Platelet rich concentrate: basic science and current clinical applications.
Improvements in resuscitation, dissemination of ATLS protocols, and growth of regional and local trauma centers has increased the survivability after severe traumatic injuries. Furthermore, advances in medical management have increased life expectancy and also patients with orthopaedic injuries. While mechanical stabilization has been a hallmark of orthopaedic fracture care, orthobiologics are playing an increasing role in the management of these patients with complex injuries. Platelet-rich concentrate is an autologous concentration of platelets and growth factors, including transforming growth factor-beta (TGF-beta), vascular endothelial growth factor (VEGF), and platelet-derived growth factor (PDGF). The enhancement of bone and soft tissue healing by the placement of supraphysiologic concentration of autologous platelets at the site of tissue injury or surgery is supported by basic science and clinical studies. Due to the increased concentration and release of these factors, platelet-rich plasma can potentially enhance the recruitment and proliferation of tenocytes, stem cells, and endothelial cells. A better understanding of platelet function and appropriate clinical use is essential in achieving the desired outcomes of platelet-rich concentrate in orthopaedic clinical applications.
Mehta
Samir
S
Department of Orthopaedic Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania 19104, USA.samir.mehta@uphs.upenn.edu
Watson
J Tracy
JT
D001792:Blood Platelets / Q000502:physiology*; D017102:Fracture Healing / Q000502:physiology*; D050723:Fractures, Bone / Q000503:physiopathology; D006801:Humans; D009985:Orthopedics; D010982:Platelet-Derived Growth Factor / Q000502:physiology; D053657:Platelet-Rich Plasma / Q000502:physiology*; D017695:Soft Tissue Injuries / Q000503:physiopathology; D016212:Transforming Growth Factor beta / Q000502:physiology; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology
D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A