Introduction: Chronic vascular ulcers are associated with a high use of resources. Conventional treatment consists of wound cleansing, necrotic tissue debridement, prevention, diagnosis, and, if necessary, treatment of infection and dressing application; although conventional treatment has limited effectiveness with wound healing (around 15-30%).8-11 Platelet-rich plasma, used in various fields of medicine, improves chronic vascular ulcer results, but is more expensive.
Methods: A cost-effectiveness analysis was performed using a 48-week period comparing plateletrich plasma with standard care. A meta-analysis of papers identified by a literature search was done.
Results: A combined measure of effectiveness at 12 weeks for each treatment option was calculated and served as the basis for estimating the probability of healing at 48 weeks with a Markov model.
Conclusions: The probability of healing and associated costs were 56% and €5224 using platelet-rich plasma and 31% and €5133 with usual care. The incremental cost that must be assumed to achieve additional healing with platelet-rich plasma is €364. .
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Partial-thickness rotator cuff tears (PTRCTs) are a common source of shoulder pathology, both in the aging population and in younger overhead athletes. Advanced imaging modalities used currently have led to increases in recognition, diagnosis, and treatment of these tears. The anatomy, five-layer histology, and relationship to the Ellman classification of PTRCTs have been well studied, with recent interest in radiographic predictors, such as the critical shoulder angle and acromial index.
View Article and Find Full Text PDFInstr Course Lect
January 2025
The medial ulnar collateral ligament of the elbow is the primary stabilizer against valgus load. It can tear acutely or through attritional damage as in repetitive overhead sports. Although baseball players, particularly pitchers, are the most vulnerable athletes, these injuries also occur in contact athletes, gymnasts, and javelin throwers.
View Article and Find Full Text PDFClin Orthop Relat Res
December 2024
Federal University of Bahia, Salvador, Brazil.
Background: Several meta-analyses have evaluated the use of platelet-rich plasma (PRP) in the treatment of Achilles tendinopathy. Although they generally did not find PRP to be effective, an updated meta-analysis containing all the available, high-quality randomized trial evidence that addresses the methodological shortcomings identified in earlier meta-analyses needs to be performed.
Question/purposes: This systematic review and meta-analysis aimed to evaluate the efficacy of PRP in improving (1) pain and function as assessed using the Victorian Institute of Sports Assessment-Achilles (VISA-A) score 3 months, 6 months, and 1 year after treatment and (2) VAS pain scores 3 months after treatment in patients with chronic Achilles tendinopathy.
Rotator cuff tears are a prevalent musculoskeletal issue, particularly among middle-aged and elderly individuals, affecting shoulder stability and arm movement. These tears can arise from acute injuries or chronic wear and tear, leading to conditions ranging from tendinopathy to cuff tear arthropathy. The prevalence increases with age, with a significant portion of older adults affected, many of whom may be asymptomatic.
View Article and Find Full Text PDFCureus
December 2024
Department of Orthopedic Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, USA.
This review examines intrinsic and extrinsic augmentation techniques for uniting hand and upper extremity fractures, including bone morphogenic proteins (BMPs), platelet-rich plasma (PRP), low-intensity pulsed ultrasound (LIPUS), and pulsed electromagnetic fields (PEMF). While BMPs, PRP, LIPUS, and PEMF show potential in accelerating bone healing and reducing nonunion rates, their clinical adoption is limited by high costs and inconsistent results. This paper focuses on understanding the efficacy of these techniques, their drawbacks, and potential next steps for the field.
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