Plasma rico em plaquetas para consolidação de ossos longos

Abstract

Objective:To evaluate effectiveness of the use of platelet-rich plasma as coadjuvant for union of long bones.Methods:The search strategy included the Cochrane Library (via Central) and MEDLINE (via PubMed). There were no limits as to language or publication media. The latest search strategy was conducted in December 2011. It included randomized clinical trials that evaluated the use of platelet-rich plasma as coadjuvant medication to accelerate union of long bones (acute fractures, pseudoarthrosis and bone defects). The outcomes of interest for this review include bone regeneration, adverse events, costs, pain, and quality of life. The authors selected eligible studies, evaluated the methodological quality, and extracted the data. It was not possible to perform quantitative analysis of the grouped studies (meta-analyses).Results:Two randomized prospective clinical trials were included, with a total of 148 participants. One of them compared recombinant human morphogenic bone protein-7 versus platelet-rich plasma for the treatment of pseudoarthrosis; the other evaluated the effects of three coadjuvant treatments for union of valgising tibial osteotomies (platelet-rich plasma, platelet-rich plasma plus bone marrow stromal cells, and no coadjuvant treatment). Both had low statistical power and moderate to high risk of bias.Conclusion:There was no conclusive evidence that sustained the use of platelet-rich plasma as a coadjuvant to aid bone regeneration of fractures, pseudoarthrosis, or bone defects.

Transforming Growth Factor Beta Family: Insight into the Role of Growth Factors in Regulation of Fracture Healing Biology and Potential Clinical Applications

“…The analysis of available literature does not provide a clear answer to the following question: what are the effects of therapy involving TGF- β on fracture healing in humans? Also effectiveness of platelet-rich plasma (PRP) administration, a blood derived preparation obtained from human blood with the increased platelet concentration, in fracture therapy, is still being studied and discussed [ 210 – 212 ]. PRP is a preparation containing supraphysiologic concentrations of growth factors including TGF- β ; therefore, indirect interpretation can be attempted for the PRP effect on possible TGF- β as a part of previous studies on bone healing [ 213 ].…”

“…PRP is a preparation containing supraphysiologic concentrations of growth factors including TGF- β ; therefore, indirect interpretation can be attempted for the PRP effect on possible TGF- β as a part of previous studies on bone healing [ 213 ]. So far, a number of randomised studies in humans on PRP effectiveness in fracture therapy are scarce [ 210 – 212 ]. Considering the methodological limitations, interpretation of individual available results cannot ensure a sufficient statistical value allowing a clear answer on PRP effectiveness in fracture healing.…”

Efficacy of platelet‐rich plasma for non‐transfusion use: Overview of systematic reviews

“…Two SRs assessing the clinical efficacy of PRP in the promotion of long bone fracture healing were identified . The SR conducted by Griffin et al was considered as possessing higher quality (AMSTAR score 12/13), and therefore its findings underpinned conclusions.…”

Plasma rico em plaquetas: mecanismo de ação, produção e indicações de uso - Revisão de literatura

“…Messora et al (2009) utilizaram o produto na cicatrização de defeitos mandibulares de cães tratados com enxerto ósseo alógeno. Em cães sua aplicação vem aumentando em fraturas de ossos longos associados ou não a enxertos (Souza et al, 2011;Lenza et al, 2013). Na área de oftalmologia, mais especificamente no tratamento de úlcera de córnea em cães, o PRP na forma de colírio ou de tampão sólido demonstrou ser um excelente adjuvante, diminuindo o processo inflamatório, a dor e contribuindo com a cicatrização epitelial (Donatti et al, 2013;Merlini et al, 2014 …”