Platelet rich plasma (PRP) has been around for decades. Only recently has it been utilized clinically to treat orthopedic conditions with frankly mixed results. Several studies support its use for chronic tennis elbow. Emerging data also suggests it may play a role in the treatment of knee osteoarthritis. It clearly is not helpful for patients with mild untreated achilles tendonitis and may or may not have a role as a adjuvant treatment for rotator cuff tears. We are, however, only now beginning to understand why PRP may be useful and how it works.
Today, the Journal of Orthopedic Research published data confirming PRP may have significant value in the treatment of tendon and cartilage injuries. One study suggested "that human PRP may enhance the migration and simulate the chondrogenic differentiation of human subchondral progenitor cells". These cells are the ones that are found after the common procedure known as "microfracture" (Full abstract) Another paper declared that the releasate from PRP "can induce human tenocyte proliferation and collagen synthesis which could be implemented for future tendon regeneration in reconstructive surgeries." (Full Abstract) A final paper noted the "synergy of tendon stem cells and platelet rich plasma in tendon healing". (Full abstract)
Taken together this elite research data fully supports further clinical investigations into the use of PRP for tendon and cartilage disorders. Human clinical trials are expensive and difficult to execute in any field even more so in autologous biologic treatments such as PRP. This is partially true because there is dramatic variability in PRP preparations. This has led to confusing results. We need to focus on specific formulations for specific indications and then conduct well powered human trials. This will not be a simple task. Worldwide collaboration will be needed. The basic science data, however, are quite clear, PRP has impressive potential.