Platelet-rich plasma for muscle injuries: game over or time out?

Abstract

Muscle injuries are common and may be associated with impaired functional capacity, especially among athletes. The results of healing with conventional therapy including rest, ice, compression, and elevation (RICE) are often inadequate, generating substantial interest in the potential for emerging technologies such as platelet-rich plasma (PRP) to enhance the process of soft-tissue healing and to decrease time to recovery. In vitro studies and animal research have suggested that PRP may have benefits associated with the increased release of cytokines and growth factors resulting from supraphysiological concentrations of platelets that facilitate muscle repair, regeneration, and remodeling. Despite the promise of basic science, there is a paucity of clinical data to support the theoretical benefits of PRP. The only double-blind controlled clinical trial was recently reported and showed no benefit of PRP in the time to resume sports activity among athletes with hamstring muscle injury. This review examines the current evidence and the theoretical framework for PRP and muscle healing. Scientific gaps and technological barriers are discussed that must be addressed if the potential promise of PRP as a therapeutic modality for muscle injury is to be realized.

Autologous platelet rich plasma enhances satellite cells expression of MyoD and exerts angiogenic and antifibrotic effects in experimental rat model of traumatic skeletal muscle injury

“…Dimauro et al (2014) [55] reported that PRP treatment reduced the level of several apoptotic markers during muscle regeneration process. Platelets present in PRP are known as a chief source of biologically active metabolites that modulate inflammation, cellular proliferation, migration, angiogenesis, vascular remodeling, antimicrobial action and ECM synthesis [56] .…”

“…One of the identified platelet secretory granules are alpha granules that contain plateletderived growth factor (PDGF), transforming growth factorbeta (TGFB), epidermal growth factor (EGF),vascular endothelial growth factor(VEGF),cytokines and others [23] . This knowledge stimulated the development of a platelet concentrate intended for increasing levels of local growth factors (GFs) delivery at the injury site to improve tissue repair, regeneration and remodeling [24,25] .Therefore, the present study was conducted to elucidate the morphometric and histological changes after local application of PRP in induced traumatic skeletal muscle injury in rats in a trial to describe the efficacy of PRP in the treatment of such cases.…”

Actovegin Equals to Performance Enhancing Drug Doping: Fact or Fiction?

“…Interventions such as Platelet Rich Plasma (PRP) and Autologous Conditioning Serum (ACS) have become popular augmentative therapies in Sports Medicine, being proposed to facilitate muscle healing by optimizing provision of growth factors from promising animal study [13][14][15]. However, again these results do not necessarily translate to human trial.…”

Tendinopathy: Investigating the Intersection of Clinical and Animal Research to Identify Progress and Hurdles in the Field

“…Protocols vary greatly with regard to velocity and duration of centrifugation. This variation alters the composition of platelet concentrates, leading to patterns of growth factor expression 65–67 , some of which may have an adverse effect by potentially enhancing the fibrotic response 67 . While promising, the optimal preparation of platelet concentrates and the time during healing wherein they might promote an effective response have not been identified.…”