Sports Medicine Applications of Platelet Rich Plasma

Abstract

Platelet rich plasma (PRP) is a powerful new biologic tool in sports medicine. PRP is a fraction of autologous whole blood containing and increased number of platelets and a wide variety of cytokines such as platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and transforming growth factor beta-1 (TGF-B1), fibroblast growth factor (FGF), Insulin-like growth factor-1 (IGF-1) among many others. Worldwide interest in this biologic technology has recently risen sharply. Basic science and preclinical data support the use of PRP for a variety of sports related injuries and disorders. The published, peer reviewed, human data on PRP is limited. Although the scientific evaluation of clinical efficacy is in the early stages, elite and recreational athletes already use PRP in the treatment of sports related injuries. Many questions remain to be answered regarding the use of PRP including optimal formulation, including of leukocytes, dosage and rehabilitation protocols. In this review, a classification for platelet rich plasma is proposed and the in-vitro, preclinical and human investigations of PRP applications in sports medicine will be reviewed as well as a discussion of rehabilitation after a PRP procedure. The regulation of PRP by the World Anti-Doping Agency will also be discussed. PRP is a promising technology in sports medicine; however, it will require more vigorous study in order to better understand how to apply it most effectively.

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“…These are the Mishra classification and the PAW classification. Mishra et al 45 proposed a classification that takes into consideration the presence of leukocytes, activation of platelets, and platelets concentration. This classification established 4 types of PRP: type 1 PRP is an L-PRP solution, type 2 PRP is an L-PRP gel (with activation), type 3 PRP is P-PRP solution, type 4 PRP is a P-PRP gel (with activation).…”

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“…Leukocytes are not only inflammatory cells: they also present anti-nociceptive effects through different chemokines, anti-inflammatory cytokines (IL-4, IL-10 and IL-13) and opioid peptides (b-endorphin, metenkephalin, and dynorphin-A) and can therefore promote a clinically relevant inhibition of pathological pain [19][20][21]. The classification previously described is the only nomenclature which considers all forms of platelet concentrates for surgical use.…”

New aspects of microcurrent electrical neuromuscular stimulation in sports medicine

“…Specifically, it contains platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor beta-1 (TGF-B1), fibroblast growth factor (FGF), and insulin-like growth factor-1 (IGF-1) 14) . Yet the experimental data on the effects *Correspondence: fujiya-1487@marianna-u.ac.jp of PRP on humans is still limited, and many open questions regarding the optimal dosage (platelet concentration, concentration fraction ratio, total platelet count, etc.)…”