Musculoskeletal Applications of Platelet-Rich Plasma: Fad or Future? (original) (raw)
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Clinical Journal of Sport Medicine, 2011
Objective: To evaluate, through a systematic review of the current literature, the evidence-based outcomes of the use of platelet-rich plasma (PRP) for the treatment of tendon and ligament injuries. studies were excluded. Tissue engineering strategies, which included a combination of PRP with additional cell types (bone marrow), were also excluded. Articles with all levels of evidence were included. Thirteen of 32 retrieved articles respected the inclusion criteria.
Platelet-rich plasma for sports-related muscle, tendon and ligament injuries: an umbrella review
Blood transfusion = Trasfusione del sangue, 2019
BACKGROUND Platelet-rich plasma (PRP) has been used in different non-transfusion indications due to its role in tissue regeneration and healing. The aim of this overview of systematic reviews (umbrella review) is to provide a summary of the existing research syntheses related to PRP use for sports-related muscle, tendon and ligament injuries. MATERIALS AND METHODS Literature searches were performed in MEDLINE, Embase, and Cochrane Library to identify systematic reviews focusing on PRP use for sports-related muscle, tendon and ligament injuries. The methodological quality of included studies was assessed using the checklist for systematic reviews and research syntheses developed by the Joanna Briggs Institute and the GRADE assessment. RESULTS Twenty-two studies met the inclusion criteria. Five studies evaluated PRP use for acute muscle injury, and 17 evaluated PRP use for tendon and ligament injury. Studies were heterogeneous in terms of the dose and number of PRP injections, and the...
Platelet-rich plasma (PRP) to treat sports injuries: evidence to support its use
Knee Surgery, Sports Traumatology, Arthroscopy, 2011
Tissue repair in musculoskeletal lesions is often a slow and sometimes incomplete process. In sports patients or professional athletes, the impact of musculoskeletal lesions on life and work is great, and the fast recovery of full efficiency and return to competition is of primary importance. The clinical improvement offered by available treatments is not always sufficient for highly demanding patients to return to their previous level of activity. The search for a minimally invasive solution to improve the status of the chondral surface of the injured joint is therefore highly desirable, especially in these patients. Platelet-rich plasma (PRP) is a procedure that allows to obtain a natural concentration of autologous growth factors. The attractive possibility to use the patients' own growth factors to enhance reparative process in tissues with low healing potential, the promising preliminary clinical findings and the safety of these methods, explain the wide application of this biological approach. The aim of this review is to analyse the existing published studies to look for scientific evidence in preclinical studies or in the results obtained through PRP application in humans that supports the efficacy of PRP and its use for the treatment of tendinous, ligamentous, cartilaginous and muscular injuries. The analysis of the literature shows promising preclinical results but contradictory clinical findings for the treatment of sport injuries. High-quality studies are required to confirm these preliminary results and provide scientific evidence to support its use.
Platelet-Rich Plasma Treatment for Ligament and Tendon Injuries
Clinical Journal of Sport Medicine, 2011
Platelet-rich plasma (PRP) is derived from centrifuging whole blood, has a platelet concentration higher than that of the whole blood, is the cellular component of plasma that settles after centrifugation, and contains numerous growth factors. There is increasing interest in the sports medicine and athletic community about providing endogenous growth factors directly to the injury site, using autologous blood products such as PRP, to potentially facilitate healing and earlier return to sport after musculoskeletal injury. Despite this interest, and apparent widespread use, there is a lack of high-level evidence regarding randomized clinical trials assessing the efficacy of PRP in treating ligament and tendon injuries. Basic science and animal studies and small case series reports on PRP injections for ligament or tendon injuries, but few randomized controlled clinical trials have assessed the efficacy of PRP injections and none have demonstrated scientific evidence of efficacy. Scientific studies should be performed to assess clinical indications, efficacy, and safety of PRP, and this will require appropriately powered randomized controlled trials with adequate and validated clinical and functional outcome measures and sound statistical analysis. Other aspects of PRP use that need to be determined are (1) volume of injection/application, (2) most effective preparation, (3) buffering/activation, (4) injection technique (1 depot vs multiple depots), (5) timing of injection to injury, (6) single application versus series of injections, and (7) the most effective rehabilitation protocol to use after PRP injection. With all proposed treatments, the doctor and the patient should weigh up potential benefits of treatment, potential risks, and costs. Based on the limited publications to date and theoretical considerations, the potential risks involved with PRP are fortunately very low. However, benefits remain unproven to date, particularly when comparing PRP with other injections for ligament and tendon injuries.
The emerging use of platelet-rich plasma in musculoskeletal medicine
The Journal of the American Osteopathic Association, 2015
Platelet-rich plasma (PRP) is one of many new developments within the expanding field of regenerative medicine. Specialists in areas such as orthopedics, physical medicine and rehabilitation, and rheumatology have been exploring the benefits of this novel therapy. Although PRP therapy remains controversial and has minimal clinical trial support, the use of orthobiologics such as PRP continues to advance as patients seek nonsurgical approaches to acute and chronic musculoskeletal injury and disease. However, academic acceptance as well as insurance reimbursement remain reliant on solid and repeatable positive results from large clinical trials. The authors summarize the evolution of PRP therapy and report on its status.
Platelet-rich Plasma for Muscle Injury and Tendinopathy
Sports Medicine and Arthroscopy Review, 2013
Platelet-rich plasma (PRP) is increasingly used in Regenerative Medicine. The concept of PRP as a natural source of signaling molecules with paracrine effects in different cells is the basis for the increased PRP application as treatment for sports injuries. PRP recapitulates the principal functions of the natural healing response in orchestrating cell proliferation, differentiation, migration, and angiogenesis. After systematically searching the literature, we identified 21 trials for PRP injections in tendinopathy: 57% were uncontrolled trials and 1 cohort study in muscle. Leukocyte-PRP was used in 91.7% of tendons, of which 65.5% received 1 single injection. Given the lack of large controlled trials, it is clear that the effectiveness of conservative L-PRP treatments is not proven. The clinical evaluation of alternative formulations can be extremely informative. Other unexplored issues include activation, redosing, and concomitant longitudinal tenotomies. Limiting factors for the acceptance of PRP are the lack of evidence of obvious clinical improvement and reimbursement.
Platelet-Rich Plasma: Review of Current Literature on its Use for Tendon and Ligament Pathology
Current Reviews in Musculoskeletal Medicine, 2018
Purpose of review Platelet-rich plasma (PRP) contains numerous growth factors and cytokines that potentially offer an alternative treatment modality to assist in the healing of multiple musculoskeletal issues. The purpose of this review was to examine the latest literature on the use of PRP for various ligament and tendon pathologies. Recent findings Recent literature has shown moderate-to high-quality evidence that PRP can have positive clinical effects in certain conditions such as lateral epicondylitis and rotator cuff tendinopathy. Prospective studies have shown that it can also be useful in the treatment of patella tendinopathy. Summary In summary, we found PRP to have variable success in ligament and tendon pathology; however, it should be considered a viable option in chronic musculoskeletal disease that has failed other treatments. Patient selection, duration of symptoms, and combining with other modalities such as physical therapy should all be taken into consideration in treatment with PRP.
Platelet-rich plasma in sports medicine: new treatment for tendon and cartilage lesions
The administration of platelet-rich plasma (PRP) is an innovative approach in the management of cartilage and tendon lesions. PRP is an autologous blood derivative that contains a higher concentration of platelets with respect to baseline blood level. The biological rationale is that platelets are a source of several growth factors and other bioactive molecules that play an important role in tissue homeostasis and healing process. The application of PRP on damaged sites could therefore favor tissue regeneration. PRP has been applied in several clinical conditions, both as a conservative injective approach or as an "augmentation" during surgical procedures. Studies have been published concerning the treatment of Achilles, patellar, and elbow tendinopathy, as well as rotator cuff lesions and cartilage degeneration of the knee. This review analyzes and reports the available evidence in the literature regarding clinical application of PRP in treating cartilage and tendon disorders. The evaluation of the preliminary results showed an encouraging clinical outcome, thus explaining the large interest this therapeutic approach has gained among scientists and clinicians. However, further high-level research is needed to confirm these results, determining the best indication criteria and application methods. Oper Tech Orthop 22:78-85
SICOT-J, 2017
Within orthopedics, the use of platelet-rich plasma (PRP) has been rapidly increasing in popularity, however, its true effectiveness has yet to be fully established. Several studies find that injecting PRP to the site of injury does not provide any significant benefit with respect to clinical outcomes; however, many others report the contrary. Due to the conflicting evidence and multiple meta-analyses conducted on the topic, a literature review of high-quality evidence on the use of PRP for common orthopaedic conditions was performed. Thus far, the evidence appears to suggest that PRP may provide some benefit in patients who present with knee osteoarthritis or lateral epicondylitis. On the other hand, evidence appears to be inconsistent or shows a minimal benefit for PRP usage in rotator cuff repair, patellar and Achilles tendinopathies, hamstring injuries, anterior cruciate ligament (ACL) repair, and medial epicondylitis. There is limited confidence in the conclusions from the publ...