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Editorial Commentary: Autologous Platelet-Rich Plasma

      Abstract

      Autologous platelet-rich plasma (PRP) is promising for osteoarthritis pain and may effect cartilage repair. Platelets are growth factor factories. Commercially available PRP is heterogeneous.
      Tissue engineering requires scaffolds, cells, growth factors, and perhaps structural ties, incubators, and/or “mechano-stimulation.” Healing also involves growth factors.
      • Verdonk R.
      • Goubau Y.
      • Almqvist F.K.
      • Verdonk P.
      Biological methods to enhance bone healing and fracture repair.
      • Kon E.
      • Roffi A.
      • Filardo G.
      • Tesei G.
      • Marcacci M.
      Scaffold-based cartilage treatments: With or without cells? A systematic review of preclinical and clinical evidence.
      Readily available, at a cost, is autologous platelet rich plasma, which is quite a general term because platelet concentration, red and white blood cell contamination, and other factors may vary.
      • DeLong J.M.
      • Russell R.P.
      • Mazzocca A.D.
      Platelet-rich plasma: The PAW classification system.
      Platelets may be thought of as growth factor factories. Notable in the ISAKOS Biologics Supplement: Part 1, is “Biologic enhancement of cartilage repair: The role of PRP and other commercially available growth factors.”
      • Cugat R.
      • Cuscó X.
      • Seijas R.
      • et al.
      Biologic enhancement of cartilage repair: The role of platelet-rich plasma and other commercially available growth factors.
      Cugat, Cuscó, Seijas, Álvarez, Steinbacher, Ares, Wang-Saegusa, and García-Balletbó are philosophical in their abstract, and focused on their anecdotal experience (Level V evidence). The authors are broad in their purpose “to illustrate the importance of understanding what PRP is, how it is obtained, and how it should be used; also highlighting the fact that different PRPs produce different results, and finally describe the results we have obtained in chondral defects using PRGF-Endoret following the application protocol of 3 to 5 intra-articular injections.” Cugat et al. share everything you ever wanted to know about growth factors (*but were afraid to ask); and more! Most promising, PRP injection shows promise for mild to moderate osteoarthritis pain. However, it remains to be shown that PRP effects cartilage repair.

      References

        • Verdonk R.
        • Goubau Y.
        • Almqvist F.K.
        • Verdonk P.
        Biological methods to enhance bone healing and fracture repair.
        Arthroscopy. 2015; 31: 715-718
        • Kon E.
        • Roffi A.
        • Filardo G.
        • Tesei G.
        • Marcacci M.
        Scaffold-based cartilage treatments: With or without cells? A systematic review of preclinical and clinical evidence.
        Arthroscopy. 2015; 31: 767-775
        • DeLong J.M.
        • Russell R.P.
        • Mazzocca A.D.
        Platelet-rich plasma: The PAW classification system.
        Arthroscopy. 2012; 28: 998-1009
        • Cugat R.
        • Cuscó X.
        • Seijas R.
        • et al.
        Biologic enhancement of cartilage repair: The role of platelet-rich plasma and other commercially available growth factors.
        Arthroscopy. 2015; 31: 777-783

      Linked Article

      • Biologic Enhancement of Cartilage Repair: The Role of Platelet-Rich Plasma and Other Commercially Available Growth Factors
        ArthroscopyVol. 31Issue 4
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          In part, people's quality of life depends on the “health” of their cartilage because its damage or deterioration causes pain that limits mobility and reduces autonomy. Predisposing genetic factors and modern-life environmental factors, such as diet, excessive physical exercise, or the absence of any physical exercise, in addition to injuries that can occur, all contribute to the onset and development of chronic degenerative diseases such as osteoarthritis. Regenerative medicine focuses on the repair, replacement, or regeneration of cells, tissues, or organs to restore impaired function from any cause, including congenital defects, disease, and trauma.
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