PRP or not PRP: Is the debate surrounding platelets-based blood-derived products evolving?

Area of Science:

• Orthobiologics and regenerative medicine
• Musculoskeletal disorder treatments

Background:

• Growing interest in biologic treatments for musculoskeletal issues.
• Orthobiologics, including cell-based and blood-derived therapies, are advancing non-operative care.
• Clear definitions are needed for clinical application of these injectable therapies.

Purpose of the Study:

• To highlight the complexity in classifying platelet-rich plasma (PRP).
• To emphasize the need for a standardized classification system for orthobiologics.
• To underscore the importance of precise product characterization for optimizing regenerative strategies.

Main Methods:

• Review of current literature on orthobiologics and PRP classification.
• Analysis of variables affecting PRP efficacy, including preparation, platelet concentration, leucocyte content, and activation.
• Discussion of alternative blood-derived products and their biological effects.

Main Results:

• PRP classification is complex due to variations in preparation, platelet and leucocyte content, and activation.
• Scientific debate exists on whether platelet count or enrichment is more critical for outcomes.
• Leucocyte-rich vs. leucocyte-poor PRP and the role of red blood cells present further classification challenges.

Conclusions:

• A standardized classification system for orthobiologics is essential for research and clinical practice.
• Precise documentation of product characteristics (platelet count, activation, bioactive molecules) is crucial.
• Understanding these variables will refine orthopaedic regenerative strategies and improve treatment efficacy.