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Background

Platelet-rich Plasma (PRP)

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Underlying Evidence Guidelines Meta-analysis Vs.Placebo/Control RCTs Vs. Placebo/Control Meta-analysis Vs. IAHA RCTs Vs. IAHA

Mechanism of action

  • Cellular proliferation.
  • Anti-apoptotic activity.
  • Cartilage regeneration.
  • Angiogenesis.
  • May amplify activity at the transmembrane receptors.
  • Increase in vascular permeability

Additional Information

  • Derived from autologous blood with a high platelet concentration in a small volume of plasma.
  • Contains growth factors that act during the initial phase of healing and tissue regeneration.
  • Considered a minimally invasive, simple, and relatively low-cost procedure.
  • PRP products may differ in their method of preparation and numerous devices are commercially available.
  • Lack of clarity regarding the platelet concentration, the role of white blood cell filtering, the site of injection into the knee, and the number and frequency of injections for proper effectiveness.

References

  1. Civinini R, Nistri L, Martini C, Redl B, Ristori G, Innocenti M. Growth factors in the treatment of early osteoarthritis. Clin Cases Miner Bone Metab. 2013 Jan;10(1):26-9.
  2. Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord. 2012 Nov 23;13:229.
  3. Khoshbin A, Leroux T, Wasserstein D, Marks P, Theodoropoulos J, Ogilvie-Harris D, Gandhi R, Takhar K, Lum G, Chahal J. The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis. Arthroscopy. 2013 Dec;29(12):2037-48.
  4. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013 Feb;41(2):356-64.
  5. Pintan GF, de Oliveira AS Jr, Lenza M, Antonioli E, Ferretti M. Update on biological therapies for knee injuries: osteoarthritis. Curr Rev Musculoskelet Med. 2014 Sep;7(3):263-9.
  6. Spaková T, Rosocha J, Lacko M, Harvanová D, Gharaibeh A. Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. Am J Phys Med Rehabil. 2012 May;91(5):411-7.