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.
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Article info
Publication history
Published online: January 30, 2012
Accepted:
October 19,
2011
Received:
June 13,
2011
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Note: To access the videos accompanying this report, visit the March issue of Arthroscopy at www.arthroscopyjournal.org.
Identification
Copyright
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
