Platelet-rich plasma for the treatment of bone defects: from pre-clinical rational to evidence in the clinical practice. A systematic review

Roffi, Alice; Matteo, Berardo Di; Krishnakumar, Gopal Shankar; Kon, Elizaveta; Filardo, Giuseppe

doi:10.1007/s00264-016-3342-9

Cited by 92 publications

(92 citation statements)

References 92 publications

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“…Platelet-rich-plasma (PRP), represents one of the most cost-effective autologous source of different growth factors and other bio-active proteins that can promote cell attachment, spreading, migration, growth, and differentiation (Boyd, Bradwell, & Thompson, 1993;McFarland, Thomas, DeFilippis, Steele, & Healy, 1999). It has been used in clinical practice for quite some time, such as the treatment of bone defects and ankle cartilage pathology (Roffi, Di Matteo, Krishnakumar, Kon, & Filardo, 2017;Vannini & Filardo, 2015). The platelets in PRP can release a large amount of bioactive factors upon activation, such as adhesive proteins and growth factors, but also clotting factors, derivatives of arachidonic acid metabolism, calcium ions, and others (Davì & Patrono, 2007;Yun, Sim, Goh, Park, & Han, 2016).…”

Section: Introductionmentioning

confidence: 99%

Fabrication and properties of an injectable sodium alginate/PRP composite hydrogel as a potential cell carrier for cartilage repair

Gao

Groth

et al. 2019

J Biomedical Materials Res

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Three‐dimensional scaffolds like hydrogels can be employed as cell carriers for in vitro or in vivo colonization and have become a major research topic to replace damaged tissue. In the current study, a novel composite hydrogel composed of sodium alginate (SA) and platelet‐rich‐plasma (PRP) varying in blending ratios, cross‐linked with calcium ions, released from calcium carbonate‐D‐Glucono‐d‐lactone (CaCO3‐GDL) was successfully prepared. It was found that addition of PRP changed largely the physical properties and biological performance of the composite hydrogels, which was depending on the blending ratio. The gelation rate and swelling ratio of alginate hydrogels were significantly reduced by the addition of PRP, which produced also a more homogeneous gel structure. Field emission scanning electron microscopy (FE‐SEM) investigation confirmed the incorporation of PRP‐derived proteins in the hydrogel, where a porous structure with a pore size of 200–300 μm was found. On the other hand, an increase in surface roughness was observed after the addition of PRP. The compressive mechanical strength of SA/PRP composite hydrogel was enhanced in comparison to the pure SA gel. The composite hydrogels with the highest PRP content exhibited at a maximum compressive stress of 0.26 MPa a maximum strain of 55%, while the maximum compressive strain of pure SA hydrogels was only 45% at a stress of 0.08 MPa. It was also found that the in vitro degradation of the alginate gel was accelerated by the addition of PRP. In terms of cellular responses, all gels exhibited an excellent cytocompatibility. Indeed, the composite hydrogels supported bone marrow‐derived mesenchymal stem cells proliferation and their chondrogenesis with up‐regulation of chondrogenic marker genes Sox9 and Aggrecan. Overall, the present study suggests a great potential of SA/PRP composite hydrogels as cell carriers for cartilage tissue engineering.

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Section: Introductionmentioning

confidence: 99%

Fabrication and properties of an injectable sodium alginate/PRP composite hydrogel as a potential cell carrier for cartilage repair

Gao

Groth

et al. 2019

J Biomedical Materials Res

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“…However, these results and this latter conclusion is at least consistent with numerous clinical studies in people that fail to identify a positive effect of PRP on bone healing, even when open fracture gaps and open osteotomies are considered. [7] Rather, further studies should likely be performed in relevant models or human clinical populations in which bone loss, fracture gaps, or delayed union are present so as to optimize the likelihood of identifying a treatment effect.…”

Section: Discussionmentioning

confidence: 99%

“…[8] However, other authors conclude that the evidence remains ambiguous as numerous studies, particularly when considering clinical trials in people, fail to provide consistent or convincing evidence of benefit. [7] Contradictory results from different studies and contradictory conclusions from different reviews preclude making a general conclusion as to whether PRP is likely to augment bone healing.…”

Section: Introductionmentioning

confidence: 99%

“…All of these variable have likely contributed to the extreme heterogeneity in the data available. [7] As a result, further research is needed to determine which specific types of PRP may be beneficial in improving bone healing and in which specific medical conditions. In order to address this issue there is a need for well-controlled experiments using thoroughly characterized PRP products, including in preclinical animal models.…”

Section: Introductionmentioning

confidence: 99%

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The effect of platelet-rich plasma on osseous healing in dogs undergoing high tibial osteotomy

2017

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ObjectivesThe purpose of this study was to investigate whether platelet-rich plasma (PRP) enhances osseous healing in conjunction with a high tibial osteotomy in dogs.Study designRandomized controlled trial.MethodsSixty-four client-owned pet dogs with naturally occurring rupture of the anterior cruciate ligament and that were to be treated with a high tibial osteotomy (tibial plateau leveling osteotomy) were randomized into the treatment or control group. Dogs in the treatment group received autologous platelet-rich plasma activated with calcium chloride and bovine thrombin to produce a well-formed PRP gel that was placed into the osteotomy at the time of surgery. Dogs in the control group received saline lavage of the osteotomy. All dogs had the osteotomy stabilized with identical titanium alloy implants and all aspects of the surgical procedure and post-operative care were identical among dogs of the two groups. Bone healing was assessed at exactly 28, 49, and 70 days after surgery with radiography and ultrasonography and with MRI at day 28. The effect of PRP on bone healing was assessed using a repeated measures analysis of covariance with radiographic and ultrasonographic data and using a t-test with the MRI data.ResultsSixty dogs completed the study. There were no significant differences in age, weight, or gender distribution between the treatment and control groups. Twenty-seven dogs were treated with PRP and 33 were in the control group. The average platelet concentration of the PRP was 1.37x106 platelets/μL (±489x103) with a leukocyte concentration of 5.45x103/μL (±3.5x103). All dogs demonstrated progressive healing over time and achieved clinically successful outcomes. Time since surgery and patient age were significant predictors of radiographic healing and time since surgery was a significant predictor of ultrasonographic assessment of healing. There was no significant effect of PRP treatment as assessed radiographically, ultrasonographically, or with MRI.ConclusionThe PRP used in this study did not hasten osseous union in dogs treated with a high tibial osteotomy.

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“…Platelet-rich plasma is commonly studied pre-clinically, as well as currently used clinically, for repair of bone defects. 128 Dense polyP granules are found in many cell types, particularly within the mitochondria. This includes osteoblasts, where polyP is found in high concentrations (0.5 M in the dense granules in the mitochondria), and osteoclasts, which have a high number of mitochondria.…”

Section: The Curious Role Of Polyphosphatesmentioning

confidence: 99%

Critical and diverse roles of phosphates in human bone formation

et al. 2019

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Platelet-rich plasma for the treatment of bone defects: from pre-clinical rational to evidence in the clinical practice. A systematic review

Cited by 92 publications

References 92 publications

Fabrication and properties of an injectable sodium alginate/PRP composite hydrogel as a potential cell carrier for cartilage repair

Fabrication and properties of an injectable sodium alginate/PRP composite hydrogel as a potential cell carrier for cartilage repair

The effect of platelet-rich plasma on osseous healing in dogs undergoing high tibial osteotomy

Critical and diverse roles of phosphates in human bone formation

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