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Effect of platelet-rich plasma therapy in conjunction with physical therapy for rotator cuff tendinopathy
... BD Vacutainers (BD, Franklin Lakes, New Jersey, USA) consisting of ACD (trisodium citrate 22.0g/L, citric acid 8.0g/L, and dextrose 24.5g/L) to halt clotting. Using a benchtop centrifuge, the collected blood underwent an initial spin at 1000rpm for 10 minutes to derive multilayered components such as a platelet-poor plasma (PPP) level and a middle buffy coat level (rich in platelets and leucocytes), as well as a red blood cell layer [4]. ...
... PPP was then extracted to the level of 10mm and discarded. The PPP and a residual platelet plug were reconstituted with a mild manual agitation, which resulted in the development of 3mL leukocyte-rich PRP [4]. ...
... Thus, higher cellular components grown in culture were reported to have the maximum potential for tissue regeneration and anti-inflammatory effects. PRP also consists of proteins that could modify the pain receptors, thereby reducing pain sensation with its anti-inflammatory effect on affected tendons [4,16]. ...
Patients with musculoskeletal disorders who are recalcitrant to formal rehabilitation may seek non-surgical interventions such as orthobiologics. The care pathway following an orthobiologic procedure may include but is not limited to ancillary modalities, supplements, booster injections, and formal rehabilitation. In some cases, the decision to pursue post-procedural rehabilitation may be questioned due to a paucity of evi-dence supporting efficacy and safety following orthobiologic procedures. Moreover, patients and physicians may possess a level of uncertainty in pursuing an intervention that may have been previously unsuccessful. Although higher-level evidence does not exist to support routine post-procedural rehabilitation, a body of evidence supports enhanced physical functioning as well as cellular and molecular effects synergistic to orthobiologics. Given the potential benefits of post-procedural rehabilitation, there would seem to be little downside to participation, provided that the physician and rehabilitation specialist consider individual patient characteristics such as the current pathoanatomical diagnosis, stage of acuity, and pre-morbid activity levels.
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