Vannini Francesca, Di Matteo Berardo, Filardo Giuseppe
I Orthopaedic Clinic and Movement Analysis Laboratory, Rizzoli Orthopaedic Institute, Via di Barbiano n. 1/10, 40136, Bologna, Italy.
II Orthopaedic Clinic and Biomechanics Laboratory, Rizzoli Orthopaedic Institute, Via di Barbiano n. 1/10, 40136, Bologna, Italy.
J Exp Orthop. 2015 Dec;2(1):2. doi: 10.1186/s40634-015-0019-z. Epub 2015 Feb 12.
Platelet-rich Plasma (PRP) is a fascinating biological treatment showing promising results for the management of cartilage disorders. However, despite the step forwards in this research area and the increasing use of PRP in clinical practice, its use remains still controversial and especially its application as injective treatment for ankle cartilage pathology have been scarcely investigated.The aim of this paper is to describe the translational evidence for the use of PRP in cartilage treatment and to systematically review all the available evidence regarding the clinical application of PRP for ankle cartilage disorders, in order to understand what is the current state of the art for this specific clinical indication, underlining both limits and potential of this biological strategy.A systematic review of the clinical literature was performed on the use of PRP to treat ankle cartilage disorders and 7 papers were identified. PRP has been used in two different ways: 5 of the available papers focus on its use as an augmentation procedure to various surgical techniques for cartilage regeneration, while only two studies report its conservative application through intra-articular injections. Based on the limited number of clinical studies available on this topic, this systematic review showed the lack of major adverse events related to PRP and overall good results for the treatment of ankle cartilage pathology, thus confirming the translational potential of this biological treatment suggested by several preclinical studies. Further high quality clinical trials in the ankle are still needed to clarify proper indications and best applicative modalities.
富血小板血浆（PRP）是一种引人关注的生物治疗方法，在软骨疾病的治疗中显示出了有前景的效果。然而，尽管该研究领域取得了进展，且PRP在临床实践中的应用日益增多，但其使用仍存在争议，尤其是其作为踝关节软骨病变的注射治疗应用几乎未得到研究。本文的目的是描述PRP在软骨治疗中应用的转化证据，并系统回顾关于PRP用于踝关节软骨疾病临床应用的所有现有证据，以便了解这一特定临床适应症的当前技术水平，强调这种生物治疗策略的局限性和潜力。对使用PRP治疗踝关节软骨疾病的临床文献进行了系统回顾，共识别出7篇论文。PRP有两种不同的使用方式：现有5篇论文关注其作为各种软骨再生手术技术的增强手段，而只有两项研究报告了其通过关节内注射的保守应用。基于关于该主题的临床研究数量有限，本系统回顾显示与PRP相关的主要不良事件较少，且在治疗踝关节软骨病变方面总体效果良好，从而证实了一些临床前研究表明的这种生物治疗的转化潜力。仍需要在踝关节方面进行进一步的高质量临床试验，以明确合适的适应症和最佳应用方式。
