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Opened Vial Duration: Once opened and accessed via needle puncture, the vial remains viable only if aseptic technique is maintained and storage conditions are met

Tendon and ligament injuries Acute tears: ACL, rotator cuff, Achilles, or other tendon/ligament injuries

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This step introduces the highest-risk variable in the entire protocol

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Gentler alternatives like niacinamide or PDRN have stronger safety profiles in the absence of definitive data and are reasonable substitutes during this window