Andia Isabel, Maffulli Nicola
*Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital, Barakaldo, Spain †Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Center for Sports and Exercise Medicine Mile End Hospital, London, UK.
Sports Med Arthrosc Rev. 2013 Dec;21(4):191-8. doi: 10.1097/JSA.0b013e318299972b.
Platelet-rich plasma (PRP) is increasingly used in Regenerative Medicine. The concept of PRP as a natural source of signaling molecules with paracrine effects in different cells is the basis for the increased PRP application as treatment for sports injuries. PRP recapitulates the principal functions of the natural healing response in orchestrating cell proliferation, differentiation, migration, and angiogenesis. After systematically searching the literature, we identified 21 trials for PRP injections in tendinopathy: 57% were uncontrolled trials and 1 cohort study in muscle. Leukocyte-PRP was used in 91.7% of tendons, of which 65.5% received 1 single injection. Given the lack of large controlled trials, it is clear that the effectiveness of conservative L-PRP treatments is not proven. The clinical evaluation of alternative formulations can be extremely informative. Other unexplored issues include activation, redosing, and concomitant longitudinal tenotomies. Limiting factors for the acceptance of PRP are the lack of evidence of obvious clinical improvement and reimbursement.
富含血小板血浆（PRP）在再生医学中的应用日益广泛。PRP作为信号分子的天然来源，对不同细胞具有旁分泌作用，这一概念是PRP作为运动损伤治疗手段应用增加的基础。PRP在协调细胞增殖、分化、迁移和血管生成方面重现了自然愈合反应的主要功能。在系统检索文献后，我们确定了21项关于PRP注射治疗肌腱病的试验：57%为非对照试验，1项为肌肉方面的队列研究。91.7%的肌腱使用了白细胞PRP，其中65.5%接受了单次注射。鉴于缺乏大型对照试验，保守的白细胞PRP治疗的有效性尚未得到证实。替代制剂的临床评估可能极具参考价值。其他未探索的问题包括激活、再次给药以及同时进行纵向腱切断术。PRP被接受的限制因素是缺乏明显临床改善的证据以及报销问题。
