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富血小板血浆在骨折愈合中的治疗潜力:一项综述

Therapeutic Potential of Platelet-Rich Plasma in Fracture Healing: A Comprehensive Review.

作者信息

Kale Prathamesh, Shrivastava Sandeep, Balusani Prashanth, Pundkar Aditya

机构信息

Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

出版信息

Cureus. 2024 Jun 12;16(6):e62271. doi: 10.7759/cureus.62271. eCollection 2024 Jun.

Abstract

Fracture healing is a dynamic process essential for the restoration of bone integrity and function. However, factors such as patient age, comorbidities, and the severity of the fracture can impede this process, leading to delayed healing or nonunion. Platelet-rich plasma (PRP) has emerged as a promising therapeutic option for enhancing fracture healing. PRP is an autologous blood product containing a concentrated mixture of platelets, growth factors, and cytokines known to promote tissue regeneration and repair. This comprehensive review provides an overview of the fracture healing process, emphasizing the importance of timely and efficient bone repair. We discuss the mechanisms underlying the purported efficacy of PRP in fracture healing, drawing upon both preclinical and clinical evidence. Preclinical studies in animal models have demonstrated the ability of PRP to accelerate fracture healing, stimulate osteogenesis, and enhance bone regeneration. Clinical studies have yielded mixed results, with some reporting positive outcomes in terms of accelerated healing and improved functional outcomes, while others have shown no significant benefits over standard treatments. Factors influencing the efficacy of PRP, such as timing of administration, PRP concentration, and patient-specific variables, are also examined. Furthermore, safety considerations and potential adverse effects associated with PRP therapy are discussed. Despite the promising preclinical findings, challenges remain in standardizing PRP formulations, optimizing administration protocols, and addressing unanswered questions regarding its long-term efficacy and safety. This review aims to provide insights into the therapeutic potential of PRP in fracture healing, informing future research directions and guiding clinical practice.

摘要

骨折愈合是恢复骨骼完整性和功能所必需的动态过程。然而,患者年龄、合并症以及骨折严重程度等因素会阻碍这一过程,导致愈合延迟或不愈合。富血小板血浆(PRP)已成为促进骨折愈合的一种有前景的治疗选择。PRP是一种自体血液制品,含有浓缩的血小板、生长因子和细胞因子混合物,已知这些成分可促进组织再生和修复。这篇综述概述了骨折愈合过程,强调了及时、有效的骨修复的重要性。我们借鉴临床前和临床证据,讨论PRP在骨折愈合中所谓疗效的潜在机制。动物模型的临床前研究表明,PRP能够加速骨折愈合、刺激成骨并增强骨再生。临床研究结果不一,一些研究报告称在加速愈合和改善功能结果方面有积极成果,而另一些研究则表明与标准治疗相比没有显著益处。还研究了影响PRP疗效的因素,如给药时间、PRP浓度和患者特定变量。此外,还讨论了与PRP治疗相关的安全性考虑因素和潜在不良反应。尽管临床前研究结果很有前景,但在标准化PRP制剂、优化给药方案以及解决有关其长期疗效和安全性的未决问题方面仍存在挑战。这篇综述旨在深入了解PRP在骨折愈合中的治疗潜力,为未来的研究方向提供信息并指导临床实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb1d/11245593/b21bc8e38580/cureus-0016-00000062271-i01.jpg

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