Abstract
Platelet-rich plasma (PRP) is perhaps the most widely studied of the biologic therapies,
with an ever-growing body of evidence supporting its safety and efficacy in decreasing
inflammation and pain and promoting healing in the setting of both nonoperative and
operative treatments. PRP is produced by the centrifugation of whole blood, isolating
its constituent parts based on their unique densities. These density gradients can
be selectively harvested so as to obtain different concentrations of various blood
product components, such as platelets and leukocytes. A precise and consistent method
for describing the essential characteristics of different PRP formulations is critical
for both practical and research purposes. The concentration of platelets, method of
activation, and the total number of red blood cells (RBCs), white blood cells (WBCs),
and neutrophils relative to baseline values are all of particular importance in accurately
describing a PRP formulation. The biologic activity of PRP is manifold: platelet granules promote the release of various growth factors, including vascular endothelial
growth factor and tissue growth factor β, while inflammation is modulated through
inhibition of the nuclear factor-κB pathway. PRP has been convincingly shown to be
efficacious in the setting of patellar tendinopathies, knee osteoarthritis, and lateral
epicondylitis. In fact, several recent randomized controlled trials have demonstrated
the superiority of PRP over both corticosteroids and hyaluronic acid in treating knee
OA-related symptoms. There is also substantial promise for the utility of PRP in treating
partial hamstring tears and as an adjunct to rotator cuff (RC) repair, especially
in the setting of small- to medium-sized tears, where it appears to exert substantial
analgesic effects and promote enhanced rates of RC repair healing.
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Article info
Publication history
Accepted:
July 6,
2021
Received:
February 16,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: A.J.S. reports personal fees from Arthroscopy and grants from Embody, Inc., outside the submitted work. A.W.A. reports grants and personal fees from Arthrex, personal fees from Ossur, and grants from KLSMC Stem Cell, outside the submitted work. J.P.B. reports royalties from Arthrex, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2021 Published by Elsevier on behalf of the Arthroscopy Association of North America
