Journal ArticleDOI
Platelet-rich plasma: a milieu of bioactive factors.
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TLDR
It is supported that more than just platelets are playing a role in clinical responses to PRP, and the clinical use can theoretically be matched to the pathology being treated in an effort to improve clinical efficacy.Abstract:
Platelet concentrates such as platelet-rich plasma (PRP) have gained popularity in sports medicine and orthopaedics to promote accelerated physiologic healing and return to function. Each PRP product varies depending on patient factors and the system used to generate it. Blood from some patients may fail to make PRP, and most clinicians use PRP without performing cell counts on either the blood or the preparation to confirm that the solution is truly PRP. Components in this milieu have bioactive functions that affect musculoskeletal tissue regeneration and healing. Platelets are activated by collagen or other molecules and release growth factors from alpha granules. Additional substances are released from dense bodies and lysosomes. Soluble proteins also present in PRP function in hemostasis, whereas others serve as biomarkers of musculoskeletal injury. Electrolytes and soluble plasma hormones are required for cellular signaling and regulation. Leukocytes and erythrocytes are present in PRP and function in inflammation, immunity, and additional cellular signaling pathways. This article supports the emerging paradigm that more than just platelets are playing a role in clinical responses to PRP. Depending on the specific constituents of a PRP preparation, the clinical use can theoretically be matched to the pathology being treated in an effort to improve clinical efficacy.read more
Citations
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Journal ArticleDOI
The Anti-inflammatory and Matrix Restorative Mechanisms of Platelet-Rich Plasma in Osteoarthritis
Emily A. Sundman,Brian J. Cole,Vasili Karas,Craig J. Della Valle,Mathew W. Tetreault,Hussni O. Mohammed,Lisa A. Fortier +6 more
TL;DR: Results indicate that PRP acts to stimulate endogenous HA production and decrease cartilage catabolism, and support its use in OA joints to reduce pain and modulate the disease process.
Journal ArticleDOI
Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials.
TL;DR: Current evidence indicates that, compared with HA and saline, intra-articular PRP injection may have more benefit in pain relief and functional improvement in patients with symptomatic knee OA at 1 year postinjection.
Journal ArticleDOI
Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis
TL;DR: PRP injections reduced pain more effectively than did placebo injections in OA of the knee (level of evidence: limited due to a high risk of bias) and this significant effect on pain was also seen when PRP injections were compared with hyaluronic acid injections.
Journal ArticleDOI
Hyaluronic Acid Versus Platelet-Rich Plasma: A Prospective, Double-Blind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intra-articular Biology for the Treatment of Knee Osteoarthritis:
TL;DR: No difference was found between HA and PRP at any time point in the primary outcome measure: the patient-reported WOMAC pain score, which suggests that the anti-inflammatory properties of PRP may contribute to an improvement of symptoms.
Journal ArticleDOI
Current Clinical Recommendations for Use of Platelet-Rich Plasma.
TL;DR: Evidence of its efficacy has been highly variable depending on the specific indication, and additional high-quality clinical trials with longer follow-up will be critical in shaping the perspective of this treatment option.
References
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Journal ArticleDOI
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Journal ArticleDOI
Platelet-Rich Plasma From Basic Science to Clinical Applications
TL;DR: This study reviews and evaluates the human studies that have been published in the orthopaedic surgery and sports medicine literature and the regulation of PRP by antidoping agencies is discussed.
Journal ArticleDOI
Platelet α–granules: Basic biology and clinical correlates
Price Blair,Robert Flaumenhaft +1 more
TL;DR: The role of alpha-granules in inflammation, atherosclerosis, antimicrobial host defense, wound healing, angiogenesis, and malignancy has become increasingly appreciated as the function of platelets in the pathophysiology of these processes has been defined.