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Review
. 2021 Feb;19(1):1-14.
doi: 10.1007/s11914-020-00643-x. Epub 2021 Jan 4.

The Use of Platelet-Rich Plasma (PRP) for the Management of Non-union Fractures

Christian Andersen  1 , Nicholas M Wragg  2   3 , Maryam Shariatzadeh  2 , Samantha Louise Wilson  4
Affiliations
Review

The Use of Platelet-Rich Plasma (PRP) for the Management of Non-union Fractures

Christian Andersen et al. Curr Osteoporos Rep. 2021 Feb.

Abstract

Purpose of review: 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.

Recent findings: 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.

Keywords: Bone healing; Fracture; Non-union; Platelet-rich plasma (PRP).

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Conflict of interest statement

The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in this manuscript.

Figures

Fig. 1
Fig. 1
Prisma flowchart of study selection criteria
Fig. 2
Fig. 2
The current proportions of pre-clinical and clinical studies investigating the use of PRP for the treatment of bone defects from 2005 to 2016, reproduced from Roffi et al. (2017) [37] with permission from copyright owner (the authors)
Fig. 3
Fig. 3
A generalised overview of the PRP process
See this image and copyright information in PMC

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