Tischer T, Bode G, Buhs M, Marquass B, Nehrer S, Vogt S, Zinser W, Angele P, Spahn G, Welsch G H, Niemeyer P, Madry H
Department of Orthopaedic Surgery, University medicine Rostock, Doberanerstr. 142, 18057, Rostock, Germany.
Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Freiburg, Freiburg, Germany.
J Exp Orthop. 2020 Sep 3;7(1):64. doi: 10.1186/s40634-020-00282-2.
Platelet rich plasma (PRP) is widely used in orthopaedics, but is still heavily debated. Therefore, a survey among the German "Working Group for Clinical Tissue Regeneration" of the German Society of Orthopaedics and Traumatology was conducted to achieve a consensus about the current therapeutical potential of PRP.
A first survey (n = 65 experts, all orthopaedic/trauma surgeons) was conducted (n = 13 questions). Following, a second round (n = 40 experts) was conducted with 31 questions to achieve consensus in 5 categories: three most common indications, PRP application, future research areas.
Therapeutic PRP application was regarded as useful (89%), possibly even more important in the future (90%). Most common indications were tendon pathologies (77%), osteoarthritis (OA) (68%), muscle injuries (57%) and cartilage damage (51%). Consensus was reached in 16/31 statements. The application of PRP for early knee OA (Kellgren-Lawrence grade II) was regarded as potentially useful, as well as for acute and chronic tendinopathies. For chronic lesions (cartilage, tendons), multiple injections (2-4) were seen preferable to singular injections. However, no sufficient data exists on the time interval between the injections. Standardization of PRP preparation, application, frequency, as well as determining the range of indication is strongly recommended.
There is a need of further standardization of the PRP preparation methods, indication and application protocols for knee OA and other indications, which must be further evaluated in basic science studies and randomized controlled clinical trials.
Consensus of expert opinion, Level V.
富血小板血浆（PRP）在骨科领域应用广泛，但仍存在诸多争议。因此，德国骨科与创伤外科学会的“临床组织再生工作组”开展了一项调查，旨在就PRP目前的治疗潜力达成共识。
首先进行了第一轮调查（n = 65名专家，均为骨科/创伤外科医生）（共13个问题）。随后，进行了第二轮调查（n = 40名专家），包含31个问题，以在5个类别上达成共识：三个最常见的适应症、PRP的应用、未来研究领域。
治疗性PRP应用被认为是有用的（89%），甚至在未来可能更重要（占90%）。最常见的适应症是肌腱病变（77%）、骨关节炎（OA）（68%）、肌肉损伤（57%）和软骨损伤（51%）。在31条陈述中有16条达成了共识。PRP用于早期膝关节OA（凯尔格伦-劳伦斯分级II级）以及急性和慢性肌腱病被认为可能是有用的。对于慢性病变（软骨、肌腱），多次注射（2 - 4次）比单次注射更可取。然而，关于注射之间的时间间隔尚无足够数据。强烈建议对PRP的制备、应用、频率进行标准化，并确定适应症范围。
需要进一步规范PRP的制备方法、膝关节OA及其他适应症的适应症和应用方案，这些必须在基础科学研究和随机对照临床试验中进一步评估。
专家意见共识，V级。
