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Review
. 2024 Feb 28:6:100008.
doi: 10.1016/j.jposna.2024.100008. eCollection 2024 Feb.

Platelet-rich plasma and other injectables in the young athlete

Akbar N Syed  1 , Kevin Landrum  1 , Theodore J Ganley  1
Affiliations
Review

Platelet-rich plasma and other injectables in the young athlete

Akbar N Syed et al. J Pediatr Soc North Am. .

Erratum in

Abstract

Pediatric sports participation and subsequent injuries have increased in parallel. Additionally, pediatric athletes and families are highly invested in rapid return to pre-injury status and the ability to sustain high impact loads and tension. Recently, an increase and diversification of biologically derived substances, known as orthobiologics, have been used to accelerate tissue healing. While commonly used in adults, the indications are ambiguous, and evidence for effectiveness is conflicting. Despite this, an interest in pediatric indications for orthobiologics has increased as both a standalone intervention and as a supplement to current treatment. There is a dearth of literature pertaining to the pediatric population, which warrants a review of what research has been performed. The purpose of this review was to critically examine the indications and results of orthobiologics in immature athletes. Much of the existing literature is composed of case studies or studies performed with relatively small sample sizes. As such, we believe more research is needed in almost every context for absolute guidelines and recommendations to be established. While orthobiologics have been purported to provide a significant healing benefit to augment the treatment of sports injuries, we find no additional benefit compared to standard treatment.

Key concepts: 1)While orthobiologics have been used in small sample sizes to provide additional healing for pediatric patients being treated for sports-related injuries, there is little research in large cohorts of pediatric athletes.2)Adding to the ambiguity, the literature that does exist presents conflicting findings regarding benefits of orthobiologics.3)Orthobiologics have the potential to provide significant advanced healing benefits, however significantly more research of larger cohort size, higher evidence level, and a pediatric-only population is necessary for absolute guidelines and recommendations to be made.

Keywords: Mesenchymal stem cells; Orthobiologics; Pediatric sports medicine; Platelet-rich-plasma; Sports medicine.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Theodore Ganley reports a relationship with Arthrex that includes: travel reimbursement. Theodore Ganley has received research support from Allosource and Vericel. He has also received education payments from Paladin Technology Solutions and hospitality and education payments from Arthrex. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
The healing triad. The interaction of various “signals,” “scaffold,” and “cell” plays a role in healing, and each of these steps can be amplified or augmented. Signals can be amplified by using healing factors like platelet-rich plasma (PRP), while cells and scaffolds can be augmented by using mesenchymal stem cells (MSC)/bone marrow concentrate (BMC) and bone graft/minced cartilage, respectively.
Figure 2
Figure 2
Preparation of platelet-rich plasma (PRP). (a) Blood is drawn in a syringe → Loaded in the centrifuge → Separation into layers. (b) PRP extracted for centrifuged syringe and ready for use.
See this image and copyright information in PMC

References

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