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The increasing use of platelet-rich plasma (PRP) in orthopaedics presents significant opportunities—as well as significant questions—about appropriate clinical applications for this developing therapy.

A centrifuge is used to isolate the platelets, which are rich in growth factors. The composition of PRP varies with the preparation technique used. Although all PRP preparations contain a basic set of growth factors, the relative concentration of each factor can differ among preparations. Various methods are now commercially available for preparing PRP and a similar material called “autologous growth factor,” which is PRP plus the white blood cell buffy coat obtained during PRP preparation.

 Although PRP therapy seems quite promising in several areas, it is not appropriate in all cases. What we know to date is that PRP may play a positive role in soft tissue healing.

PRP preparations do not provide a source of autogenous cells; their effects depend on the presence of influencing local tissue. In addition to increasing the proliferation of cells and matrix synthesis, the growth factors associated with PRP also promote fibroblastic growth, differentiation, and scar formation.

 Scientific literature on the clinical use of PRP suggests that considerable variability exists in its effectiveness, even in the same clinical setting. If one surveys the Internet regarding Platelet Rich Plasma, the information returned would lead you to believe PRP to be an established orthopedic methodology. Such is not the case however and usage is based on anecdote for the most part. Certainly, PRP has been given a celebrity status by application within the professional sports environment.

Use with care, but consider use though at as out of pocket expense

 In summary, available data suggest that PRP may be valuable in enhancing soft-tissue repair and in wound healing.

While significant additional research is needed to define the role of PRP and to determine in which settings it might—or might not—be valuable; there still is a reason for a patient to consider PRP in certain soft tissue settings as a way to avoid surgery.

 Warning, to the best of my knowledge, PRP is not covered by third party payers

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