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Platelet-rich Plasma: Current Concepts and Application in Sports Medicine

March 4, 2010

Platelet-rich Plasma: Current Concepts and Application in Sports MedicinePlatelet-rich plasma is defined as autologous blood with a concentration of platelets above baseline values. Platelet-rich plasma has been used in maxillofacial and plastic surgery since the 1990s; its use in sports medicine is growing given its potential to enhance muscle and tendon healing. In vitro studies suggest that growth factors released by platelets recruit reparative cells and may augment soft-tissue repair. Although minimal clinical evidence is currently available, the use of platelet-rich plasma has increased, given its safety as well as the availability of new devices for outpatient preparation and delivery. Its use in surgery to augment rotator cuff and Achilles tendon repair has also been reported. As the marketing of platelet-rich plasma increases, orthopaedic surgeons must be informed regarding the available preparation devices and their differences. Many controlled clinical trials are under way, but clinical use should be approached cautiously until high-level clinical evidence supporting platelet-rich plasma efficacy is available.

Platelet-rich plasma (PRP) is defined as a sample of autologous blood with concentrations of platelets above baseline values. Platelets play an instrumental role in the normal healing response via the local secretion of growth factors and recruitment of reparative cells1 (Table 1). As a means of growth factor delivery, PRP was first popularized in maxillofacial and plastic surgery in the 1990s.2 Its use in orthopaedics began early in this decade as PRP was used with bone grafts to augment spinal fusion and fracture healing. Although debate continues regarding the potential benefit of PRP to improve bone healing,3,4 a growing body of laboratory evidence supports the use of PRP injections for the treatment of muscle and tendon injuries and degeneration.5-15 Despite minimal clinical evidence, recent development of marketed devices to enable PRP preparation in the outpatient and surgical settings has led to an increased use in sports medicine in both Europe and North America.16

Platelet-rich plasma is defined as autologous blood with a concentration of platelets above baseline values. Platelet-rich plasma has been used in maxillofacial and plastic surgery since the 1990s; its use in sports medicine is growing given its potential to enhance muscle and tendon healing. In vitro studies suggest that growth factors released by platelets recruit reparative cells and may augment soft-tissue repair. Although minimal clinical evidenceis currently available, the use of platelet-rich plasma has increased, given its safety as well as the availability of new devices for outpatient preparation and delivery. Its use in surgery to augment rotator cuff and Achilles tendon repair has also been reported. As the marketing of platelet-rich plasma increases, orthopaedic surgeons must be informed regarding the available preparation devices and their differences. Many controlled clinical trials are under way, but clinical use should be approached cautiously until high-level clinical evidence supporting platelet-rich plasma efficacy is available.

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