National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK.
Centre for Biological Engineering, Wolfson School of Mechanical, Electrical and Manufacturing Engineering, Loughborough University, Epinal Way, Loughborough, Leicestershire, LE11 3TU, UK.
Curr Osteoporos Rep. 2021 Feb;19(1):1-14. doi: 10.1007/s11914-020-00643-x. Epub 2021 Jan 4.
The treatment of non-union fractures represents a significant challenge for orthopaedic surgeons. In recent years, biologic agents have been investigated and utilised to support and improve bone healing. Among these agents, platelet-rich plasma (PRP) is an emerging strategy that is gaining popularity. The aim of this review is to evaluate the current literature regarding the application and clinical effectiveness of PRP injections, specifically for the treatment of non-union fractures.
The majority of published studies reported that PRP accelerated fracture healing; however, this evidence was predominantly level IV. The lack of randomised, clinical trials (level I-II evidence) is currently hampering the successful clinical translation of PRP as a therapy for non-union fractures. This is despite the positive reports regarding its potential to heal non-union fractures, when used in isolation or in combination with other forms of treatment. Future recommendations to facilitate clinical translation and acceptance of PRP as a therapy include the need to investigate the effects of administering higher volumes of PRP (i.e. 5-20 mL) along with the requirement for more prolonged (> 11 months) randomised clinical trials.
非愈合性骨折的治疗对矫形外科医生来说是一个巨大的挑战。近年来，生物制剂已被用于支持和改善骨愈合。其中，富血小板血浆（PRP）是一种新兴的策略，越来越受到关注。本综述旨在评估关于 PRP 注射应用和临床效果的现有文献，特别是治疗非愈合性骨折的效果。
大多数已发表的研究报告称 PRP 可加速骨折愈合；然而，这些证据主要是 IV 级的。目前，缺乏随机对照临床试验（I-II 级证据）阻碍了 PRP 作为治疗非愈合性骨折的疗法的成功临床转化。尽管有关于其单独使用或与其他形式的治疗联合使用时治疗非愈合性骨折的潜力的积极报告。为了促进 PRP 作为一种治疗方法的临床转化和接受，未来的建议包括需要研究给予更高体积的 PRP（即 5-20 毫升）的效果，以及需要更长时间（>11 个月）的随机临床试验。
