Advances with Platelet-Rich Plasma for Bone Healing

Area of Science:

• Orthopaedic Surgery
• Regenerative Medicine
• Biologics in Bone Healing

Background:

• Fracture non-union is a significant challenge in orthopaedic surgery despite advances in osteosynthesis.
• Platelet-rich plasma (PRP) is an orthobiologic extensively studied for bone and soft tissue healing.
• Understanding basic science mechanisms of fracture healing is crucial for developing biological strategies.

Purpose of the Study:

• To review pre-clinical and clinical data on the efficacy of PRP in enhancing bone healing.
• To investigate PRP's role in primary fracture management and non-union treatment.
• To highlight the impact of PRP preparation and delivery heterogeneity on clinical outcomes.

Main Methods:

• Narrative review of in-vitro and in-vivo pre-clinical studies.
• Analysis of clinical observations and studies investigating PRP for bone healing.
• Emphasis on heterogeneity in PRP preparation, composition, activation, and delivery methods.

Main Results:

• Current data do not support the routine use of PRP for enhancing primary fracture healing or non-union management.
• Significant heterogeneity exists in PRP preparation techniques and clinical application across studies.
• The variability in PRP treatments obscures definitive conclusions regarding its efficacy.

Conclusions:

• The routine application of PRP for bone healing in primary fractures and non-unions is not currently supported by robust evidence.
• Extensive heterogeneity in PRP preparation and application across clinical studies complicates interpretation of results.
• Further research, including refined and standardized PRP protocols and repetition studies, is warranted to establish its clinical utility.