Platelet-Rich Fibrin and Its Emerging Therapeutic Benefits for Musculoskeletal Injury Treatment

Abstract

New therapies that accelerate musculoskeletal tissue recovery are highly desirable. Platelet-rich fibrin (PRF) is a leukocyte- and platelet-rich fibrin biomaterial that acts as a binding site for both platelets and growth factors. Through increasing the local concentration of growth factors at specific tissues, PRF promotes tissue regeneration. PRF has been frequently used in combination with bone graft materials to reduce healing times and promote bone regeneration during maxillofacial surgery. However, its benefits during muscle repair and recovery are less well-documented. Here, we perform a narrative review on PRF therapies and muscle injuries to ascertain its beneficial effects. We reviewed the factors that contribute to the biological activity of PRF and the published pre-clinical and clinical evidence to support its emerging use in musculoskeletal therapy. We include in vitro studies, in vivo animal studies and clinical articles highlighting both the success and failures of PRF treatment. PRF can promote the healing process when used in a range of orthopaedic and sports-related injuries. These include cartilage repair, rotator cuff surgery and anterior cruciate ligament surgery. However, conflicting data for these benefits have been reported, most likely due to inconsistencies in both PRF preparation protocols and dosing regimens. Despite this, the literature generally supports the use of PRF as a beneficial adjuvant for a range of chronic muscle, tendon, bone or other soft tissue injuries. Further clinical trials to confirm these benefits require consistency in PRF preparation and the classification of a successful clinical outcome to fully harness its potential.

Applications of Biocompatible Scaffold Materials in Stem Cell-Based Cartilage Tissue Engineering

“…A-PRF released significantly greater quantities of growth factors than traditional PRF ( Miron et al, 2017 ). Thus, PRP is optimal for fast delivery of growth factors while PRF and A-PRF are best used when long-term release is desired ( Grecu et al, 2019 ). PRF is composed of leukocytes, cytokines, platelets, and adhesive proteins such as fibronectin, fibrinogen, vitronectin, and thrombospondin-1 ( Miron and Zhang, 2018 ).…”

Regenerative medicine: characterization of human bone matrix gelatin (BMG) and folded platelet-rich fibrin (F-PRF) membranes alone and in combination (sticky bone)

“…Recently, a rapidly emerging number of articles have been published on autologous platelet rich blood products in tissue and bone regeneration, especially in regenerative dentistry (Chaparro et al 2016;EDQM 2019;Miron et al 2017;Theys et al 2018;Dawood et al 2018;Crisci et al 2019;Kemmochi et al 2018;Grecu et al 2019;Isobe et al 2017).…”

Growth Factor Delivery to a Cartilage-Cartilage Interface Using Platelet-Rich Concentrates on a Hyaluronic Acid Scaffold

“…There is significant variability in the methods of preparation and composition of platelet-rich concentrates [15][16][17] . Previous studies that have evaluated platelet-rich concentrates have used a variety of protocols for preparation of platelet-rich concentrates with variation in initial blood volume, velocity and time of centrifugation, number of centrifugation cycles, and inclusion or exclusion of leukocytes, which can alter the effect on tissue repair by changing its composition 18 .…”