Background: Platelet-rich plasma [PRP] has received increasing interest across many musculoskeletal disciplines and has been widely applied clinically to stimulate tissue healing in numerous anatomical regions. The known actions of platelet-derived factors suggest that PRP may have significant potential in the treatment of pathological conditions of cartilage, tendon, ligament, and muscle.
Purpose: The aim of this manuscript is to review current literature regarding the biology of PRP and the efficacy of using PRP to augment healing of tendon ligament and muscle injuries, as well as early osteoarthritis.
Methods: A comprehensive literature review of musculoskeletal applications of PRP was performed, including basic science and clinical studies such as randomized controlled trials, case controlled series, and case series.
Results: The most compelling evidence to support the efficacy of PRP is for its application to tendon damage associated with lateral and medial epicondylitis. Although some promising studies have been reported supporting the use of PRP in osteoarthritis and ligament and muscle injuries, it currently remains unknown whether PRP effectively alters the progression of osteoarthritis or aids the healing of ligament and muscle tissues.
Conclusion: The rationale for the use of PRP to improve tissue healing is strong, but the efficacy for many musculoskeletal applications remains unproven. PRP has been shown to be a safe treatment. A number of questions regarding PRP remain unanswered, including the optimal concentration of platelets, what cell types should be present, the ideal frequency of application, or the optimal rehabilitation regimen for tissue repair and return to full function.
Keywords: healing; ligament; osteoarthritis; platelet-rich plasma; tendon.
Platelet-rich plasma treatment for ligament and tendon injuries.Clin J Sport Med. 2011 Jan;21(1):37-45. doi: 10.1097/JSM.0b013e31820758c7. Clin J Sport Med. 2011. PMID: 21200169 Review.
Platelet-rich plasma products in sports medicine.Phys Sportsmed. 2011 Sep;39(3):94-9. doi: 10.3810/psm.2011.09.1925. Phys Sportsmed. 2011. PMID: 22030945 Review.
Platelet-rich plasma: where are we now and where are we going?Sports Health. 2010 May;2(3):203-10. doi: 10.1177/1941738110366385. Sports Health. 2010. PMID: 23015939 Free PMC article.
Sports medicine and platelet-rich plasma: nonsurgical therapy.Clin Podiatr Med Surg. 2015 Jan;32(1):99-107. doi: 10.1016/j.cpm.2014.09.006. Clin Podiatr Med Surg. 2015. PMID: 25440421 Review.
Application of Platelet-Rich Plasma to Disorders of the Knee Joint.Cartilage. 2013 Oct;4(4):295-312. doi: 10.1177/1947603513487553. Cartilage. 2013. PMID: 26069674 Free PMC article.
Cited by 13 articles
Current advances in the treatment of medial and lateral epicondylitis.J Orthop. 2018 Feb 2;15(1):107-110. doi: 10.1016/j.jor.2018.01.040. eCollection 2018 Mar. J Orthop. 2018. PMID: 29657450 Free PMC article. Review.
Comparative Analysis of Different Platelet Lysates and Platelet Rich Preparations to Stimulate Tendon Cell Biology: An In Vitro Study.Int J Mol Sci. 2018 Jan 10;19(1):212. doi: 10.3390/ijms19010212. Int J Mol Sci. 2018. PMID: 29320421 Free PMC article.
Superparamagnetic Iron Oxide Nanoparticles in Musculoskeletal Biology.Tissue Eng Part B Rev. 2017 Aug;23(4):373-385. doi: 10.1089/ten.TEB.2016.0437. Epub 2017 Jan 11. Tissue Eng Part B Rev. 2017. PMID: 27998240 Free PMC article.
Normal platelet function in platelet concentrates requires non-platelet cells: a comparative in vitro evaluation of leucocyte-rich (type 1a) and leucocyte-poor (type 3b) platelet concentrates.BMJ Open Sport Exerc Med. 2016 Mar 7;2(1):e000071. doi: 10.1136/bmjsem-2015-000071. eCollection 2016. BMJ Open Sport Exerc Med. 2016. PMID: 27900155 Free PMC article.
Efficacy of autologous platelet-rich plasma for the treatment of muscle rupture with haematoma: a multicentre, randomised, double-blind, placebo-controlled clinical trial.Blood Transfus. 2016 May;14(2):245-54. doi: 10.2450/2015.0099-15. Epub 2015 Sep 21. Blood Transfus. 2016. PMID: 26509827 Free PMC article.