PRP Review Template
PRP Review Template
PRP Review Template
Abstract
This article will review the principle indications for PRP use and the
the profile of adverse effects associated with its use. This article will
administration, the evidence for the practice and the risks and adverse
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modulate inflammation, either through suppression (corticosteroids) or
glycerol).
effective in the context of cardiac surgery. In the mid 1990s oral and
PRP biology
cells and platelets in plasma. Platelets, which are formed through the
2
many pseudopods [George]. Activation of the platelets in PRP for clinical
General principles
centrifugation, such that a heavy bottom layer of red blood cells and the
coat which is rich in platelets and white blood cells. This supernatant may
times the baseline concentration [mishra] . P-PRP and L-PRP are the
PRP. A consensus does not yet exist regarding what platelet concentration
3
constitutes platelet rich plasma. Marmotti [marmotti] defined PRP as
Anitua has suggested that a lower cut off point (above 300,000 / l) can
three layers
o Top layer platelets, plasma and some white blood cells
o Middle layer Buffy coat rich in white blood cells
o Bottom layer - Red blood cells
4. Transfer the top layer (to obtain P-PRP) or top and middle layers (for
4
Published variations on this technique typically vary at step 3 and 4 in
or otherwise of the buffy coat for transfer to the second tube. Landesberg
tubes. Clinicians should be aware of this possibility with their own systems
FDA regulation.
Under FDA 21 CFR 1271 of the Code of Regulations [ref FDA regs] some
the typical manner with regard to clinical trials [Beitzel]. PRP preparation
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preparation systems were designed for application in the orthopaedic
setting to mix bone graft. In this regard their use for the preparation of
Guidelines?
taken when preparing the product that labelling and patient identification
adversely affect the release of growth factors from the platelet alpha
granules [schippinger].
6
As an autologous blood product, allergic reaction is very unlikely, but a
General considerations
placebo control are problematic, particularly in the case of PRP, where the
a treatment effect. In most cases, the evidence base for PRP treatment of
patient numbers. They concluded that the evidence for an PRP in sports
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controlled trials to clarify. the true efficacy of PRP in the musculoskeletal
Upper limb
Lateral epicondylitis
Lower limb
Hamstring tendinopathy
Patellar tendinopathy
Achilles tendinopathy
large well designed clinical trial has not yet been reported in the
treated with standard therapy plus PRP injection and those treated with
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standard therapy and placebo saline injection [de Vos, de jonge].
of achilles tendinopathy. They found that both high volume injection and
follow up. Notably, the mean reduction in VISA-A score (Victorian Institute
trial by Boesen at al, while Krogh et al found a mean change of only 3.4
sporting population may be limited due to the higher mean age of the
patients included in it (49 and 50 years in the PRP and placebo groups
respectively). They also point out that the actual platelet concentration
administered to the treatment group was unknown, and that the use of an
inactivated PRP may limit the efficacy of the injection in vivo, as the
injectate may actually extrude from the tendon injection site before it is
Technical consideration
9
Conclusion
References
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Figures
Figure 1.
Figure 2
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Tables
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and antiapoptotic
properties [matsumoto]
VEGF Epithelialization,
collagen deposition,
chemotaxis and
angiogenesis [bao]
Acknowledgements
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