Platelet-rich plasma in orthopaedic sports medicine: state of the art

Platelet-rich plasma (PRP) is one of the many new developments within the expanding field of regenerative medicine. It aims to improve the process of tissue repair through local delivery of autologous bioactive agents to influence critical physiological mechanisms such as inflammation, angiogenesis or extracellular matrix synthesis. Within orthopaedics and sports medicine, the use of PRP has been rapidly increasing in popularity as patients seek non-surgical approaches to acute and chronic musculoskeletal injury and disease. The popularity of this new treatment option has prompted a rapid increase in research endeavours. Although preclinical studies were encouraging, clinical studies often reported controversial results. The differences in the composition and application techniques of PRP have made comparisons regarding its efficacy difficult and somehow inconclusive. Although PRP appears to be a safe treatment option with potentially beneficial effects to injured musculoskeletal tissues, continuous efforts are needed to identify factors that influence the biological response to PRP treatment. It is likely that in the near future the PRP preparation will be tailored not only to the specific pathology of interest but also to stage of disease. However, the growing emphasis on an evidence-based approach in the sports medicine setting demands additional research efforts before incorporating this technology in routine clinical care. The current review explores the latest findings on PRP efficacy in several musculoskeletal conditions, focusing on results of the highest level of evidence available.