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Limitations in Clinical Evidence and Trial Design The current orthopaedic literature on peptides is dominated by animal models, small prospective cohorts, and case series, with very limited RCTs

( Pharmaceuticals , 2026) reviewed BPC-157 in Achilles tendon repair and muscle-to-bone healing, with proposed mechanisms involving EGR-1 gene upregulationa transcription factor important in tendon and ligament repair

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