Platelet-Rich Plasma Peptides: Key for Regeneration
Table 3
Platelet-plasma-derived peptides are current in clinical use and clinical trials.
Year
Researchers
Health problems
Clinical protocols
Level of evidence
Results
2005
Carreon et al.
Bone healing in instrumented posterolateral spinal fusions
Retrospective cohort study to evaluate rates of nonunionin patients (n = 76) with autologous iliac bone graft augmented with platelet gel
Level 4, case control group of 76 randomly selected patients who were matched and grafted with autogenous iliac bone graft with no platelet gel
Nonunion rate in platelet gel group was 25%; 17% in control group ()
2006
Mishra and Pavelko
Chronic elbow tendinitis
Cohort, 15 patients injected with PRP
Level 2, 5 controls
Decreased pain at 2 years (measured by visual analog pain score)
Savarino et al.
Bone healing in varus HTOs for genu varus
Randomized case control, 5 patients with bone grafted with bone chips and PRP
Level 4, 5 controls bone grafted without PRP
No functional or clinical difference; histology shows increased amounts of osteoid and osteoblasts in PRP group
Sánchez et al.
Achilles tear healing
Case control, 6 repairs with PRP
Level 3, 6 matched retrospective controls
Improved ROM and early return to activity with PRP by ± 4–7 weeks
2007
Dallari et al.
Bone healing in varus HTOs for genu varus
Prospective randomized control: group A, bone chips with platelet gel (n = 11); group B, bone chips, BMC, and platelet gel (n = 12)
Level 1, 10 controls treated with bone chips only
Biopsies at 6 weeks after surgery showed increased osteoid and osteoblasts in groups A and B; radiographic differences decreased with time; no clinical difference at 1 year among groups
Kitoh et al.
Bone healing in distraction osteogenesis for limb lengthening and short stature
Retrospective, comparison case control; at 3 weeks, patients injected with expanded BMC with or without PRP (n = 32 bones)
Level 3, 60 bones in retrospective control group (high % of congenital etiologies versus PRP group)
Average healing in BMC + PRP was 34 ± 4 d/cm; control group average was 73.4 ± 27 d/cm ()
2009
Sánchez et al.
Bone healing in nonunions
Retrospective, case series; 16 nonhypertrophic nonunions treated with either surgery and PRGF or percutaneous injections of PRGF to stimulate (n = 3) without surgery
Level 4, no control group
84% healed after surgical treatment; unclear if PRGF made a difference
Some published human clinical orthopaedic PRP studies. PRP: platelet-rich plasma; ROM: range of motion; HTO: high tibial osteotomy; BMC: bone marrow cells; PRGF: preparation rich in growth factors [27]. Taken from Foster et al. [27].