Volume 26, Issue 9 , Page 1145, September 2010
Author's Reply
Article Outline
We read with great interest the letter by Dr. Dines in reference to several publications1, 2, 3, 4 that confuse and mix concepts regarding the language and conclusions when using autologous blood products to enhance ligament and tendon healing. After analyzing his arguments, we can say that we absolutely agree with his opinions, and even though in our article, we use the term “platelet concentrate,”4 we believe that in future publications the term “PRP” might be more appropriate, and “growth factors” should only be used when pure forms are applied.
In December 2008 the Journal published for the first time a clinical trial on the use of platelet-rich plasma (PRP) in anterior cruciate ligament reconstruction4; since then, several articles on the same subject have followed. It has come to our attention that in a “Current Concepts” review published in the Journal by Goulding and colleagues,5 in their conclusions they support the use of PRP in musculoskeletal lesions but there is no reference to this article. In a second publication, also mentioned in Dr. Dines' letter, there is no mention of our results even though similar conclusions are made.6 In a later article by Nin et al.,1 this could be explained because their article was received in October 2008 and accepted for publication in June 2009.
In conclusion, we clearly need to define a common language and perform a critical and rigorous analysis of investigations that report the use of PRP in human orthopaedic surgery. Promising results have been published,2, 3, 4, 5, 6 but they should be reproduced before we can clearly recommend their use in clinical practice.
References
- Has platelet-rich plasma any role in anterior cruciate ligament allograft healing?. Arthroscopy. 2009;25:1206–1213
- Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy. 2010;26:50–57
- . Concerns about the effects of platelet concentrate. Arthroscopy. 2009;25:941–942(letter)
- Effects of platelet concentrate and a bone plug on the healing of hamstring tendons in a bone tunnel. Arthroscopy. 2008;24:1373–1380
- The use of platelet-rich plasma in arthroscopy and sports medicine: Optimizing the healing environment. Arthroscopy. 2010;26:269–278
- . Ligamentization of tendon grafts treated with an endogenous preparation rich in growth factors: Gross morphology and histology. Arthroscopy. 2010;26:470–480
PII: S0749-8063(10)00629-8
doi:10.1016/j.arthro.2010.06.021
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Refers to article:
- Growth Factor Confusion
Volume 26, Issue 9 , Page 1145, September 2010