Platelet-Rich Plasma in Orthopaedic Surgery: A Critical Analysis Review

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Excerpt

Platelet-rich plasma, an autologous blood concentrate, has gained popularity among physicians as a treatment modality for orthopaedic injuries. The biologic rationale for its use involves the local delivery of growth factors, inflammation modulators, and cell adhesion molecules that are released from a concentrated pool of degranulating platelets. These bioactive proteins, which include platelet-derived growth factor, insulin-like growth factors I and II, fibroblast growth factor, vascular endothelial growth factor, and transforming growth factor-beta, are all thought to facilitate and enhance the healing of injured tissue. As a result, platelet-rich plasma is believed to augment the natural healing process by increasing the concentration of these cytokines at the site of injury. The autologous nature and thus the safety of platelet-rich plasma make it an attractive treatment option. Categorized as a minimally manipulated tissue and autologous blood product, platelet-rich plasma has avoided the regulatory hurdles of extensive preclinical and clinical trial testing, resulting in its widespread use despite the lack of consistent evidence supporting its efficacy. This article provides a critical analysis of the available literature on platelet-rich plasma treatment in orthopaedic surgery, with a focus on recent Level-I and II studies.
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