Platelet-rich plasma (PRP) is commonly used in orthopaedic sports medicine. One main application is in the field of treatment of osteoarthritis (OA) and to imnprove outcome after cartilage regeneration procedures (Fice 2019). Positive disease modifying effects of PRP in the treatment of osteoarthritis have been described in animal models (Boffa 2021) and basic science rational for cartilage regeneration have been shown (Fice 2019). However, neither PRP preparation or clinical application (preparation, concentration, timing, number of PRP applications, ...) are standardized, making both basic science as well as clinical research challenging, not to mention the clinical application (Kieb 2017). Therefore, guidelines from scientific societies and consensus projects like the ESSKA orthobiologics initiative try to fill the gap between basic science research and clinical use in order to better standardize PRP application.
A characterized, lyophilized platelet growth factor preparation (PRP powder) can overcome limitations regarding standardized growth factor content (Kieb 2017). Positive dose-dependent effects of PRP have been described on chondrocytes in a standardized cell culture model (Hahn 2020). Current problems with PRP such as absent standardization, lack of consistency among studies, and black box dosage could be solved by using a characterized PRP powder made by pooling and lyophilizing multiple platelet concentrates, which gives a hugh amount of exactely the same PRP preparations. Research is ongoing if lyophilized PRP can be used as a coating of implants to biofunctionalize them.
Also PRP is used with many other biomaterials in order to improve tissue regeneration, especially in the field of cartilage research (Chang 2018). This talk will introduce briefly the advantages of combining biomaterials with PRP, with a special focus on the new trend of using minced cartilage (Salzmann 2021).
The Role of Platelet-Rich Plasma in Cartilage Pathology: An Updated Systematic Review of the Basic Science Evidence.
Fice MP, Miller JC, Christian R, Hannon CP, Smyth N, Murawski CD, Cole BJ, Kennedy JG.
Arthroscopy. 2019 Mar;35(3):961-976.e3. doi: 10.1016/j.arthro.2018.10.125.
Platelet-rich plasma injections induce disease-modifying effects in the treatment of osteoarthritis in animal models.
Boffa A, Salerno M, Merli G, De Girolamo L, Laver L, Magalon J, Sánchez M, Tischer T, Filardo G.
Knee Surg Sports Traumatol Arthrosc. 2021 Dec;29(12):4100-4121. doi: 10.1007/s00167-021-06659-9.
Platelet-Rich Plasma Powder: A New Preparation Method for the Standardization of Growth Factor Concentrations.
Kieb M, Sander F, Prinz C, Adam S, Mau-Möller A, Bader R, Peters K, Tischer T.
Am J Sports Med. 2017 Mar;45(4):954-960. doi: 10.1177/0363546516674475.
Dose-Dependent Effects of Platelet-Rich Plasma Powder on Chondrocytes In Vitro.
Hahn O, Kieb M, Jonitz-Heincke A, Bader R, Peters K, Tischer T.
Am J Sports Med. 2020 Jun;48(7):1727-1734. doi: 10.1177/0363546520911035.
Therapeutic Effects of the Addition of Platelet-Rich Plasma to Bioimplants and Early Rehabilitation Exercise on Articular Cartilage Repair. Nai-Jen Chang, Yanjmaa Erdenekhuyag, Pei-Hsi Chou, Chih-Jou Chu, Chih-Chan Lin, Ming-You Shie. Am J Sports Med. 2018 Jul;46(9):2232-2241. doi: 10.1177/0363546518780955. Epub 2018 Jun 21. DOI: 10.1177/0363546518780955
Autologous Minced Cartilage Implantation for Treatment of Chondral and Osteochondral Lesions in the Knee Joint: An Overview.
Salzmann GM, Ossendorff R, Gilat R, Cole BJ.
Cartilage. 2021 Dec;13(1_suppl):1124S-1136S. doi: 10.1177/1947603520942952. Epub 2020 Jul 25.