EDITORIAL
Editorial F. Alan Barber, MD, FACS
P
latelet-rich plasma (PRP) is a supraphysiologic concentration of platelets that may positively augment tissue healing. Both patients and clinicians are interested in PRP for its potential for biological augmentation of tissue healing and regeneration by introducing increased levels of platelets and their associated bioactive molecules at the injury site. As a consequence, PRP is being used to treat many different sports-related injuries. Yet, universally accepted improvements in healing and clinical outcomes have not been consistently documented. This inconsistent clinical response may be because not all PRPs are the same. Differences in the volume of whole blood used, platelet recovery efficacy, processing, activation by exogenous thrombin, fibrin formation induced by the addition of calcium chloride, donor health and physiology, and even the presence or absence of leukocytes probably alter the healing response. As yet, the clinical data do not conclusively prove a benefit from PRP, but discernment is required in evaluating the published results. Confusion in the clinical data does not conclusively prove a benefit from PRP, and results may be dose dependent. Considering all articles with the words platelet-rich plasma in the title to be referring to the same material is a mistake. This issue presents review articles addressing the use of PRP for muscle, tendon, ligament, articular cartilage, and meniscal healing. In some applications there is strong evidence that a benefit exits. In others, the benefit is dubious. Well-designed, prospective, randomized, and blinded clinical studies are required to investigate the role of various PRP preparations in augmenting connective tissue healing. In addition, investigators and regulators alike must resist the temptation to consider all PRP formulations to be the same. Data related to one form may not be applicable to other forms. The patient’s age and health may play the most significant role in the ultimate outcome.
Disclosure: The author declares no conflict of interest. Copyright r 2013 by Lippincott Williams & Wilkins
Sports Med Arthrosc Rev
Volume 21, Number 4, December 2013
www.sportsmedarthro.com |
179
Editorial F. Alan Barber, MD, FACS
P
latelet-rich plasma (PRP) is a supraphysiologic concentration of platelets that may positively augment tissue healing. Both patients and clinicians are interested in PRP for its potential for biological augmentation of tissue healing and regeneration by introducing increased levels of platelets and their associated bioactive molecules at the injury site. As a consequence, PRP is being used to treat many different sports-related injuries. Yet, universally accepted improvements in healing and clinical outcomes have not been consistently documented. This inconsistent clinical response may be because not all PRPs are the same. Differences in the volume of whole blood used, platelet recovery efficacy, processing, activation by exogenous thrombin, fibrin formation induced by the addition of calcium chloride, donor health and physiology, and even the presence or absence of leukocytes probably alter the healing response. As yet, the clinical data do not conclusively prove a benefit from PRP, but discernment is required in evaluating the published results. Confusion in the clinical data does not conclusively prove a benefit from PRP, and results may be dose dependent. Considering all articles with the words platelet-rich plasma in the title to be referring to the same material is a mistake. This issue presents review articles addressing the use of PRP for muscle, tendon, ligament, articular cartilage, and meniscal healing. In some applications there is strong evidence that a benefit exits. In others, the benefit is dubious. Well-designed, prospective, randomized, and blinded clinical studies are required to investigate the role of various PRP preparations in augmenting connective tissue healing. In addition, investigators and regulators alike must resist the temptation to consider all PRP formulations to be the same. Data related to one form may not be applicable to other forms. The patient’s age and health may play the most significant role in the ultimate outcome.
Disclosure: The author declares no conflict of interest. Copyright r 2013 by Lippincott Williams & Wilkins
Sports Med Arthrosc Rev
Volume 21, Number 4, December 2013
www.sportsmedarthro.com |
179
