Update on platelet-rich plasma

DeLong, Jeffrey M.; Beitzel, Knut; Mazzocca, Augustus D.; Shepard, David Owen; Roller, Brandon L.; Hanypsiak, Bryan T.

doi:10.1097/bco.0b013e318236bd55

Cited by 21 publications

(18 citation statements)

References 80 publications

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“…These negative effects are largely due to neutrophils and include the release of oxygen-free radicals, catabolic cytokines, matrix metalloproteinases (MMPs), and interleukin B, which degrade tissue. 14 …”

Section: Discussionmentioning

confidence: 99%

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Analysis of Platelet-Rich Plasma Extraction

Fitzpatrick

Bulsara

McCrory

et al. 2017

Orthopaedic Journal of Sports Medicine

149

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Background:Platelet-rich plasma (PRP) has been extensively used as a treatment in tissue healing in tendinopathy, muscle injury, and osteoarthritis. However, there is variation in methods of extraction, and this produces different types of PRP.Purpose:To determine the composition of PRP obtained from 4 commercial separation kits, which would allow assessment of current classification systems used in cross-study comparisons.Study Design:Controlled laboratory study.Methods:Three normal adults each donated 181 mL of whole blood, some of which served as a control and the remainder of which was processed through 4 PRP separation kits: GPS III (Biomet Biologics), Smart-Prep2 (Harvest Terumo), Magellan (Arteriocyte Medical Systems), and ACP (Device Technologies). The resultant PRP was tested for platelet count, red blood cell count, and white blood cell count, including differential in a commercial pathology laboratory. Glucose and pH measurements were obtained from a blood gas autoanalyzer machine.Results:Three kits taking samples from the “buffy coat layer” were found to have greater concentrations of platelets (3-6 times baseline), while 1 kit taking samples from plasma was found to have platelet concentrations of only 1.5 times baseline. The same 3 kits produced an increased concentration of white blood cells (3-6 times baseline); these consisted of neutrophils, leukocytes, and monocytes. This represents high concentrations of platelets and white blood cells. A small drop in pH was thought to relate to the citrate used in the sample preparation. Interestingly, an unexpected increase in glucose concentrations, with 3 to 6 times greater than baseline levels, was found in all samples.Conclusion:This study reveals the variation of blood components, including platelets, red blood cells, leukocytes, pH, and glucose in PRP extractions. The high concentrations of cells are important, as the white blood cell count in PRP samples has frequently been ignored, being considered insignificant. The lack of standardization of PRP preparation for clinical use has contributed at least in part to the varying clinical efficacy in PRP use.Clinical Relevance:The variation of platelet and other blood component concentrations between commercial PRP kits may affect clinical treatment outcomes. There is a need for standardization of PRP for clinical use.

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Section: Discussionmentioning

confidence: 99%

“…DeLong et al 14 considered that PRP preparations can be divided into 2 forms: 1 plasma based, the other based on buffy coat preparations. Plasma-based preparations aim to capture platelets from the plasma after centrifugation and exclude red and white blood cells.…”

mentioning

confidence: 99%

Analysis of Platelet-Rich Plasma Extraction

Fitzpatrick

Bulsara

McCrory

et al. 2017

Orthopaedic Journal of Sports Medicine

149

View full text Add to dashboard Cite

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“…This preparation technique involves higher spin rates and longer centrifugation to produce three to eight times the baseline levels of platelet concentrations but also includes WBC/leukocytes as well as RBCs. 22 The different preparations results in different concentrations of platelets, WBCs, and RBCs, the importance of which is discussed in detail in the following.…”

mentioning

confidence: 99%

The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis

et al. 2018

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With average life expectancy and the rising prevalence of obesity, osteoarthritis (OA) is creating an increasingly large financial and physical burden on the U.S. population today. As the body ages and experiences trauma, articular cartilage surfaces in joints are gradually worn away, leading to OA. Traditionally, treatment options have included lifestyle modifications, pain management, and corticosteroid injections, with joint replacement reserved for those who have exhausted nonsurgical measures. More recently, hyaluronic acid, micronized dehydrated human amniotic/chorionic membrane tissue, and platelet-rich plasma (PRP) injections have started to gain traction. PRP has been shown to have both anti-inflammatory effects through growth factors such as transforming growth factor-β and insulin-like growth factor 1, and stimulatory effects on mesenchymal stem cells and fibroblasts. Multiple studies have indicated that PRP is superior to hyaluronic acid and corticosteroids in terms of improving patient-reported pain and functionality scores. Unfortunately, there are many variations in PRP preparation, and lack of standardization in factors, such as speed and duration of centrifugation, leads to wide ranges of platelet and leukocyte concentrations. This review examines the current literature addressing the use of PRP in symptomatic knee OA and addresses suggestions for future studies in this area.

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“…The addition of activated PRP can make microenvironmental conditions similar to the natural ones that occur during bone trauma. But it is known that platelets release a major portion of regulatory factors immediately after injury [74], which might be sufficient to stimulate ADSCs immediately after its implantation but definitely not for a longer period. The manner and applied doses of PRP obviously was enough to support development and maintenance of osteogenesis guided by previously in vitro osteoinduced ADSCs [46] and was not sufficient to support maintenance of osteogenic process guided by untreated ADSCs within SVF [56].…”

Section: One-step Versus Multistep Approachesmentioning

confidence: 99%

Application of Adipose-Derived Stem Cells in Treatment of Bone Tissue Defects

Najman¹,

Najdanović²,

Cvetković³

2021

Clinical Implementation of Bone Regeneration and Maintenance

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Despite excellent self-regeneration capacity of bone tissue, there are some large bone defects that cannot be healed spontaneously. Numerous literature data in the field of cell-based bone tissue engineering showed that adipose-derived stem cells (ADSCs) after isolation could be subsequently applied in a one-step approach for treatment of bone defect, without previous in vitro expansion and osteoinduction. However, standard approaches usually involve in vitro expansion and osteoinduction of ADSCs as an additional preparation step before its final application. Bioreactors are also used for the preparation of ADSC-based graft prior application. The commonly used approaches are reviewed, and their outcomes, advantages, disadvantages, as well as their potential for successful application in the treatment of bone defects are discussed. Difficulty in spontaneous healing of bone defects is very often due to poor vascularization. To overcome this problem, numerous methods in bone tissue engineering (BTE) were developed. We focused on freshly isolated stromal vascular fraction (SVF) cells and ADSCs in vitro induced into endothelial cells (ECs) as cells with vasculogenic capacity for the further application in bone defect treatment. We have reviewed orthotopic and ectopic models in BTE that include the application of SVFs or ADSCs in vitro induced into ECs, with special reference to co-cultivation.

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Update on platelet-rich plasma

Cited by 21 publications

References 80 publications

Analysis of Platelet-Rich Plasma Extraction

Analysis of Platelet-Rich Plasma Extraction

The Use of Platelet-Rich Plasma in Symptomatic Knee Osteoarthritis

Application of Adipose-Derived Stem Cells in Treatment of Bone Tissue Defects

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