Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, U.S.A.
Department of Orthopaedic Surgery, Stanford University, Stanford, California, U.S.A.
Arthroscopy. 2024 Feb;40(2):470-477.e1. doi: 10.1016/j.arthro.2023.08.020. Epub 2023 Aug 23.
To establish consensus statements on platelet-rich plasma (PRP) for the treatment of musculoskeletal pathologies.
A consensus process on the treatment of PRP using a modified Delphi technique was conducted. Thirty-five orthopaedic surgeons and sports medicine physicians participated in these consensus statements on PRP. The participants were composed of representatives of the Biologic Association, representing 9 international orthopaedic and musculoskeletal professional societies invited due to their active interest in the study of orthobiologics. Consensus was defined as achieving 80% to 89% agreement, strong consensus was defined as 90% to 99% agreement, and unanimous consensus was indicated by 100% agreement with a proposed statement.
There was consensus on 62% of statements about PRP.
(1) PRP should be classified based on platelet count, leukocyte count, red blood count, activation method, and pure-plasma versus fibrin matrix; (2) PRP characteristics for reporting in research studies are platelet count, leukocyte count, neutrophil count, red blood cell count, total volume, the volume of injection, delivery method, and the number of injections; (3) the prognostic factors for those undergoing PRP injections are age, body mass index, severity/grade of pathology, chronicity of pathology, prior injections and response, primary diagnosis (primary vs postsurgery vs post-trauma vs psoriatic), comorbidities, and smoking; (4) regarding age and body mass index, there is no minimum or maximum, but clinical judgment should be used at extremes of either; (5) the ideal dose of PRP is undetermined; and (6) the minimal volume required is unclear and may depend on the pathology.
Level V, expert opinion.
就富血小板血浆（PRP）治疗肌肉骨骼病变达成共识声明。
采用改良 Delphi 技术对 PRP 治疗进行共识流程。35 名骨科医生和运动医学医生参与了这些关于 PRP 的共识声明。参与者由生物协会的代表组成，代表了 9 个国际骨科和肌肉骨骼专业协会，他们因对骨科生物制剂的研究兴趣而被邀请参加。共识定义为达成 80%至 89%的一致，强烈共识定义为 90%至 99%的一致，而 100%的一致则表示对提议的声明达成一致。
有 62%的关于 PRP 的声明达成了共识。
（1）PRP 应根据血小板计数、白细胞计数、红细胞计数、激活方法以及纯血浆与纤维蛋白基质进行分类；（2）研究中报告 PRP 特征的是血小板计数、白细胞计数、中性粒细胞计数、红细胞计数、总体积、注射体积、输送方法和注射次数；（3）接受 PRP 注射的患者的预后因素包括年龄、体重指数、病变的严重程度/等级、病变的慢性程度、先前的注射和反应、原发性诊断（原发性与手术后与创伤后与银屑病）、合并症和吸烟；（4）关于年龄和体重指数，没有最小或最大，但在任何极端情况下都应使用临床判断；（5）PRP 的理想剂量尚未确定；（6）所需的最小体积尚不清楚，可能取决于病变。
V 级，专家意见。
