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VOLUME 52 , ISSUE 2 ( April-June, 2018 ) > List of Articles

REVIEW ARTICLE

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

Keywords : Knee osteoarthritis, Orthobiologics, Platelet-rich plasma, Sports injury

Citation Information : Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years. J Postgrad Med Edu Res 2018; 52 (2):64-72.

DOI: 10.5005/jp-journals-10028-1278

License: CC BY-NC 4.0

Published Online: 01-04-2019

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

Introduction: Platelet-rich plasma (PRP) is fast emerging as a minimally invasive treatment option in a wide variety of orthopedic conditions. We were the forerunners in India in its use in osteoarthritis (OA), lateral epicondylitis, plantar fasciitis, and sports injuries. We present our experience with prospective clinical studies and multiple research projects, and have shown some aspects to be reproducible and evidence-based, whereas some areas of application seem to demand more evidence prior to routine recommendation for use. Materials and methods: Since 2009, PRP is in routine use at the Postgraduate Institute of Medical Education and Research (PGIMER); this ensued after our initial struggle of standardizing PRP as a product, followed by its clinical use in early OA knee, followed by use in recalcitrant tennis elbow, recalcitrant plantar fasciitis and various sports injuries. We also carried forward our PRP work with some experimental in vitro studies on anterior cruciate ligament (ACL) regeneration by PRP in a cell culture model. Our work on guinea pig OA model to compare PRP vs normal saline to document histological and biomarkers in OA is ongoing, and initial experience with that is also presented. Conclusion: From our experience, and a meta-analysis of the literature, it can be stated that PRP is effective in early degenerative knees (as a short-term modality) and lateral epicondylitis. We also recommend its use in chronic tendinopathies and various sports injuries; however, its use in these situations needs to be limited, as there is conflicting evidence in the literature, and our work on this aspect is preliminary in nature. In the case of ACL regeneration, we found equivocal experimental findings, and more research toward this area is the necessity of the hour.


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