Kunze Kyle N, Hannon Charles P, Fialkoff Jared D, Frank Rachel M, Cole Brian J
Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, United States.
Department of Orthopedic Surgery, University of Colorado School of Medicine, Boulder, CO 80309, United States.
World J Orthop. 2019 Jul 18;10(7):278-291. doi: 10.5312/wjo.v10.i7.278.
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.
To clarify the effects of PRP on muscular pathologies at the cellular and tissue levels by evaluating the basic science literature.
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 and studies examining PRP effects on muscles, myocytes and/or myoblasts were eligible for inclusion. Extracted data included PRP preparation methods and study results.
Twenty-three studies were included (15 , 6 , 2 /). Only one reported a complete PRP cytology (platelets, and red and white blood cell counts). Five studies reported increased cellular proliferation, four reported increased gene expression, and three reported increased cellular differentiation. Five studies reported increased gene expression, three reported superior muscle regeneration, and seven reported improved histological quality of muscular tissue.
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.
富含血小板血浆（PRP）作为一种生物辅助剂在肌肉损伤治疗中的应用日益广泛，因为人们认为它能加速愈合。尽管其应用广泛，但对于PRP在某些患者中产生有效作用的机制却知之甚少。
通过评估基础科学文献，阐明PRP在细胞和组织水平对肌肉病变的影响。
按照系统评价和Meta分析的首选报告项目（PRISMA）指南及清单，对PubMed/MEDLINE和EMBASE数据库进行系统综述。纳入研究PRP对肌肉、肌细胞和/或成肌细胞影响的Ⅲ级及以上研究。提取的数据包括PRP制备方法和研究结果。
共纳入23项研究（15项队列研究、6项病例对照研究、2项随机对照试验）。仅有1项报告了完整的PRP细胞学检查结果（血小板、红细胞和白细胞计数）。5项队列研究报告细胞增殖增加，4项报告基因表达增加，3项报告细胞分化增加。5项病例对照研究报告基因表达增加，3项报告肌肉再生更佳，7项报告肌肉组织的组织学质量改善。
关于PRP用于肌肉病变的基础科学文献表明，与对照组相比，PRP治疗对愈合具有多种潜在有益作用。未来需要开展研究以确定PRP用于肌肉病变的最佳细胞学、剂量、时机和给药方法。
