Although mechanical stabilisation has been a hallmark of orthopaedic surgical management, orthobiologics are now playing an increasing role. Platelet-rich plasma (PRP) is a volume of plasma fraction of autologous blood having platelet concentrations above baseline. The platelet alpha granules are rich in growth factors that play an essential role in tissue healing, such as transforming growth factor-beta, vascular endothelial growth factor, and platelet-derived growth factor. PRP is used in various surgical fields to enhance bone and soft-tissue healing by placing supraphysiological concentrations of autologous platelets at the site of tissue damage. The easily obtainable PRP and its possible beneficial outcome hold promise for new regenerative treatment approaches. The aim of this literature review was to describe the bioactivities of PRP, to elucidate the different techniques for PRP preparation, to review animal and human studies, to evaluate the evidence regarding the use of PRP in trauma and orthopaedic surgery, to clarify risks, and to provide guidance for future research.

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Platelet-rich plasma (PRP), an autologous derivative of whole blood that contains a supraphysiological concentration of platelets, has gained increasing attention in both the scientific literature and the wider media for its potential application in the treatment of traumatic musculoskeletal injury. The theoretical benefit of PRP in providing a local environment for tissue regeneration which is rich in growth factors and other cytokines has been supported by in vitro and animal studies which suggest a positive influence on the migration and proliferation of a number of cell types. However, the reported clinical use of PRP is largely confined to the last two decades and initially centred around its application in dental and maxillofacial surgery. More recently, developments in research of the regenerative effects of PRP in a range of tissue types including bone, cartilage, tendon and muscle, particularly in the context of traumatic injury, have attracted interest in fields such as orthopaedic and plastic surgery where effective union of sometimes poorly vascularised and damaged tissue is a critical determinant of successful clinical outcome. Despite the lack of high-quality trial data, results from clinical studies have been encouraging, and PRP administration remains an attractive strategy given its cost-effective and minimally invasive nature. In this review, we summarise the current literature on the use of PRP and highlight areas of controversy and emerging clinical applications.