Platelet-rich plasma (PRP): methodological aspects and clinical applications

The clinical use of platelet-rich plasma (PRP) is based on the increase in the concentration of growth factors and in the secretion of proteins which are able to maximize the healing process at the cellular level. Since PRP is an autologous biologic material, it involves a minimum risk of immune reactions and transmission of infectious and contagious diseases, and it has been widely used for the recovery of musculoskeletal lesions. Despite the great potential for applicability, the implementation of the therapeutic employment of PRP as a clinical alternative has become difficult, due to the lack of studies related to the standardization of the techniques and/or insufficient description of the adopted procedures. Therefore, it is required establish standard criteria to be followed for obtaining a PRP of high quality, as well as a larger number of studies which should establish the proper concentration of platelets for the different clinical conditions. In this context, the purpose of this review is to discuss some methodological aspects used for achieving the PRP, as well as to discuss the bioactive properties of PRP, and to point out its therapeutic use in different fields of regenerative medicine.

Uso do soro autólogo condicionado e do plasma rico em plaquetas na terapia ortopédica de equinos

Musculoskeletal injuries that occur in horses during sports activities are often disabling and require a long period of treatment and rehabilitation, most resulting in scar tissue, predisposing to recurrence. In search of more effective therapies and tissue regeneration, studies have been carried out with blood derivatives - platelet rich plasma and autologous conditioned serum. In spite of both being blood-derived therapies, platelet rich plasma and autologous conditioned serum are distinct products, with equally distinct indications for their use. Platelet rich plasma shows promising results in ligament and tendon injuries in clinical and experimental trials. This occurs also in osteoarticular lesions with both hemoderivates, autologous conditioned serum and platelet rich plasma. This review aims to present clinical and experimental studies (in vivo and in vitro) in the equine species, as an aid for an appropriate therapeutic choice, when hemoderivates are considered for treatment of musculoskeletal lesions.

Evaluation of the marsh deer stifle joint by imaging studies and gross anatomy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Analysis of experimental tendinitis in rats treated with laser and platelet-rich plasma therapies by Raman spectroscopy and histometry

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Use of power doppler for the assessment of vascularization in equine tendinitis treated with mesenchymal stem cells

Tendinous lesions are very common in athlete horses. The process of tendon healing is slow and the quality of the new tissue is often inferior to the original, leading in many cases to recurrence of the lesion. One of the main reasons for the limited healing capacity of tendons is its poor vascularization. At present, cell therapy is used in equine practice for the treatment of several disorders including tendinitis, desmitis and joint disease. However, there is little information regarding the mechanisms of action of these cells during tissue repair. It is known that Mesenchymal Stem Cells (MSCs) release several growth factors at the site of implantation, some of which promote angiogenesis. Comparison of blood flow using power Doppler ultrasonography was performed after the induction superficial digital flexor tendon tendinitis and implantation of adipose tissue-derived MSCs in order to analyze the effect of cell therapy on tendon neovascularization. For quantification of blood vessel histopathological examinations were conducted. Increased blood flow and number of vessels was observed in treated tendons up to 30 days after cell implantation, suggesting promotion of angiogenesis by the cell therapy.

Avaliação da resposta inflamatória local após aplicação de células tronco mesenquimais alogênicas em tendão flexor digital superficial de equinos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Ocorrência de lesões de ligamentares e músculo tendíneas ao longo das fases do ciclo menstrual de atletas de alto redimento: um estudo de caso longitudinal

Female athletes are more susceptible to injury when compared with males. This increased risk of injury, may be caused by fertile-menstrual cycle. The aims of this study were to investigate the prevalence in the occurrence of muscle-tendon and ligament injuries in different phases of the menstrual cycle over a period of high performance sports training and identify possible differences of occurrences between the phases. Fifteen female athletes, members of a women's basketball team, with ages between 15 and 22 years (average 17.5 ± 2.6 years), with regular menstrual cycles and daily practitioners of training, received follow-up during the menstrual cycle for 5 months. During the period were noted occurrences of injury in relation to the menstrual period of each athlete. The results showed 13 injuries, all of anterior cruciate ligament. The distribution of percentage values indicated a significantly higher risk of athletes suffer injuries in the follicular phase. The result makes us believe that significant elevations in the concentrations of estrogen in this fertile menstrual cycle phase, more open women to a higher risk of performing different injuries.

Relação entre a reatividade de pontos de acupuntura e atividade física com afecções ortopédicas determinadas por exames de imagens em equinos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos do corticosteroide injetado no tendão calcâneo de coelhos: análise histológica, biomecânica e das expressões de metaloproteinases e interleucinas

Pós-graduação em Bases Gerais da Cirurgia - FMB

Relação entre a reatividade de pontos de acupuntura e atividade física com afecções ortopédicas determinadas por exames de imagens em equinos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Efeitos do corticosteroide injetado no tendão calcâneo de coelhos: análise histológica, biomecânica e das expressões de metaloproteinases e interleucinas

Pós-graduação em Bases Gerais da Cirurgia - FMB

Ultrastructural features of the myotendinous junction of the sternomastoid muscle in Wistar rats: from newborn to aging

The myotendinous junction (MTJ) is a major area for transmitting force from the skeletal muscle system and acts in joint position and stabilization. This study aimed to use transmission electron microscopy to describe the ultrastructural features of the MTJ of the sternomastoid muscle in Wistar rats from newborn to formation during adulthood and possible changes with aging. Ultrastructural features of the MTJ from the newborn group revealed pattern during development with interactions between muscle cells and extracellular matrix elements with thin folds in the sarcolemma and high cellular activity evidenced through numerous oval mitochondria groupings. The adult group had classical morphological features of the MTJ, with folds in the sarcolemma forming long projections called finger-like processes and sarcoplasmic invaginations. Sarcomeres were aligned in series, showing mitochondria near the Z line in groupings between collagen fiber bundles. The old group had altered finger-like processes, thickened in both levels of sarcoplasmic invaginations and in central connections with the lateral junctions. We conclude that the MTJ undergoes intense activity from newborn to its formation during adulthood. With increasing age, changes to the MTJ were observed in the shapes of the invaginations and finger-like processes due to hypoactivity, potentially compromising force transmission and joint stability. Microsc. Res. Tech. 75:12921296, 2012. (C) 2012 Wiley Periodicals, Inc.

Correction of Severe Ptosis with a Silicone Implant Suspensor: 22 Years of Experience

Background: Patients with severe ptosis caused by poor or absent function of the levator muscle but with good frontalis muscle excursion usually benefit from a frontalis sling procedure. This is currently carried out using organic or inorganic material to connect the upper eyelid to the frontalis muscle. Methods: The aim of this study was to evaluate retrospectively 112 patients who underwent frontalis sling procedures between 1989 and 2011 using a preformed silicone implant suspensor to correct severe ptosis. Results: The results obtained using this technique were good or fair in 95.54 percent of the cases and poor in 4.46 percent of the cases. The authors discuss the results of the study and the cases in which the procedure should be indicated and highlight the advantages of the method. Conclusion: The availability of this low-cost sterile device, together with the fact that it is ready to use, requires less invasive surgery, saves time, and is sufficiently versatile to allow adjustments to be made at any time, makes the silicone eyelid sling an attractive choice for correcting ptosis. (Plast. Reconstr. Surg. 129: 453e, 2012.)

Low-level laser therapy in collagenase-induced Achilles tendinitis in rats: Analyses of biochemical and biomechanical aspects

NSAIDs are widely prescribed and used over the years to treat tendon injuries despite its well-known long-term side effects. In the last years several animal and human trials have shown that low-level laser therapy (LLLT) presents modulatory effects on inflammatory markers, however the mechanisms involved are not fully understood. The aim of this study was to evaluate the short-term effects of LLLT or sodium diclofenac treatments on biochemical markers and biomechanical properties of inflamed Achilles tendons. Wistar rats Achilles tendons (n?=?6/group) were injected with saline (control) or collagenase at peritendinous area of Achilles tendons. After 1?h animals were treated with two different doses of LLLT (810?nm, 1 and 3?J) at the sites of the injections, or with intramuscular sodium diclofenac. Regarding biochemical analyses, LLLT significantly decreased (p?<?0.05) COX-2, TNF-a, MMP-3, MMP-9, and MMP-13 gene expression, as well as prostaglandin E2 (PGE2) production when compared to collagenase group. Interestingly, diclofenac treatment only decreased PGE2 levels. Biomechanical properties were preserved in the laser-treated groups when compared to collagenase and diclofenac groups. We conclude that LLLT was able to reduce tendon inflammation and to preserve tendon resistance and elasticity. (c) 2012 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 30:19451951, 2012

Distribuição do nervo ibular comum em fetos de equinos e descrição anatômica de pontos para bloqueio anestésico

Analisou-se a distribuição do nervo fibular comum em 30 fetos de equinos, sem raça definida, provenientes do acervo do Laboratório de Anatomia Animal da Faculdade de Medicina Veterinária da Universidade Federal de Uberlândia, que foram injetados e conservados em solução aquosa de formaldeído a 10%. Contatou-se que o referido nervo deriva do isquiático, divide-se em nervos fibulares superficial e profundo, distribuindo-se para os músculos extensores lateral e longo do dedo, fibular terceiro e tibial cranial. Traçando-se uma linha imaginária na região médio-lateral da tuberosidade do osso tíbia, o nervo fibular comum pode ser bloqueado em sua parte proximal, no terço caudal, entre o tendão de inserção do músculo bíceps femoral e a face lateral do músculo gastrocnêmio lateral (terço médio); e o nervo fibular profundo, na parte proximal da tíbia, crânio-distalmente ao fibular comum. O bloqueio do nervo fibular superficial pode ser realizado em duas regiões da tíbia: na proximal, considerando-se a linha imaginária, distalmente ao ponto citado para o fibular comum e caudalmente ao descrito para o fibular profundo; e na distal, na face lateral da articulação tíbio-társica, entre os tendões de inserção dos músculos extensores lateral e longo do dedo.