An article published in the Journal of the American Academy of Orthopaedic Surgeons titled, “Platelet-rich Plasma to Augment Connective Tissue Healing: Making Sense of it All,” summarizes PRP’s recent applications and subsequent considerations.
The article published by Arnochzky et al concludes, “Although the rationale, based on
basic science, for enhancing connective tissue healing through the addition of an exogenous source of concentrated growth factors is supported by scores of in vitro and numerous in vivo animal studies, reported clinical outcomes regarding the benefits of PRP are not consistent.”
Initially, the article reports, case studies and expert opinion studies provided substantial optimism for the efficacy of Platelet-rich Plasma in tendinopathy and expediting post-operative healing in rotator cuff injuries. This was followed by a flurry of media coverage circulating around a “blood spinning” treatment that helped professional athletes return to competition faster.
However, subsequent studies have resulted in a variety of inconsistent outcomes. The article says these inconsistencies are due to the way PRP is prepared and applied, stating “all PRP preparations are not created equal.”
Variability among results are due to platelet concentration levels, how much blood is drawn, how much plasma is used to suspend platelets, presence or absence of red and white blood cells, addition of calcium chloride or thrombin to induce fibrin formation, and the addition of pH-altering compounds.
The article states, “Thus, because PRP preparations are not all the same, it is incorrect to summarily conclude that the failure or success of one product is invariably applicable to all others.”
Besides growth factors, other components within the PRP compound may also work to initiate and expedite healing such as proteins and clotting factors.
The article emphasizes coming studies must describe specific levels of PRP components used. Only in doing so will optimal PRP use be known.