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Review
. 2024 Jan 25:18:29-59.
doi: 10.2147/BTT.S290341. eCollection 2024.

Advances with Platelet-Rich Plasma for Bone Healing

Blake M Bacevich  1 , Richard David James Smith  1 , Alec M Reihl  1 , Augustus D Mazzocca  1   2 , Ian D Hutchinson  1
Affiliations
Review

Advances with Platelet-Rich Plasma for Bone Healing

Blake M Bacevich et al. Biologics. .

Abstract

Despite significant advances in the understanding and delivery of osteosynthesis, fracture non-union remains a challenging clinical problem in orthopaedic surgery. To bridge the gap, basic science characterization of fracture healing provides a platform to identify and target biological strategies to enhance fracture healing. Of immense interest, Platelet-rich plasma (PRP) is a point of care orthobiologic that has been extensively studied in bone and soft tissue healing given its relative ease of translation from the benchtop to the clinic. The aim of this narrative review is to describe and relate pre-clinical in-vitro and in-vivo findings to clinical observations investigating the efficacy of PRP to enhance bone healing for primary fracture management and non-union treatment. A particular emphasis is placed on the heterogeneity of PRP preparation techniques, composition, activation strategies, and delivery. In the context of existing data, the routine use of PRP to enhance primary fracture healing and non-union management cannot be supported. However, it is acknowledged that extensive heterogeneity of PRP treatments in clinical studies adds obscurity; ultimately, refinement (and consensus) of PRP treatments for specific clinical indications, including repetition studies are warranted.

Keywords: bone regeneration; fracture healing; fractures; platelet rich plasma; ununited.

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Conflict of interest statement

ADM disclosures include research support and consulting with Arthrex Inc., Naples, FL, as well as consulting and stock interests in Restor3d. All other authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Density Gradients of Cells Contained within Blood Aspirate.
Figure 2
Figure 2
(A) Plasma-Based PRP Preparation. (B) Buffy Coat-Based PRP Preparation.
See this image and copyright information in PMC

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