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富血小板血浆在骨科外科学中的应用。

Platelet Rich Plasma in Orthopedic Surgical Medicine.

机构信息

Science and Research Department, Gulf Coast Biologics, Fort Myers, FL, USA.

Orthopedic Partnership, Son, The Netherlands.

出版信息

Platelets. 2021 Feb 17;32(2):163-174. doi: 10.1080/09537104.2020.1869717. Epub 2021 Jan 5.

Abstract

There is a global interest in optimizing post-surgical tissue repair strategies, leading to better patient outcomes and fewer complications, most ideally with reduced overall cost. In this regard, in recent years, the interest in autologous biological treatments in orthopedic surgery and sports medicine has increased greatly, and the addition of platelet-rich plasma (PRP) to the surgical armamentarium is of particular note. Unfortunately, the number of PRP preparation devices has also grown immensely over the recent decades, raising meaningful concern for the considerable variation in the qualities of currently available PRP preparations. The lack of consensus on the standardization of PRP preparation and of agreement on condition specific PRP formulations is largely responsible for the sometimes contradictory outcomes in the literature. Furthermore, the full potential of PRP technology, the concept of individualized treatment protocols based on bioformulation options, and platelet dosing, angiogenesis, and antimicrobial and painkilling effects of PRP relevant to orthopedic surgery have rarely been addressed. In this review, we will discuss recent developments regarding PRP preparations and potential therapeutic effects. Additionally, we present a synopsis of several published data regarding PRP applications in orthopedic surgery for treating tendon injuries, inducing bone repair, strengthening spinal fusion outcomes, and supporting major joint replacements.

摘要

人们普遍关注优化术后组织修复策略,以实现更好的患者预后和更少的并发症,最理想的情况是降低总体成本。在这方面,近年来,骨科手术和运动医学中对自体生物治疗的兴趣大大增加,特别是添加富含血小板的血浆(PRP)到手术器械中。不幸的是,近年来 PRP 制备设备的数量也大幅增加,这对目前可用的 PRP 制剂的质量差异提出了重大关注。PRP 制备的标准化以及针对特定条件的 PRP 配方的共识的缺乏在很大程度上导致了文献中有时相互矛盾的结果。此外,PRP 技术的全部潜力、基于生物配方选择的个体化治疗方案的概念、以及与骨科手术相关的 PRP 的血小板剂量、血管生成、抗菌和止痛作用,很少得到解决。在这篇综述中,我们将讨论 PRP 制剂的最新发展和潜在的治疗效果。此外,我们还总结了一些关于 PRP 在骨科手术中治疗肌腱损伤、诱导骨修复、加强脊柱融合效果和支持大关节置换的应用的已发表数据。

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