering platelet-rich plasma (PRP) into the knee joint for treatment of meniscus injuries (not extending into the articular surface) so that patients would improve clinically, and it would have also an effect on the meniscus shown on MRI.Materials and methods: We studied treatment results in 87 patients (50 men and 37 women). The patients were divided into 2 groups: group 1 received an ultrasound-guided PRP injection into the posterior horn, and group 2 received a standard intra-articular PRP injection via the superolateral approach. The treatment efficacy was assessed using visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, Lysholm score, and Knee Society Score (KSS). We also assessed changes on MRI 6 and 12 months after treatment.Results: The comparative analysis demonstrated that based on the findings of scores and MRI the ultrasound-guided intrameniscal PRP injection is more effective.Conclusions: Our results show that the intrameniscal PRP injection is a more effective and safe way to treat such meniscus injuries.

Introduction Non-surgical treatment of osteoarthritis is aimed at managing joint degeneration and inflammation to prolong the life of the original joint and delay total joint replacement. The objective was to pathomorphologically substantiate preclinical effectiveness of PRP in OA using comparative analysis of depleted plasma and serum. Material and methods The experiment was performed in 120 Wistar rats, divided into 4 groups. Osteoarthritis was simulated using an original method. Knee joint injection given to the animals after skin dissection under inhalation anesthesia and visual control two weeks later contained 0.05 ml PRP in group 1, 0.05 ml plasma in groups 2 and 0.05 ml blood serum in groups 3. The same volume of physiological saline solution was used for the injections produced for control animals. Injections were administered three times at 2-week intervals. Animals were sacrificed in groups of 10 at 2 weeks of each injection. Results The median MANKIN value scored 2.0 (1.0; 2.0) in group 1, 6.0 (5.0; 7.0) in group 2 and 7.0 (6.0; 7.0) in group 3 at 6 weeks. The median MANKIN value scored 7.5 (7.0, 8.0) in the control group. Statistically significant differences were determined between the groups at p < 0.001. Discussion Literature data on preclinical evaluation of the effectiveness of PRP therapy in biological models of OA are controversial. An original, low-traumatic functional method was used for simulating knee OA to reproduce major pathogenetic mechanisms in rats. Conclusion The findings suggested a pronounced therapeutic effect with improved morphofunctional features of the hyaline cartilage and MANKIN score of 2 at 6 days of intra-articular administration of modified PRP as compared with plasma and serum.

Introduction. The pathogenetic theory of interstitial cystitis/bladder pain syndrome (IC / BPS) development declares that due to vascular changes and trophic disorders in the bladder wall, a complex of dystrophic, necrobiotic and sclerotic processes develops, involving all layers of the bladder wall with the subsequent development of fibrosis. Therapy of moderate-to-severe symptoms of IC/BPS that recommended in EAU guidelines is not so effective.Objective. To evaluate the results of intradetrusor autologous platelet-rich plasma (PRP) injections in female IC / BPS-patients.Matherials & methods. A single-centre controlled randomized prospective trial that includes 85 women from 20 to 79 years old and with average disease duration of 4.8 ± 2.1 years. They were divided into two groups: group 1 — 35 patients were treated with total of five cystoscopies and hydrodistension, each once in two weeks for 10 weeks; group 2 — 50 patients were treated with total of 5 intradetrusor PRP-injection (mean platelet concentration was 982 х 103/l) into 20 – 22 points, each once in two weeks. We assessed pain (VAS-scale), urgency and frequency (PUF-scale, IUS-scale), bladder urinary, Global Response Assessment (GRA), bladder diary and bladder capacity before treatment, after one and 12 months.Results. Conventional IC/BPS therapy leads to a significant reduction in symptoms one month after its completion, and a similar pattern of symptoms and signs is observed in the PRP-treatment group. However, in group 1, negative dynamics is further determined up to 12 months, but the indicators do not reach the initial values. In contrast, in group 2, we found stabilisation of pain severity and improvement of all other symptoms and signs by 12 months compared to baseline and one month after the completion of PRP-therapy.Conclusion. The developed method of PRP-therapy of IC/BPS has high efficacy not only at the treatment completion, but also at monitoring of patients for 24 months. PRP-therapy combined with classical treatment will probably have a higher level of efficacy both in terms of symptoms and signs of the disease over a long-term monitoring.

Objective: based on clinical and morpho — functional analysis of retinal restoration and assessment of the cellular composition of platelet-rich plasma, to determine its optimal fraction for surgical treatment of macular hole. Materials and methods. This study presents the results of 120 cases of surgical treatment of eyes with macular hole. The patients were divided into 2 groups. In the 1st group (60 eyes), the technology developed in our clinic was used without the use of postoperative tamponade of the vitreal cavity and the use of autologous platelet-rich plasma (PRP), in the 2nd — traditional technology for the treatment of macular hole s (60 eyes). The cellular composition of the PRP of 30 patients was analyzed. Results. 2 months after surgery, 119 patients had the restoration of all retinal layers in the macular hole area and positive dynamics of visual acuity was recorded in comparion with the preoperative period. After observation for 6 months after surgery, cases of recurrence of macular hole were not detected. Conclusion. The therapeutic value of BoTP lies in the tamponing and regenerative effect. According to the results of this study, for maculrupture surgery, it is rational to use plasma from a layer of pure platelet-rich plasma (P-PRP), which contains a sufficient number of platelets capable of having a positive therapeutic effect, and a minimum number of leukocytes capable of performing the functions of immune protion and repair of the retiand surrounding tissues.

Purpose: to compare the effectiveness of conventional preserved amnion and amnion saturated with platelet-rich (PRP) plasma lysate for the treatment of persistent corneal erosions (PCE) after high-risk keratoplasty.Materials and methods. 40 patients with persistent corneal erosions after high-risk penetrating keratoplasty, followed up for 12 months, were divided into two clinical groups of 20 people each. The main group of patients, aged 34 to 84, received Flexamer amniotic membrane + PRP lysate, while the comparison group, aged 41 to 80, received Flexamer amniotic membrane only. Amniotic membrane coating was used in persistent corneal erosions of penetrating keratoplasty after unsuccessful conservative treatment. The amnion was sewn 2 mm from the limb with a continuous suture and covered with a soft contact lens. As a source of platelets, we used the blood of healthy volunteers, from which platelet-rich plasma with platelet concentration of over 1000 thousand/µl was taken, which was then frozen at -40 °C and defrosted at 0…4 °C to obtain PRP lysate. The criteria for evaluating the effectiveness of both groups were the times of epithelialization, the number of amniotic membrane coatings, and the number of preserved transplants at the end of the follow-up.Results. Lyophilized amniotic membrane saturated with autologous PRP lysate growth factors was shown to be biocompatible. It was found to be safe for the patients, to reduce the epithelialization time, to reduce the number of operations required to cover the PÑE with the amnion, and to increase the likelihood of successful transparent and translucent engraftment of a penetrating keratograft.Conclusion. The use of a lyophilized amniotic membrane enriched with growth factors of autologous PRP lysate is a promising method for the treatment of PCE of the penetrating corneal graft after high-risk keratoplasty.

Objective. To analyze the effectiveness and safety of using an orthobiological product in osteoplasty of bone defects of the vertebrae with simultaneous reosteosynthesis. Material and Methods. The results of screw augmentation technology using thrombogel-enriched allogeneic bone were studied in a retrospective, single-center, non-randomized study, which included 17 patients (10 women, 7 men) with instability of the hardware in the form of screw loosening and osteolysis around screws. Results within 12 months were followed up in 17 patients (100 %). We compared preoperative and postoperative instrumental data, clinical parameters in dynamics. Results. The mean age of the patients was 59 (43–75) years. The distribution of patients, according to the primary pathology, was as follows: 11 patients (64.7 %) had a degenerative-dystrophic pathology of the spine, 4 patients (23.5 %) had a traumatic injury, and 2 patients had a kyphotic deformity on the background of Bechterew’s disease (11.8 %). The mean time from primary to revision surgery was 7.06 months (3.1–12.1), mean CRP was 4.48 (0.5–15.0). When observing patients for 12 months, all patients showed a positive trend in the form of a statistically significant regression of back pain according to VAS from 7.0 (6.0; 7.3) to 1.0 (0.0; 1.0) points (χ2 = 47.9, df 3, р < 0.0001). A positive trend was also noted in the form of a decrease in ODI indicators and an improvement in the quality of life of patients from 63.8 (57.1; 69.1) to 3.0 (2.0; 7.5) at 12 months. When comparing the parameters (VAS and ODI), the obtained differences before/after the operation were statistically significant, while these changes have a pronounced correlation. Postoperative CT studies (3, 6, 12 months) showed no instability of the screws. Conclusion. Osteoplasty of vertebral bone defects and screw augmentation using orthobiological approaches have demonstrated their primary efficacy and safety. Further studies with a large sample size are needed to confirm the obtained results.

Fistulas of various etiologies are one of the severe and life-threatening diseases of the upper respiratory tract. The most common cause is bronchial stump failure after pulmonary resection, usually pneumonectomy. The incidence and mortality of this complication is 3 %-4 % and 12.5 %-71.2 %, respectively. Despite the fact that many devices and methods have been described to date, it is usually treated with surgical closure. Standard surgical approaches are associated with significant morbidity and mortality and are not reliably successful. In recent years, cell therapies aimed to stimulate tissue healing rose to prominence and can be considered a potential treatment method. We review current trends in bronchopleural fistula treatment using cell therapy and report cases of the bronchopleural fistula treatment according to the research protocol developed in our clinic. Although clinical experience is quite limited owing to a small number of patients in the most studies, the information on safety and tolerance can help plan future larger trials with innovative methods to further improve clinical results.

Local injection therapy (LIT) is an important component of the complex treatment of musculoskeletal disorders (MSD), which is widely used in real clinical practice. Glucocorticoids, hyaluronic acid drugs (HA), autologous cell drugs, botulinum toxin type A, radioactive isotopes, etc. are used for LIT. LIT makes it possible to achieve a pronounced symptomatic effect, while in some cases, for example, repeated HA treatments in patients with osteoarthritis, the possibility of slowing the progression of the disease and reducing the need for surgical treatment is discussed.The performance of LIT requires special skills and abilities of the physician, careful compliance with the rules of asepsis and antisepsis, and instrumental visualization. LIT can be associated with serious complications and therefore must be performed according to strict indications.The Expert Council was devoted to defining the basic principles of LIT. The indications for the use of certain types of this therapies, the evidence base for its efficacy and safety, the order of application of different drugs, and the need to combine LIT with other drug and non-drug treatments of MSD were reviewed.

INTRODUCTION Development of effective biological products, based on human platelets, is very actual in regenerative medicine. The initial material for biological products’ obtaining is platelet-rich plasma (PRP), but the method of PRP isolation has not yet been standardized.AIM To assess the quality of platelets in PRP, harvested by different centrifugation modes.MATERIAL AND METHODS For platelet study, venous blood was harvested from volunteer donors. We used 3 methods for PRP-preparation, each methods included 2-stage centrifugation: 5 min 300g and 17 min 700g (Group 1); 10 min 300g and 10 min 700g (Group 2); 15 min 300g and 5 min 700g (Group 3). Platelets were examined using morphofunctional method based on vital cell staining.RESULTS In Group 1 and Group 2, the overall safety of biologically high-grade platelets in PRP was similar and estimated 55-60% of their total content in the blood. In Group 3 the safety of biologically high-grade platelets was only 30% (p

Background: Platelet-rich plasma (PRP) was originally described as a small volume of plasma that contains higher concentrations of platelets, compared to peripheral blood. Although currently the use of PRP in most indications is off-label, it is not prohibited. Initially, PRP was used for wound healing and tissue regeneration in fields such as orthopaedics, dermatology, maxillofacial surgery and dentistry. Aim of the study: The aim of this article was to present and summarise the modern production methods, the mechanism of action at the molecular and biochemical level and the most important uses and indications of PRP in present-day medicine. Material and methods: A cross-sectional search of relevant literature was performed in databases using accepted wording. Publications from 2003-2023 were included. The entire process has been supplemented with additional procedures to increase the reliability of this publication. Results: Orthopaedics has gained many minimally invasive therapeutic solutions thanks to PRP. Its effects on ligament and tendon tissues have been studied, where promising data have been proven. Also in aesthetic medicine and dermatology, many treatment strategies have been developed using PRP, mainly for the treatment of acne, androgenic alopecia and delaying tissue ageing as much as possible. Conclusion: Platelet-rich plasma has found application in the treatment of many conditions in orthopaedics, dermatology, aesthetic medicine and dentistry. It is characterised by good therapeutic efficacy, with relatively low risk. However, high-quality studies are still lacking to provide more reliable data.

Introduction: In the knee joint are two menisci, which are fibrocartilaginous structures. The tears of the meniscus are one of the most common injuries within knee. Arthroscopy with suturing of torn or menisectomy are the most popular methods of treatment, however in long term observation menisectomy often results in osteoarthritis 10-20 years after surgery. For this reason, less invasive treatment methods are being sought, such as platelet-rich plasma injections. Platelet-rich plasma has many growth factors, which stimulates healing. Objective: The aim of this study is to review latest the literature on the use of platelet-rich plasma injections in the patients with meniscus tears. Material and methods: A literature review was conducted on databases such as PubMed and Google Scholar using the terms: ”meniscus”, “meniscus tear”, “platelet-rich plasma”, “platelet-rich plasma injections”, “meniscus injuries treatment’. Conclusions: The injuries of meniscus are very common, and often must be treated by arthroscopy. Platelet-rich plasma has a positive impact on tissue healing. Platelet-rich plasma injuries in the patients with meniscal tears repair lead to improve healing rates compare with patients without PRP injections, but there is no guidelines and further studies are necessary.

Purpose: to describe the mechanisms of the therapeutic effect of platelet-rich plasma (PRP) components on the retina in macular hole (MH) surgery. Material and methods. The results of autologous PRP use in 36 cases of surgical treatment of eyes with idiopathic full-thickness MH sized 96 to 932 mm (ave. 546.4 ± 49.8 mm) are presented. Corrected visual acuity before surgery was 0.04 to 0.2 (0.09 ± 0.01). The quantity of cell elements in PRP fractions was determined using a hematological analyzer Sysmex XS-500i (Germany). Results: 2 months after the operation, all retinal layers in the MH area were found to restore in all patients, who showed an increase in visual acuity to 0.2–0.6 (0.40 ± 0.04). 35 patients (97 %) had no MH relapse over the 6-month post-surgery period. A technique was proposed to evaluate the quality of PRP by the presence of large platelets. The mechanisms of the therapeutic effect of PRP components on the retina were presented. Conclusion. The collection of data on the effectiveness of PRP components is instrumental in planning its wider use in the treatment of degenerative, infectious, post-traumatic and other disorders of eye structures. The evaluation of PRP quality by the content of functionally active platelets will also contribute to more effective PRP use in ophthalmology.

Aim to study the effectiveness of the combined treatment of contractures of proximal interphalangeal joint. Material and methods. The study included 30 patients with a diagnosis of post-traumatic mixed contracture of the proximal interphalangeal joint. The patients were divided into 3 groups. In the first group, the patients were administered a combined treatment, including the arthrolysis of the joint, the imposition of a dynamic distraction apparatus, the injection of hyaluronic acid preparations and platelet-rich plasma. The second group of patients underwent the arthrolysis of the joint and the application of the apparatus. The third group underwent only arthrolysis. Results. The results of the study indicated the effectiveness of all three methods of treatment. However, in the first group where the combined treatment was used, the registered improvement in the angles of joint function and a decrease in pain were significant, which ultimately led to better functional indices of the hand and a shorter treatment period.

Background. Intra-articular injections of autologous platelet-rich plasma (PRP), which is a natural biological stimulant and affects various parts of the regenerative process, are often used in the treatment of adhesive capsulitis. Another line of using the reparative potential of biopolymers is the application of polynucleotides (PN), which, due to their effect on fibroblasts, are able to stimulate regeneration processes during adhesive capsulitis. Aim of study. To evaluate the clinical efficacy of intra-articular injections of autologous platelet-rich plasma and a polynucleotide-based drug in the complex therapy of shoulder adhesive capsulitis, depending on the stage of the disease. Methods. Performed prospective cohort study included 42 patients aged 47 to 60 years with the diagnosis of adhesive capsulitis. The duration of the disease varied from 3 months to 5 years. The patients were divided into 2 groups depending on the stage of the disease at the time of the treatment: 24 patients with the first stage of the disease (group AC1) and 18 patients with the second stage (AC2). Each group was divided into 2 subgroups of patients. In subgroups either PRP or PN were administered. The results were assessed 1 week, 1 month, 3 months after the start of the treatment. Evaluation of pain management efficacy was carried out using the visual-analog scale (VAS). The change in the quality of life of patients and the function of the shoulder joint were defined using the DASH questionnaire for assessing the function of the upper limb and the Simple Shoulder Test (SST). Results. The use of PRP made it possible to achieve pain relief regardless of the stage of the disease. Patients of the AC1 group had a progressive pain syndrome attenuation from 80 to 45 points according to the VAS scale during the first 7 days after the start of the treatment. On the contrary, patients of the AC2 group had a slight pain increase by the end of the 1st week, that was associated with growing physical activity of patients. In the group of patients treated with PN, all experienced pain regression after the first injection. 20% of patients had pain relief within 24-36 hours after the start of the treatment., Increased joint pain was registered in 2 (10%) patients, which passed spontaneously during the first day. Pain syndrome intensity decreased in patients with both stages of the disease. According to the VAS, it decreased from 90-80 to 65 points after the first injection within 4 days in the AC1 group. Patients of the AC2 group did not notice significant effect after the first injection. The second injection reduced the pain to 65-70 points. Conclusion. The effectiveness of PN-based drugs had no statistically significant difference from that of PRP, but their effect was achieved faster.

Purpose: To study the biological effect of a combination of platelet lysate and amniotic membrane, preserved by various techniques, on human buccal epithelium culture. Materials and methods. Human amnion transplants were preserved using 3 methods: silicate drying, lyophilization, cryopreservation. The blood of healthy volunteers was used as a source of platelets. Platelet-rich plasma (PRP) with a platelet content over 1000 thousand/mcl and more was isolated from the donors blood, frozen at -80 °С and defrosted at 0–4 °С to prepare platelet lysate. Growth-stimulating effect of the amnion transplants was studied in different groups: control group 1 — without amnion and without PRP lysate; control group 2 — PRP lysate without amnion; experimental group 1 — amnion without PRP lysate; experimental group 2 — amnion samples combined with PRP lysate. The study was carried out on the example of human buccal epithelium culture of 3–5 passages. The dynamics of cell growth was evaluated after 1, 2 and 3 days from the moment of seeding. The number of cells and their viability were evaluated using original methods based on vital cell staining and their examination in a fluorescent microscope. Results. All samples of preserved amnions were non-toxic and did not damage the structural and functional characteristics of the buccal epithelium. On the other hand, the use of amnion without PRP lysate did not have a growth-stimulating effect on cells. Among the amnion samples combined with PRP lysate, the combination of lyophilized amnion and PRP lysate was the most effective during the entire study period. Conclusions. Silicate drying, lyophilization and cryopreservation of the amniotic membrane makes it possible to obtain biocompatible and non-toxic transplants, based on human amnion. Lyophilized amnions are the most optimal for saturating PRP lysate. The combination of lyophilized amnion and PRP lysate stimulates cell growth in vitro without violating their structural integrity.

Introduction: PRP is an autologous serum containing high concentrations of platelets and growth factors. It is used in dermatology for a variety of purposes, including hair growth, skin renewal, the removal of acne scars, dermal augmentation, and the treatment of striae distensae. The origins of PRP trace back to the 1970s, originating within the field of hematology as a treatment for patients grappling with thrombocytopenia. The subsequent decades, specifically the 1980s and 1990s, witnessed the integration of PRP into surgical procedures, notably in maxillofacial and plastic surgeries. The rationale underlying the employment and therapeutic potential of a concentrated platelet solution hinges upon their remarkable ability to furnish elevated levels of vital growth factors, thus instigating a regenerative impetus that facilitates repair in tissues characterized by limited innate healing capabilities. This comprehensive review delves into the multifaceted facets of PRP, encompassing mechanisms of action, prevailing indications, existing clinical substantiation, safety considerations, and the burgeoning spectrum of potential applications within the domain of skin condition treatments. Aim of the study: To review the current literature on the use of PRP in the field of dermatology Materials and Methods: We reviewed the literature available in PubMed, using the key words “platelet rich plasma”, “prp”, “autologous platelet rich plasma”, “alopecia”, “anti-aging” Results: PRP has a lot of potential in dermatology and its therapeutic uses are growing. Future research should standardize PRP therapy procedures for particular reasons. Summary: The versatile action of PRP has made it the subject of intense research. However, the reports in the literature to date on its use require further studies on larger groups of people to confirm its effects.

INTRODUCTION. Peroneal tendons pathology is an underestimated cause of pain in the lateral part of the foot in athletes, which is difficult to distinguish from lateral ankle ligament injuries. As a result, the athlete's training and participation in competitions may be restricted for a long time. Platelet-rich plasma (PRP) injections have been suggested as a promising method for the treatment of peroneal tendinopathy. AIM. To evaluate the effectiveness of the use of PRP in the complex rehabilitation of athletes with peroneal tendinopathy by comparing the time to return to play (RTP) and the evaluation of pain symptoms. To develop a model for pain evaluation and physical activity dosingin athletes with this pathology, in order to objectify the transition from one rehabilitation stage to another. MATERIAL AND METHODS. This prospective, non-randomised study analyzed the treatment outcomes of 60 male patients, aged 21.0±1.4 years with peroneal tendinopathy. Depending on the treatment, two groups of patients were identified. Group I (30 athletes), in addition to complex rehabilitation (physiotherapy and physical therapy), had percutaneous PRP injections under the ultrasound guidance. Group II (30 athletes) received only physiotherapy and exercise therapy. RESULTS AND DISCUSSION. A statistically significant difference in pain symptoms between the groups was observed starting from the 28th day of treatment. The average time for the athletes in group I to return to regular training activities was on average 10 days shorter than for those in group II (p

Introduction and objective: Osteoarthritis (OA) is a chronic condition characterized by progressive damage to the joint cartilage and bone. Platelet-rich plasma (PRP) has gained increasing interest as a potential therapeutic approach for relieving symptoms and improving joint function. The aim of this article is to present the current knowledge regarding the PRP preparation method, mechanisms of action, and treatment outcomes in OA based on scientific literature and recent research. Materials and methods: A review of scientific literature available on Google Scholar, PubMed, and Via Medica journal database was conducted using relevant keywords. State of knowledge: Platelet-rich plasma is obtained from the patient's own blood using differential centrifugation method, resulting in a concentration of platelets (PLT) that is 300-700% higher compared to the baseline. PLTs release various biologically active substances, including growth factors, which stimulate tissue repair and regeneration processes. Numerous studies have shown that PRP administration in patients with osteoarthritis of the knee and hip joints leads to pain reduction and improved joint function. The therapeutic effect yields long-lasting results, lasting up to 12 months after the completion of the treatment. Conclusions: The use of platelet-rich plasma (PRP) in the treatment of osteoarthritis presents a promising alternative to conventional therapies. However, further research is needed to confirm the effectiveness of PRP on a larger sample size and assess the long-term effects of this therapy. Knowledge regarding dosage, treatment protocols, and the duration of therapy remains limited.

Androgenetic alopecia is the most common type of hair loss and affects at least 80% of men and half of women before the age of 70, with the incidence increasing with age. Androgenetic alopecia is an ailment conditioned by genetic and hormonal factors, associated with excessive stimulation of the androgen receptor in the cells of the hair follicle. With the development of medicine, more and more therapeutic methods for androgenetic alopecia appear on the market, including minoxidil, 5-α-reductase inhibitors, microneedling, platelet-rich plasma, low-energy laser therapy, rosemary oil, or siRNA. Thanks to the constantly growing amount of scientific research, progressively more is known about the mechanisms of androgenetic alopecia development and potential strategies to stop it. The article analyzes the literature using electronic databases and textbooks to compile methods that can be an effective alternative for people who do not want to undergo surgery. Some of the methods presented in the article have the potential to not only slow down, but also reverse the progression of the disease. However, each of them still has its limitations.

Purpose. To compare the anatomical and functional results of surgical treatment for full-thickness macular holes with and without the gas tamponade of the vitreous cavity. Material and methods. The study included 2 groups of patients. All surgeries were performed at the Ekaterinburg Branch of the Fyodorov Eye Microsurgery Federal State Institution in the period from 2018 to 2020. In the 1st group (30 eyes), the traditional MH treatment technology was used, patients in the second group (30 eyes) were treated without the use of tamponade, according to the method developed at the center. In the 1st group, the minimal diameter of the macular hole was from 194 to 755 (446.43±32.37) μm, the best corrected visual acuity (BCVA) – from 0.04 to 0.4 (0.16±0.02). The minimal diameter of the macular rupture in the 2nd group was from 100 to 932 μm (558.5±50.9), BCVA – from 0.02 to 0.25 (0.11±0.02) (p>0.05). The follow-up period was 1 to 20 months (8.9±0.8). Results. Complete closure of the macular hole in the early postoperative period: 1st group was achieved in 29 out of 30 cases (96.6%), 2nd group – in 30 out of 30 cases (100%). BCVA on the first day after the surgery: 1st group – from 0.005 to 0.15 (0.02±0.01), 2nd group – from 0.08 to 0.35 (0.2±0.02) (p0.05). Conclusion. Comparative analysis of the effectiveness of surgical treatment of through MH without the use of postoperative vitreal tamponade and the traditional method based on gas tamponade showed a significant reduction in the rehabilitation period for the method without tamponade.

Objective. Immunohistochemistry testicular tissue collagens evaluation in the treatment of azoospermia with platelet-rich plasma (PRP) and extracorporeal shock wave therapy (ESWT).Materials and methods. We used biopsy material of testicular fragments from 14 patients with an established diagnosis of secretory azoospermia before and after the use of PRP plus ESWT (patent granted RU2738543 from 14.12.2020). The mean age was 33.07 ± 4.64 (28–43 years), the mean duration of the disease – 4,1 ± 2,26 years (1–9 years). All participants received 2 therapy sessions per week during 6 weeks. 1st session included ultrasound-guided PRP injections into testicles and spermatic cords, finally PRP was activated with ESWT (Dornier Aries), 2nd session included ESWT per testicles and epididymis. Immunohistochemistry analysis with antibodies to collagen types I, III and IV of patient’s biopsies with azoospermia were completed on 90 days before treatment and 180 days from last PRP-injection.Results. Before PRP and ESWT therapy: type I collagen was 22.9 ± 4.2 % (p

In the previous article, we talked about the use of platelet-rich plasma. One of the promising ways to stimulate the processes of repair and regeneration in the tissues of the damaged organ in different types of pathology is the use of platelet-rich plasma lysate. This part of the literature review covers the mechanism of action of platelet-rich plasma lysate, indications and contraindications for its use, describes the results of treatment when platelet-rich plasma lysate is used to stimulate osteogenesis. The preparation technology provides for the removal of all cellular components from the plasma, so it becomes possible to store the obtained graft for a long time. The procedure for the preparation of platelet lysate allows the simultaneous isolation of all growth factors from the cells, since the platelet lysis occurs. Lysate of platelet concentrates can be considered as a preparation that contains a complete set of stimulating growth factors. Under the influence of the lysate, the proliferation of latent osteoblasts is resumed, the signaling pathways of angiogenesis are activated, the secretion of the factors accelerating angiogenesis is stimulated, the differentiation of osteoblasts and the formation of bone tissue are triggered. The aim of this article is to summarize the results of treatment using autologous platelet lysate to improve bone regenerative potential in orthopaedics. In a final article, we shall look at the ways to use autologous red bone marrow.

Up-to-date, the platelet-rich plasma (PRP) treatment method is actively used in many fields of medicine. In traumatology, PRP is used to treat bone and cartilage defects, ligamentous apparatus. In combustiology for the healing of burns, in surgery ¾ trophic ulcers. There is evidence of the feasibility of using PRP in some dermatological diseases, as well as in dental practice. For urology, the method is new and is just beginning to be studied. The article discusses the methods of treatment of interstitial cystitis (IC) and erectile dysfunction (ED) using PRP. During the review, we relied on existing data on the effectiveness of intravesical injections of PRP in the treatment of IC, as well as on the successful treatment of ED with activated, nonactivated PRP and PRP augmented phosphodiesterasetype 5 (PDE-5) inhibitors.

Despite the high level of development of modern macular surgery, recurrent macular holes remain a rather serious problem for vitreoretinal surgeons. Recurrent macular holes can be of two types: macular holes that have not closed after primary surgery, and macular holes that have reopened after a successful initial surgery. In foreign literature they are called persistent and recurrent macular holes. This article presents a review of modern scientific literature on epidemiology, causes of development and surgical treatment of recurrent macular holes. This review provides information on the rationality and effectiveness of modern surgical approaches to the treatment of this condition. The most effective methods for treating large macular holes, which are one of the main causes of failure to close a defect during the first surgery or the development of a recurrence of this condition sometime after the first surgery, are covered. Based on the literature data, we can say that the main methods of choice in surgery for recurrent macular holes today are the use of platelet-rich plasma and various modifications of the inverted internal limiting membrane flap technique, transplantation of the autologous internal limiting membrane, including the displaced internal limiting membrane flap technique patented in the Russian Federation.

Introduction. So far, a large number of skin scars treating methods have been proposed and tested. The use of platelet-rich plasma (PRP) is currently being considered as one of the most promising approaches to skin scar treatment.Aim. Clinical efficacy and safety evaluation of complex treatment of post-acne scars using PRP.Materials and methods. An open, randomized, prospective study was conducted in parallel groups. The study included 78 patients with post-acne scars, then randomized into 2 groups. Group 1: 36 patients receiving platelet-rich plasma (PRP); group 2: 42 patients receiving complex treatment with PRP and fractional radiofrequency ablation (PRP + FRF). PRP procedures using the micro-papular technique in group 1 were carried out 5 times with an interval of 2 weeks. The combination of PRP + FRF in group 2 was performed according to the following: the first procedure – FRF, two weeks later – PRP using the micro-papular technique. Then after 2 weeks FRF was performed again, and so on. The total number of procedures of both techniques was 10.Results and discussion. As a result of the treatment, in all patients with post-acne, the clinical indicators of the severity of skin scarring changes decreased significantly, while the most noticeable dynamics were common for patients in group 2. The scars assessment using the Vancouver scale showed that 6 and 12 months after treatment, the severity of objective components and the severity of subjective sensations decreased in most patients. The severity of their own attitude to persistent defects also decreased. Analysis of the frequency of adverse reactions during treatment and in the early period showed that there were no significant intergroup differences in individual adverse reactions. The overall frequency of adverse events in the long-term period also did not significantly differ.Conclusion. The results of the study indicate that the use of PRP in the complex treatment of scarring is a clinically effective and safe method of treatment and allows you to expand the range of therapeutic approaches for scarring skin deformities.

Objective: To determine the optimal technological modes for the preparation of platelet-rich plasma (PRP) using standard laboratory equipment.Material and methods: Blood for the research was taken from 25 healthy volunteers. Its centrifugation was performed on a standard CM-6M laboratory centrifuge using various modes and two types of vacuum tubes with lithium heparin containing separation gel and without it. The number of platelets and leukocytes was calculated in the upper, lower and middle layers of the obtained plasma sample.Results: Plasma samples obtained during centrifugation modes from 415 to 1660 g for 10 minutes using test tubes that do not contain separation gel are optimal in terms of the number of platelets. Plasma intake from the lower layer of the obtained sample after centrifugation is always accompanied by the inclusion of leukocytes in its composition, which can lead to undesirable tissue reactions when it is used.Conclusion: To obtain PRP, it is possible to use standard laboratory equipment in the centrifugation mode from 415 to 1660 g for 10 minutes using test tubes that do not contain separation gel. Plasma sampling for clinical use should be carried out from the middle layer of the obtained sample.

The main method of surgical treatment of patients with post-traumatic disorders of bone regeneration is the use of bone grafting. Until now, the optimal plastic material has been a bone autograft, which use involves additional trauma to the patient. Alternative materials that are used for grafting have only an osteoconductive effect, of varying effectiveness. To optimize the properties of plastic materials, giving them an osteostimulating effect, they can be used in combination with biologically active substances. A source of biologically active substances can be platelet-rich plasma, platelet lysate and red bone marrow. This literature review includes a description of three main methods to stimulate osteogenesis. The first part examines the mechanism of action of platelet-rich plasma, indications and contraindications for its use, describes the results of treatment when platelet-rich plasma is used to stimulate osteogenesis. Platelet-rich plasma is a product of a human native blood obtained by centrifugation. The output is a high concentration of platelets in a small volume of plasma, which contain growth factors and cytokines that have a direct effect on the regeneration process. Local platelet-rich plasma therapy is performed to stimulate osteogenesis. Autologous platelet-rich plasma with growth factors contained in α-granules of platelets is injected into an allogeneic graft or into a fracture zone. The aim of this article is to summarize the results of treatment using platelet-rich plasma to improve bone regenerative potential in orthopaedics.

Osteoarthritis is one of the most common chronic diseases, which is characterized by the destruction of joint cartilage and leads to changes in the structure of other joint elements, the formation of osteophytes and the development of inflammation in the immediate area. Precise assessment of the frequency and distribution of the disease in the population may be difficult due to the inconsistent definition of the disease and the selected diagnostic criteria, but it is estimated that it may occur in up to 60% of the elderly population, more often in women than men. There are many documented risk factors for the occurrence of the disease, such as age or genetic predisposition, but the modifiable ones deserve special attention. Recently, great emphasis in the context of osteoarthritis has been put on the fight against obesity, which not only increases the mechanical load on the joints, but also intensifies the generalized inflammation in the cartilage and its surroundings. This is one of the reasons why non-pharmacological therapy, i.e. patient education and physiotherapy, is a basic element of management, both alone and in combination with pharmacological treatment. The most common drugs used in OA are non-opioid analgesics from the lowest level of the analgesic ladder - mainly NSAIDs, and their proven effectiveness is consistent with the current concept of inflammation as the main pathogenetic factor. As a second-line treatment, injections of glucocorticoids, hyaluronic acid (HA) and platelet-rich plasma (PRP) directly into the joint may be considered. Unfortunately, most randomized studies show that the administration of steroids is effective, but the effects are relatively short-lived, up to a few weeks, while more reliable scientific evidence is needed to confirm the effectiveness of other substances.

Purpose: to study the effectiveness of the use of thrombofibrin clot of platelet-rich plasma (PRP) in patients with corneal ulcers. Material and methods. A clinical study, conducted by the Department of Traumatology and Reconstructive Surgery of Helmholtz National Medical Research Center of Eye Diseases, involved 20 patients, aged from 22 to 82, with corneal ulcers of inflammatory and burn genesis more than 100 microns deep. All patients got coated with a thrombofibrin PRP clot from autologous blood. Prior to the study, all patients received standard treatment for 2 weeks to 3 months, including multiple amniotic membrane coating, with no effect. The thrombofibrin clot was produced by the Scientific Department of Biotechnology and Transfusiology of the N.V. Sklifosovsky Research Institute for Emergency Medicine. The ready clot was placed on the surface of the cornea and covered with an amniotic membrane. The membrane was fixed to the episclera along the border of the limb with a circular suture, whereupon autologous serum was injected along the limb in 4 quadrants, to be followed by temporary lateral blepharography. Results. On the 2nd day following the procedure, the patients noted a decrease in lacrimation and pain in the operated eye. As shown by optical coherence tomography, the average depth of the corneal ulcer at the beginning of the study in all patients was 129 ± 28.5 microns. On the 5th day, the depth lowered to an average of 71 ± 32.6 microns, and on the 10th day, to 23.3 ± 15.1 microns. In 7 patients (35%), complete healing of the defect was observed on the 15th day, while in 9 patients (45%) it was stated between the 16th and the 20th day. Thus, the average time of healing of the ulcer with complete epithelization occurred was 15 days. In four patients with the consequences of severe burns (20%), the ulcer did not heal due to extensive damage to the limbal zone. Conclusion. The use of a thrombofibrin PRP clot in combination with amniotic membrane transplantation allows achieving a stable and fairly rapid healing of corneal ulcers of various origins. However, this method is ineffective in patients with limbal cell insufficiency, severe burns and extensive damage to the limbal zone. In such cases, it is advisable to use more radical surgical methods, such as buccal or limbal cell transplantation, or allolimbal transplantation.

The authors have described a clinical case of a spontaneous pregnancy in a patient with decreased ovarian reserve, secondary infertility and a history of an in vitro fertilization failure. Based on literature data and their own experience, the authors believe that intraovarian administration of platelet-rich plasma can increase the ovarian reserve and improve reproductive potential.

The aim of the study was to determine the effectiveness of autologous bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP) intraosseous injection in the treatment of patients with knee OA stages II-III. Methods: The multicenter randomized study involved 40 patients (27 women, 13 men, average age 67.07.8 years, BMI 32.74.8, duration of disease 17.33.7 months) with knee OA of stages II-III according to the Kellgren-Lawrence (K-L) classification. Patients of the main (BMAC group) group (n=19) underwent a single intraosseous injection of BMAC, in the comparison group (n = 21) a PRP injection (PRP group). The results were evaluated after 1, 3, 6, 12 months with the verbal rating scale (VRS), VAS, Leken and WOMAC scales. Results: Comparison of the results in the groups on the VRS showed that at an earlier time (3 and 6 months), the preferences of patients were in favor of the treatment of BMAC (65% and 55% positive reviews) before PRP (55% and 45% positive reviews), whereas after 12 months the differences were insignificant. Analysis of VAS indicators in patients of both groups indicated a more pronounced decrease in the severity of pain syndrome after BMAC intraosseous injection. The analysis of the Leken scale indicators showed in favor of BMAC throughout the entire observation period, the differences were most pronounced in the first 3 months of observation. The ratio of the values of the WOMAC index in both patients groups indicated statistically significant differences that persisted in all periods of follow-up, the increase in indicators occurred to a lesser extent after the introduction of BMAC compared with PRP. Conclusions: A single intraosseous BMAC injection has an advantage over a similar PRP injection in terms of pain, knee function and physical activity of patients at all follow-up periods. Both methods of treatment are equally safe.

Relevance. In a number of pathological conditions accompanied by defects of the basal membrane, such as chemical or thermal burn, mechanical trauma, Schegren’s syndrome, herpetic keratitis processes of corneal epithelization are slowed down, and sometimes epithelization does not occur at all. Slow epithelization or its complete absence creates conditions for infection, thinning, and sometimes perforation of the cornea. That is why the problem of chronic corneal erosions is very relevant. The most perspective method of treatment is the use of autologous platelet-riched plasma (PRP). Presence of platelet growth factors, adhesive molecules and cytokines in PRP allows to use it for acceleration of regeneration of corneal defects, and the presence of live platelets allows to refer this procedure to autologous cell transplantations.Objective: To evaluate the clinical and morphological features of corneal epithelium regeneration in response to the application of PRP in conditions of experimental chronic corneal erosion (ECCE).Materials and methods. Researches were carried out on 12 rabbits of Chinchilla breed (24 eyes). At first stage the model of ECCE was reproduced for all animals: local ultraviolet (UV) irradiation with the exposure time of 45 min. on the preliminary de-epithelized corneal surface. At the second stage all animals under study were divided into three groups (4 rabbits in each group). I-st main group (MG) was instillated with PRP at a rate of 1 drop / 1 min within 10 minutes (total of 10 drops) once, in the II MG treatment was carried out according to the above method, every day for 5 days. In the control group (CG) PRP treatment was not applied.Results. 45-min. UV irradiation causes persistent ECCE up to 30 days of the experiment and reverts only after surface vessels are ingrowed in the affected area. Single use of PRP has insufficient therapeutic effect. Instillation within 5 days accelerates the cornea reparative regeneration in ECCE conditions. The absence of epithelial defect, newly formed vessels and corneal clouding was registered on the 9th day. Histologically, on the 30th day a normal multilayer non-squamous epithelium was found, while the stroma had an organized structure with no signs of inflammation.Conclusions. Therapeutic effect of PRP in ECCE conditions is based on reforming of the normal «adhesion complex» between epithelium, olfactory membrane and multifactor stimulation of reparative regeneration due to growth factors located in it, adhesive molecules and cytokines, as a result of which the typical corneal epithelium is restored.

Objectives assessment of structural changes in the calcaneal tendon tissue in experimental tendinopathy under autologous platelet-rich plasma. Material and methods. Twenty mature Wistar rats, selected for the study, were divided into 5 groups. Rats of all groups received intra- and peritendinous injections of 0.5 ml of 10% sterile talc suspension to provide the experimental modeling of tendinopathy of the calcaneal tendon. Then the tendinopathy area was treated by injections of autologous platelet-rich plasma (PRP), a hyaluronic acid preparation "Rusvisk" (Rusvisk, Russia) and their sequential combination. The results were evaluated after 10 weeks in the autopsy preparations using a light microscopy method and morphometry. Results. The histological signs characteristic of tendinopathy were revealed, such as the disorganization of collagen structures, mucoid and lipoid degeneration, neovascularization, lymphoid and histiocytic infiltration. The injection of PRP, hyaluronic acid, or their sequential combination in the area of simulated tendinopathy led to changes in the histological presentation of the tissue. As a result, the collagen matrix had less signs of disorganization and less pronounced degenerative changes, as well as manifestations of the inflammatory process in the peritenon and the soft tissues surrounding the tendon, in comparison with the histological profile, which was observed in micropreparations in animals with tendinopathy who had no treatment. Conclusion. The introduction of PRP into the area of the calcaneal tendon has reduced the manifestations of the inflammatory process, disorganization of the collagen matrix, promoted the enhancement of collagen synthesis by cells and, ultimately, the processes of tissue remodeling.

Objectives to evaluate the effectivenes of platelet-rich plasma preparations in the treatment of chronic inflammatory diseases of lower extremities. Material and methods. The study involved patients hospitalized in the Research Institute S. V. Ochapovsky Regional Clinic Hospital No.1, Krasnodar, with trophic ulcers and chronic osteomyelitis. The patients received injections of platelet-rich plasma as platelet lysate and/or platelet gel. Results. The study involved 19 patients with trophic ulcers of the lower extremities with a duration of more than 2 months. Previously, the patients had underwent therapy without effect. In all cases, the patients received a complex of therapeutic measures, including debridement, dressing, conservative treatment, physiotherapy, antibiotic therapy. In the presence of large ulcers, 8 patients underwent autodermoplasty with complete engraftment. It has been noted that during platelet-rich plasma use the average healing time was 6-7 weeks. Four patients were observed with chronic osteomyelitis. During operation, the bone cavity was filled with platelet gel. The postoperative period was uneventful in all cases. The maximum observation period was 1.5 years. No recurrence of osteomyelitis was detected. Conclusion. The results of the study demonstrate the positive effects of platelet-rich plasma products use.

Aim. To increase the effectiveness of complex treatment of women with intrauterine synechiae (IS) through intrauterine administration of platelet-rich plasma (PRP). Materials and methods. The authors studied the complex treatment results of 60 women with second and third degree intrauterine synechiae: 20 patients in the active treatment group, after hysteroscopic destruction of intrauterine synechiae, underwent intraoperative subendometrial administration of PRP followed by irrigating the uterine cavity with PRP on the 2nd and 3rd days after the operation, along with complex postoperative treatment (antibacteria and cyclic hormone therapy, physiotherapy); 40 patients in the comparison group underwent only complex postoperative treatment without PRP administration. The authors conducted comparative assessments of menstrual function, endometrial thickness and uterine cavity during check-up hysteroscopy procedure. Results. Two months after the treatment, a statistically more significant increase in the thickness of endometrial tissue was found with the use of PRP compared with patients treated without PRP (p=0.03 and 0.04). Statistically more significant changes in the state of the uterine cavity were revealed when using PRP in the group of patients with the second-degree process severity (p=0.00005), while in patients with the third-degree process severity there were no statistically significant differences identified depending on the method of treatment used. The authors confirm high safety and reliability of the method as well as no adverse reactions to parenteral and intracavitary administration of autologous PRP. Conclusion. The study confirmed applicability and prospects of using PRP as a stage in complex treatment of IS patients.

The paper reviews the data available in the literature on the mechanisms of action of platelet-rich plasma (PRP) and the experience of its use in patients with rheumatoid arthritis (RA). It defines the place of PRP in the systemic and local therapy of RA. The chemical composition of PRP and the structure of the platelet organelles included in it are described. An estimate is made for procedures to prepare platelet-rich plasma containing different concentrations of key growth factors, such as platelet-derived growth factor (PDGF), transforming growth factor α (TGFα), vascular endothelial growth factor (VEGF), insulin-like growth factor (IGF), and epidermal growth factor (EGF). The variants of PRP classifications, which take into account differences in the composition and levels of the growth factors, are considered. The experience with intra-articular injections of autologous plasma products in patients with RA and synovitis is analyzed. These findings lead to the conclusion that PRP therapy can be an effective tool to relieve inflammation and to stimulate local reparative processes in damaged joint tissues in patients with RA. Further study of the possibilities of using this method of therapy and the formation of a PRPtherapy protocol for patients with rheumatoid arthritis will provide effective personalized care to these patients.

There are many different surgical techniques for bone reconstruction. However, biological reconstruction methods are being increasingly developed. The main purpose is not only to fill up defects, but to stimulate the processes of reconstruction and regeneration of bone as a complete organ. In this report, we describe the basic principles of orthobiology and the essential orthobiological materials. A clinical case is presented where a combination of allogeneic osteoplastic materials with autologous platelet-rich plasma is used to reconstruct a cavity defect in the tibia.

Introduction. Bone-destructive processes and injuries of the vertebral bodies of the thoracic and lumbar localization are a significant part of the pathology of this localization. According to etiological factors, mechanisms of pathogenesis and the nature of the course, they are a very heterogeneous groups of diseases.Objective: to identify the main factors that determine the development of disorders in compression fractures of vertebral bodies of thoracic and lumbar localization against the background of postmenopausal and senile osteoporosis for improving the prognostic criteria of the disease on the basis of an integrated assessment of the clinical course of the disease and optimizing treatment by activating reparative bone tissue regeneration according to the literature sources analyzed.Material and research methods. Depending on the treatment method used, patients were divided into 3 groups: in group 1 (control group) were 20 patients with compression fractures of vertebrae of thoracic and lumbar localization against a background of postmenopausal and senile osteoporosis, where we used standard methods of therapy. Group 2 (main group) consisted of 20 patients with compression fractures of vertebrae of thoracic and lumbar localization against the background of postmenopausal and senile osteoporosis, in the treatment of which platelet-rich plasma was also used in addition to standard methods of therapy.Research results. Based on the obtained results of the study, we developed an algorithm for surgical treatment of patients with pathological vertebral fractures against the background of osteoporosis. The choice of the method of surgical treatment depends on: the type of fracture, the level of damage, the degree of loss of bone mineral density, the degree of deformation of the spine, the general somatic state of the patient, the presence of stenosis of the spinal canal and signs of neurological deficit, the severity of the pain syndrome.Conclusion. The introduction of platelet-rich plasma to the area of the bone wound shortens the duration of the healing process, in our opinion, by eliminating the phase of inflammation, low intensification of the phase of formation of tissue-specific elements that are present in large amount in platelet growth factors. In order to accelerate the restoration of damaged bone, we used a platelet-rich plasma in addition to standard therapy, and found a positive effect on compressive fractures of the thoracic and lumbar vertebrae against the background of postmenopausal and senile osteoporosis, which justifies the advisability of further use platelet-rich plasma in clinical practice.

Local injections of platelet-rich plasma (PRP) and hyaluronic acid (HLA) are considered an effective method for treating chronic shoulder pain (CSP) associated with damage to the tendons of the rotator cuff muscles (RCM).The aim of the study is to compare the effectiveness and safety of local therapy of PRP and HLA in patients with CSP caused by damage to the tendons of the RCM muscles.Materials and methods. The study included 100 patients (54% women and 46% men, average age 51.5±15.1 years) with CSP (persisting for ≥3 months) associated with damage and tendinitis of the supraspinatus, subacute, scapular or small round muscle, confirmed by magnetic resonance imaging or ultrasound (ultrasound). The patients were randomized into two groups of 50 people who were treated with PRP (three injections at 7-day intervals) or HLA (two injections at 7-day intervals). The injections were performed under ultrasound control in the subacromial SAC. The results of the study were evaluated by the dynamics of pain intensity (on a visual analog scale, up to 100 mm) and functional disorders (ASES and CSS indices) after 1, 3 and 6 months.Results. Against the background of the use of PRP and HLA, there was a significant improvement in the condition of patients, while both drugs showed approximately the same effectiveness. The severity of VAS pain decreased from 56.8±15, respectively, after 6 months.5 and 57.6±17.8 mm to 31.8±27.8 and 30.2±26.3 mm, ASES-c 55.8±15.9 and 53.6±14.7 to 74.6±22.4 and 77.3± 22.4, CSS-c 59.2±14.4 and 47.8±16.9 to 69.9±17.3 and 65.6±19.2. the Dynamics of all these indicators in comparison with the baseline level was statistically significant (p0.05). The effectiveness of PRP and HLA (in terms of pain dynamics, ASES, and CSS) was significantly higher in individuals younger than 45 years, compared to older patients. The tolerability of therapy was good – after the introduction of PRP, 40% of patients had a short-term (3–4 days) increase in pain, which did not require the use of additional analgesics or interruption of treatment. No serious adverse reactions were observed when using PRP and HLA.Conclusion. OTP and GLA are effective and safe in the treatment of CSP associated with damage to the tendons of the RCM muscles. The dynamics of pain intensity and functional status after the use of these drugs did not differ. Treatment of PRP and HLA is more effective in people younger than 45 years.

Introduction. The urgency of the problem of polytrauma is due to the constant increase in the number of road accidents, armed conflicts, terrorist acts, accompanied by the appearance of a large number of victims with severe and extremely serious injuries.Purpose of study: to analyze the scientific literature and the results of our own experimental research and to summarize data on current trends and relevance of studying the main factors determining the development of disorders in victims with pelvic fractures in combination with multiple and combined injuries, to improve the prognostic criteria based on a comprehensive assessment of the clinical course of the disease and optimization of treatment by activating reparative regeneration of bone tissue with platelet-rich plasma.Materials and methods. In the period from 2017 to2018 in the department of severe concomitant injury of the City Clinical Emergency and Medical Care Hospital of Zaporozhye, 35 patients with pelvic concomitant injury were operated. There were 19 men (54.29%) and 16 women (45.71%), aged from 23 to 77 years old, median – 39 years.22 injured persons (62.86%) had road traffic injuries, 10 (28.57%) had household injuries, 2 (5.71%) had production injuries and 1 more (2.86%) had others. ISS scale less than 17 points was found in 20 patients (57.14%), from 17 to 25 – in 12 (34.29%), from 26 to 40 – in 2 (5.71%), more than 40 – in 1 (2.86%).In all patients (100%) varying degrees of pelvic bone injuries were verified. These lesions of the pelvic ring were more often combined with fractures of the proximal femur with a traumatic brain injury - 17 cases (48.57%), with concomitant fractures of extremities of other localization - 12 (34.29%), with intraperitoneal injury - 11 (31.43%), with vertebral fractures - 9 (25.71%), with chest trauma - 6 (17.14%).Results. In the main group of patients with treatment by platelet-rich plasma radiological visible adhesions of the key injured area in 8 weeks occurred in 10 people (83.33%). In 1 patient (8.3%) fusion occurred after 12 weeks and in 1 (8.3%) – 16 weeks after surgery. In the control group fusion at 8 weeks was detected in 14 patients (60.87%), in 8 patients (34.78%) – at 16 weeks.Conclusion. Reliably substantiated data were obtained according to the results of the analysis of contingency tables 4*4 and the calculation of χ2 for the efficiency coefficient according to the Wald formula (Chi-square 6.87 with p=0.009), which indicate the best clinical positiveness of the technique with the additional introduction of platelet-rich plasma into the treatment regimen as part of assessing the dynamics of fracture consolidation processes in victims with multiple and concomitant injuries, which allows us to predict a favorable outcome in these patients.

It is known that the level of calcium in the body is under the control of the thyroid gland, and the metabolism of collagen – the organic matrix of bone – depends on the concentration of hydroxyproline in blood plasma. Therefore, we considered it appropriate to study the effect of osteotropic agents used to correct bone defects in experimental animals on changes in calcitonin and hydroxyproline levels. To elucidate the biochemical mechanisms osteotropic influence of drugs on bone tissues studied changes in markers of bone metabolism and Са hormone levels dynamics in experimental research. The aim of the study: to investigate the effectiveness of osteoinductive materials for the reconstruction of bone defects. Object and methods of research. Osteoplastic properties of the materials were studied in a model of a bone defect of the femur of the diaphyseal zone in Wistar rats, four months old. Were formed 4 experimental groups: control group (intact animals) – 12 individuals; Group I – 14 animals, osteoplastic material «mp3 OsteoBiol» was used to heal the bone defect; Group II – 13 animals, filling the bone defect with platelet-rich plasma (PRP); Group III – 15 animals, in the augmentation of the bone defect used the composition «mp3 OsteoBiol + PRP». Alkaline phosphatase activity was determined by photometric unified method. Total acid phosphatase was determined by photometric optimized kinetic method. The mineralization index was calculated as the ratio of the activity of Alkaline Phosphatase / Acid Phosphatase enzymes. Determination of the concentration of hydroxyproline was performed photometrically and the content of calcitonin in the blood of animals was studied by enzyme-linked immunosorbent assay. Statistical processing of the obtained results was performed on a personal computer using the licensed programs «Microsoft Excel» and «Statistica». Research results and their discussion. As a result of the study, it was found that the lowest values of the concentration of calcitonin and hydroxyproline were studied in experimental animals of group III, where the bone defect was restored by our proposed composition. On day 60 of the study in animals of group III, where the healing of the bone defect occurred under the action of our proposed composition, the activity of alkaline phosphatase was equal to that of intact rats, p> 0.05, p1 , p2

Purpose: presentation of a clinical case of an idiopathic macular hole (IMH) recurrence after its successful closure augmented with platelet-rich plasma (PRP) and the results of repeated surgical treatment.Methods. The patient underwent clinical examination and optical coherence tomography (OCT) of the retina before and after surgical treatment. А 2-stage surgical treatment of the left eye with an interval of 7 days: phacoemulsification (PE) followed by microinvasive vitrectomy with Internal limiting membrane peeling (ILM) and closure with the use of PRP. The patient was discharged with improved visual acuity and closure of the macular hole (MH). After 2 weeks vision deterioration was noted by the patient in the operated eye. Clinical examination revealed macular edema (ME) and recurrence of MH. Topical steroid eye drops were used to no avail, with increase of ME and MH via OCT control. Revision of the vitreal cavity augmented with PRP was performed.Results. In follow-up a complete closure of the MH, resolution of ME and improvement in visual acuity after repeated surgery was confirmed.Conclusions. A case of recurrent MH after primary closure with PRP is described. The case suggests a possibility of clinical improvement after repeated MH closure augmented with PRP. The causes and mechanisms of the recurrence of MH are still not clear. Despite the positive results of surgery subsequent OCT retina examination is necessary.

Platelet-rich autologous plasma (PRP) is often used in various branches of medicine. The scope of PRP therapy has expanded from stimulating bone regeneration, healing wounds and ulcers, and musculoskeletal injuries to improving the ability to engrave various types of grafts. Due to the natural properties of platelet-rich plasma, its introduction into the human body is one of the most promising procedures for tissue restoration. After the destruction of platelets, PRP contains α-granules, from which many factors are released after activation, such as transforming growth factor-beta (TGF-β), vascular endothelial growth factor (VGFF) and epidermal growth factor (EGF). The current state of the problem of using APOT has a huge perspective on the development of the methodology, which is due to many aspects that make this procedure simple. PRP can improve the course of many urological diseases, such as erectile dysfunction, Peyronie’s disease, urethral stricture, vesicovaginal fistulas, interstitial cystitis, and stress urinary incontinence. There are many protocols for preparing PRP, each of which has its standardized parameters and stated results. The article presents a review of the literature on the use of platelet-rich plasma in urology, focuses on the definition of PRP, various methods of preparation and activation, as well as the concentration of growth factors.

Non-alcoholic steatohepatitis (NASH) is a consequence of the progression of non-alcoholic fatty liver disease (NAFLD), which can lead to cirrhosis or hepatocellular insufficiency. NAFLD is a predictor of cardiovascular diseases (CVD) development. The important factor of the latter development is atherogenic dyslipidemia, and this is a type of 20-80 % NASH patients. The objective: to study the effectiveness of platelet-enriched plasma (PRP) influence on the morpho-functional state of liver in rats with non-alcoholic steatohepatitis. Materials and methods. The study was carried out on 80 adult male Wistar rats. Animals were divided into three groups: I group - animals that received an atherogenic diet for 90 days (n=10); II group - animals with simulated NASH and DL which received a normal diet for 30 days (n=30); III group - animals with simulated NASH and DL and PRP correction (n=30); group of intact animals (n=10). NASH was simulated by introducing an atherogenic diet, which consisted of lard and 50 g / kg of butter for 90 days. PRP was punctured in the tissue of liver, twice at 0.05 ml with 7 days interval. The animals were taken out of the experiment after 90 days of the atherogenic diet and on the 30th day after its cessation or PRP injection. The indicators of body mass, liver mass index (LMI), lipogram, hepatic transaminases were determined, and the further pathological examination of the liver tissue was done. Results and discussion. On the 90th day of the atherogenic diet, the GH level was 3.19 ± 0.56 mmol/l, ALT activity was 118 ± 6.12 U/l, AST 86 ± 4.52 U/l, morphological signs of NASH were detected. On the 30th day, the lipid profile of group II rats did not have statistical differences from group I, in rats after correction of NASH with the use of PRP the level of LLD decreased by 51%, ALT activity - by 54%, AST - by 51% compared to control group (p Conclusions. On the 90th day of an atherogenic diet NASH was formed in experimental animals. They had dyslipidemia, which progressed for at least 30 days while maintaining a usual diet. After correction with PRP the level of atherogenic lipoproteins was significantly decreased in rats with NASH and DL; the activity of liver enzymes was lower compared to the group with simulated NASH and DL and the group with progression of NASH and DL for 30 days, morphologically the decrease in liver steatosis and severity of protein dystrophy comparing with a group with simulated NASH and DL and a group with progressive NASH and DL was observed for 30 days.

Aim. To describe a case of fat obliteration using platelet-rich plasma in a patient with recurrent chronic frontal sinusitis.Materials and methods. A clinical case of a 60-year-old patient who had repeatedly performed extranasal frontotomy for recurrent chronic frontal sinusitis with a short-term effect is described. Due to the ineffectiveness of conservative and traditional surgical treatment, taking into account the characteristics of the clinical picture and the presence of a cosmetic defect in the area of projection of the right frontal sinus, as well as CT results (postoperative bone defect of the right half of the frontal bone), a right-side extranasal frontotomy was performed. The operation involved sinus obliteration with adipose tissue obtained from areas of the thigh anterior surface by lipoaspiration under low pressures with the addition of platelet-rich plasma (PRP) prepared by a single centrifugation of whole venous blood. An assessment of the patient’s condition and fat transplant was carried out on the basis of objective examination after 4 and 6 months and 1.5 year after the surgery and the results of control computed tomography (CT).Results. No complaints regarding nasal breathing from the frontal sinus were registered during control examinations. A good cosmetic result and the absence of pain during palpation in the right frontal sinus were observed. According to CT results, the density of the contents of the frontal sinus corresponded to that of adipose tissue; the volume of material did not changed.Conclusion. Frontal sinus obliteration with adipose tissue and PRP addition is a promising method for treating patients with recurrent chronic frontal sinusitis and repeatedly performed extranasal frontotomy. This method has several advantages over other methods.

Growth factors play a key role in wound healing, deficiency of which leads to delayed healing. Various growth factors are used in the treatment of chronic wounds, including diabetic foot ulcers. The purpose of this review was to analyse the literature data on the effectiveness of epidermal growth factor, platelet-rich plasma and platelet growth factor in patients with diabetic foot syndrome. The effect of treatment with these growth factors on healing of diabetic foot ulcers and healing time were analysed. Published studies, mostly with low level of evidence, demonstrate a positive effect of various growth factors on the healing process of diabetic foot ulcers. Currently, there is no conclusion on the advantages of growth factor therapy. Further studies with a high level of evidence are needed to justify their use in routine clinical practice.

Chronic shoulder pain caused by shoulder impingement syndrome (SIS) is a common pathology that leads to worse quality of life and disability. The local administration of platelet-rich plasma (PRP) is a promising treatment for SIS.Objective: to evaluate the efficiency of subacromial injection of PRP in chronic shoulder pain caused by SIS.Patients and methods. The investigation enrolled 30 patients (13 women and 17 men; mean age, 45.8±14.1 years) with chronic shoulder pain lasting ≥3 months after rotator tendons injury confirmed by ultrasound and/or magnetic resonance imaging and inefficiency of previously medical therapy. All the patients received three subacromial injections of 5 ml of PRP at a 7-day interval. The investigators assessed the course of pain during movement (100-mm visual analogue scale (VAS)) and functional ability according to the ASES and CSC questionnaires at baseline and 1, 3 and 6 months after treatment.Results and discussion. During the treatment, there was a considerable improvement in all indicators. At baseline and 1 and 3 months, the mean pain severity measured on VAS was 49.3±10.3, 32.4±21.3, and 20.6±21.3 mm, respectively; in this case, the positive effect persisted at 6-month follow-up: 10 [0; 30] mm (p