The use of platelet-rich plasma to treat chronic tendinopathies: A technical analysis

Abstract

Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications. Although highly popular with athletes, the use of PRP for the treatment of tendinopathies remains scientifically controversial, particularly due to the diversity of products that go by the name of "PRP." To optimize its use, it is important to look at the various stages of obtaining PRP. In this literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery.

Comparison between platelet-rich plasma injections and hyaluronic acid injections in the treatment of patellar tendinopathies: a randomized trial

“…The PRP used in this study was a leukocyte-poor PRP with a concentration of 850,000 platelets/microliter which is usually recommended in other studies (26,31). To collect platelets, an apheresis machine was used to obtain the same platelet concentration for each patient (25).…”

A possible injectable tissue engineered nucleus pulposus constructed with platelet-rich plasma and ADSCs in vitro

“…It also had been certificated by several studies that PRP could improve wound healing in total knee replacements and rotator cuff injuries [ 9 – 11 ]. Recently, the clinical injection application of PRP is widespread in various chronic tendinopathies [ 8 , 12 ] which make injectable PRP gel scaffold possible.…”

Tennis Elbow, study protocol for a randomized clinical trial: Needling With and Without Platelet-rich Plasma After Failure of Up-to-date Rehabilitation

“…The most relevant ones are: direct mechanical action of the needle and fenestration technique, number of PRP injections, cells count (platelets, white blood-and red blood cells), activation of the platelets, concomitant local anesthetic use, peri-interventional use of NSAIDs and corticosteroids, concomitant rehabilitation or a contrario immobilization. (20) The positive results observed into the previous reported studies remain debatable as they can be (17,18) related to either PRP, fenestration (21), or to any of the above-mentioned confounding factors.…”