Advancements in Platelet-Rich Plasma (PRP) Therapy In Musculoskeletal Practice. Review: December 2023
Platelet-rich plasma (PRP) as a biological therapy has gained huge popularity over the last decade in the treatment of a wide variety of conditions in different fields of medicine. PRP is derived from the centrifugation of a patient’s whole blood to produce an increased concentration of autologous platelets in a small volume of plasma. Platelets are essential for normal clotting and contain a huge amount of important growth factors that are very important in tissue healing, chemotaxis, neovascularisation and synthesis of extracellular matrix. This, in combination with PRP’s ability to initiate an inflammatory healing response through cytokine release, explains why PRP is used to facilitate the natural healing process and improve tissue healing, neovascularisation and bone regeneration
Today, the scope within which PRP is being used is vast, including orthopaedics, regenerative medicine (melasma, skin rejuvenation, hyperpigmentation, hair growth, scars/stretch marks, psoriasis and vitiligo), Rheumatoid arthritis, maxillofacial/dental surgery, foot ulcers, laryngeal application (vocal cord scarring), erectile dysfunction, retinitis pigmentosa, vaginal atrophy and even infertility (intra-ovarian injections). In this December 2024 review, the authors focus on the newest available data regarding the use of PRP in musculoskeletal conditions.
This is an exciting era for regenerative musculoskeletal medicine with PRP as the most popular, as our understanding and utilisation of PRP continue to advance. PRP is a very promising conservative treatment option for many musculoskeletal joint and soft tissue conditions with healing and regenerative capabilities and clear evidence of safety.
The varying degree of PRP preparations, protocols, outcome measures and study designs has made interpreting research difficult. However, from a basic research level, the following interpretations have been made. Please bear in mind that in clinical practice much for variations suited and tailored to the patient and condition is performed.
Supporting evidence for the use of PRP in osteoarthritis (OA) is available, with a substantial body of evidence supporting its effectiveness in knee and hip OA. Research on its application in spine, hand, and shoulder OA is continuing to growth, along with elbow and ankle OA. But the same concept applies in regards to stimulating cartilage health.
High-volume level I evidence supports the use of PRP treatment in lateral epicondylitis (tennis/golfers elbow), trochanteric (hip) bursitis, plantar fasciitis and carpal tunnel nerve root entrapments. Tendon injuries and partial tendon tears have varying degrees of evidence based on the PRP protocols used, with level I evidence supporting PRP’s use in rotator cuff injuries of the shoulder and tears, with growing evidence for it use in the patella and Achille injuries and tears. With this in mind, the correct PRP protocol directly tailored to the patient's needs alongside corrective functional rehabilitation will provide far superior outcomes.
There are is growing results when PRP is used in conjunction with reconstruction surgery, with its addition providing superior outcomes in patients undergoing meniscus repair of the knee, osteochondral microfracture, and revision surgery for non-union.
Limited studies have been performed in relation to its potential as a conservative treatment for finger related conditions, however, is used in clinical practice quite regularly for thumb joint osteoarthritis and wrist pathology.
Full study can be found here
Here at Dynamic Regenerative Medicine we have been performing this fantastic biological treatment for nearly a decade, performing many thousands of treatments and have
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