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christian@orthogate.com






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In 1995, I did my biology research project in college on a new treatment called platelet-rich plasma. The research community was sure there would be all kinds of applications for this product. What is it being used for (if anything)? How successful has it been?

Platelet-rich plasma (PRP) (also known as blood injection therapy)) is a medical treatment being used for a wide range of musculoskeletal problems. For those who don't know, platelet-rich plasma refers to a sample of serum (blood) plasma that has as much as four times more than the normal amount of platelets. Platelets are like the emergency medical technicians (EMTs) of the body. When there's an injury, they are the first one on the scene of the accident, so-to-speak. Platelets have a large number of available growth factors and other bioactive molecules that signal the body to start the tissue-healing process. The platelet treatment enhances the body’s natural ability to heal itself and is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries. It has been used for years after plastic surgery and surgery on the mouth, jaw, and neck. It seems to promote bone graft healing. Researchers have found a way to combine this substance with other chemicals to make it into a putty or gel that can be painted on a surgical site to speed up healing. Now its uses have been expanded to include knee osteoarthritis, degenerative cartilage, spinal fusion, bone fractures that don’t heal, and poor wound healing. This treatment technique is fairly new in the sports medicine treatment of musculoskeletal problems, but gaining popularity quickly. Patients with chronic tendinitis (e.g., tennis elbow, patellar tendinitis or jumper’s knee, Achilles tendinitis) have also benefited from this treatment. It’s even being tried on hernias, labral (shoulder cartilage) tears, meniscal tears of the knee, and ankle sprains. Some surgeons are using it more and more with any orthopedic surgery involving the soft tissues to augment (reinforce) bone or ligamentous graft materials already being used. As for how effective is it? Well, most of the studies have been done on animals. Human studies either have not been high enough quality or too different in design to make comparisons possible. There are also different growth factors released and different concentrations of platelets in samples used from study to study. It's not really clear yet just how much platelet-rich plasma is needed for each type of injury or even how many platelets are needed for the best response. The lack of high-quality, randomized controlled trials points to the need for attention in this area. Before expanding its use to an even wider array of musculoskeletal problems, it should be proven that the treatment has a positive benefit for each type of injury or trauma.

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