title: Classification of platelet concentrates (Platelet-Rich Plasma-PRP, Platelet-Rich Fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives.
abstract: Platelet concentrates for topical and infiltrative use - commonly termed Platetet-Rich Plasma (PRP) or Platelet-Rich Fibrin (PRF) - are used or tested as surgical adjuvants or regenerative medicine preparations in most medical fields, particularly in sports medicine and orthopaedic surgery. Even if these products offer interesting therapeutic perspectives, their clinical relevance is largely debated, as the literature on the topic is often confused and contradictory. The long history of these products was always associated with confusions, mostly related to the lack of consensual terminology, characterization and classification of the many products that were tested in the last 40 years. The current consensus is based on a simple classification system dividing the many products in 4 main families, based on their fibrin architecture and cell content: Pure Platelet-Rich Plasma (P-PRP), such as the PRGF-Endoret technique; Leukocyte- and Platelet-Rich Plasma (LPRP), such as Biomet GPS system; Pure Platelet-Rich Fibrin (P-PRF), such as Fibrinet; Leukocyte- and Platelet-Rich Fibrin (L-PRF), such as Intra-Spin L-PRF. The 4 main families of products present different biological signatures and mechanisms, and obvious differences for clinical applications. This classification serves as a basis for further investigations of the effects of these products. Perspectives of evolutions of this classification and terminology are also discussed, particularly concerning the impact of the cell content, preservation and activation on these products in sports medicine and orthopaedics.
authors.affiliation: LoB5 unit, Research Center for Biomineralization Disorders, School of Dentistry, Chonnam National University, Gwangju, South Korea and Department of Stomatology, Oral Surgery, and Dental and Maxillofacial Radiology, School of Dental Medicine, University of Geneva, Switzerland.
authors.forename: David M
authors.initials: DM
authors.lastname: Dohan Ehrenfest
authors.affiliation: Regenerative Medicine Laboratory, Cruces University Hospital, BioCruces Health Research Institute, Barakaldo, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Andia
authors.affiliation: Shoulder, Elbow and Orthopedic Sports Medicine Unit, Department of Orthopaedics and Traumatology, Inselspital, University of Bern, Switzerland.
authors.forename: Matthias A
authors.initials: MA
authors.lastname: Zumstein
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai, Jiatong University, Shanghai, China.
authors.forename: Chang-Qing
authors.initials: CQ
authors.lastname: Zhang
authors.affiliation: Department of Surgical and Prosthetic Implantology, Faculty of Odontology, University of the Andes (UANDES), Santiago, Chile.
authors.forename: Nelson R
authors.initials: NR
authors.lastname: Pinto
authors.affiliation: Department and Clinic of Orthopaedics, Medical University of Silesia, Sosnowiec, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Bielecki
keywords: blood platelet; fibrin; growth factors; leukocytes; regenerative medicine; sports medicine