Platelet-rich plasma for muscle injuries: A systematic review of the basic science literature

Abstract

BACKGROUND Platelet-rich plasma (PRP) is an increasingly used biologic adjunct for muscle injuries, as it is thought to expedite healing. Despite its widespread use, little is known regarding the mechanisms by which PRP produces its efficacious effects in some patients. AIM To clarify the effects of PRP on muscular pathologies at the cellular and tissue levels by evaluating the basic science literature. METHODS A systematic review of PubMed/MEDLINE and EMBASE databases was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist. Level III in vivo and in vitro studies examining PRP effects on muscles, myocytes and/or myoblasts were eligible for inclusion. Extracted data included PRP preparation methods and study results. RESULTS Twenty-three studies were included (15 in vivo , 6 in vitro , 2 in vitro / in vivo ). Only one reported a complete PRP cytology (platelets, and red and white blood cell counts). Five in vitro studies reported increased cellular proliferation, four reported increased gene expression, and three reported increased cellular differentiation. Five in vivo studies reported increased gene expression, three reported superior muscle regeneration, and seven reported improved histological quality of muscular tissue. CONCLUSION The basic science literature on the use of PRP in muscle pathology demonstrates that PRP treatment confers several potentially beneficial effects on healing in comparison to controls. Future research is needed to determine optimal cytology, dosing, timing, and delivery methods of PRP for muscle pathologies.

The Changes of Whole Blood Cells and Plasma Proteins in Donors After Plateletpheresis: 42 Donors With a Interval of 14-16 Days and More Than 20 Times

“…Therefore, the plateletpheresis has become a routine procedure in most countries [11] , and more and more widely used in patient [12][13][14] . Because the instruments need to be imported at present, the parameters suitable for Chinese population are still improving and developing.…”

Platelet-rich plasma (PRP) as therapy for cartilage, tendon and muscle damage – German working group position statement

“…These findings were underlined by Tsai et al proving increased skeletal muscle cell viability and cell proliferation by shifting cells from the G1 phase to S1 phase and G2&M phases after PRP application, besides demonstrating increased protein expressions of cyclin A2, cyclin B1, cdk2 and PCNA [ 60 ]. A recent systematic review summed up the current scientific background as follows: (1) in the majority of studies, PRP treatment increased myocyte proliferation, growth factor expression (e.g., PDGF-A/B and VEGF), leukocyte recruitment, and angiogenesis in muscle models when compared to control groups; (2) PRP preparation techniques remain inconsistent across studies in the basic science literature; and (3) evidence from in vitro and in vivo basic science studies suggest that PRP has the potential to serve as an efficacious treatment modality that may expedite the healing process for muscular pathologies, based on observed effects at the cellular and tissue levels in treatment groups relative to control groups [ 41 ].…”

“…There are differences in the effectiveness of PRP products depending on the manufacturing process 70,0 0,0 review summed up the current scientific background as follows: (1) in the majority of studies, PRP treatment increased myocyte proliferation, growth factor expression (e.g., PDGF-A/B and VEGF), leukocyte recruitment, and angiogenesis in muscle models when compared to control groups; (2) PRP preparation techniques remain inconsistent across studies in the basic science literature; and (3) evidence from in vitro and in vivo basic science studies suggest that PRP has the potential to serve as an efficacious treatment modality that may expedite the healing process for muscular pathologies, based on observed effects at the cellular and tissue levels in treatment groups relative to control groups [41]. While retrospective studies described complete healing and no significant advantage considering time off the pitch [57], Bubnov et al observed less pain and significantly faster return to play in a cohort study of 30 athletes [10].…”

Skeletal Muscle-Derived Human Mesenchymal Stem Cells: Influence of Different Culture Conditions on Proliferative and Myogenic Capabilities

“…Given all these key aspects, over the past years a growing interest has been focused on biologic agents such as platelet-rich plasma (PrP) to complement the cell culture medium and/or significantly ameliorate musculoskeletal tissue healing (Hamid et al, 2014;Kunze et al, 2019). However, their real beneficial effect is still questioned (Grassi et al, 2018).…”