Platelet-rich plasma (PRP) to treat sports injuries: evidence to support its use

  • Elizaveta KonEmail author
  • Giuseppe Filardo
  • Alessandro Di Martino
  • Maurilio Marcacci
Sports Medicine


Tissue repair in musculoskeletal lesions is often a slow and sometimes incomplete process. In sports patients or professional athletes, the impact of musculoskeletal lesions on life and work is great, and the fast recovery of full efficiency and return to competition is of primary importance. The clinical improvement offered by available treatments is not always sufficient for highly demanding patients to return to their previous level of activity. The search for a minimally invasive solution to improve the status of the chondral surface of the injured joint is therefore highly desirable, especially in these patients. Platelet-rich plasma (PRP) is a procedure that allows to obtain a natural concentration of autologous growth factors. The attractive possibility to use the patients’ own growth factors to enhance reparative process in tissues with low healing potential, the promising preliminary clinical findings and the safety of these methods, explain the wide application of this biological approach. The aim of this review is to analyse the existing published studies to look for scientific evidence in preclinical studies or in the results obtained through PRP application in humans that supports the efficacy of PRP and its use for the treatment of tendinous, ligamentous, cartilaginous and muscular injuries. The analysis of the literature shows promising preclinical results but contradictory clinical findings for the treatment of sport injuries. High-quality studies are required to confirm these preliminary results and provide scientific evidence to support its use.


Platelet-rich plasma Sport Musculoskeletal Injury 


  1. 1.
    Anand SX, Viles-Gonzales JF, Badimon JJ, Cavusoglu E, Marmur JD (2003) Membrane-associated CD40L and sCD40L in atherothrombotic disease. Throm Haemost 90:377–384Google Scholar
  2. 2.
    Anitua E, Andia I, Ardanza B, Nurden P, Nurden AT (2004) Autologous platelets as a source of proteins for healing and tissue regeneration. Tromb Haemost 91:4–15Google Scholar
  3. 3.
    Anitua E, Andía I, Sanchez M, Azofra J, del Mar Zalduendo M, de la Fuente M, Nurden P, Nurden AT (2005) Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF production by human tendon cells in culture. J Orthop Res 23:281–286PubMedCrossRefGoogle Scholar
  4. 4.
    Anitua E, Sanchez M, Nurden AT, Nurden P, Orive G, Andía I (2006) New insights into and novel applications for platelet-rich fibrin therapies. Trends Biotechnol 24:227–234PubMedCrossRefGoogle Scholar
  5. 5.
    Anitua E, Sanchez M, Nurden AT, Zalduendo M, de la Fuente M, Azofra J, Andia I (2007) Reciprocal actions of platelet-secreted TGF-beta1 on the production of VEGF and HGF by human tendon cells. Plast Reconstr Surg 119:950–959PubMedCrossRefGoogle Scholar
  6. 6.
    Arpornmaeklong P, Kochel M, Depprich R, Kübler NR, Würzler KK (2004) Influence of platelet-rich plasma (PRP) on osteogenic differentiation of rat bone marrow stromal cells. An in vitro study. Int J Oral Maxillofac Surg 33:60–70PubMedCrossRefGoogle Scholar
  7. 7.
    Aspenberg P (2007) Stimulation of tendon repair: mechanical loading, GDFs and platelets. A mini-review. Int Orthop 31:783–789PubMedCrossRefGoogle Scholar
  8. 8.
    Aspenberg P, Virchenko O (2004) Platelet concentrate injection improves Achilles tendon repair in rats. Acta Orthop Scand 75:93–99PubMedCrossRefGoogle Scholar
  9. 9.
    Azuma H, Yasuda K, Tohyama H, Sakai T, Majima T, Aoki Y, Minami A (2003) Timing of administration of transforming growth factor-beta1 and epidermal growth factor influences the effect on material properties of the in situ frozen–thawed anterior cruciate ligament. J Biomech 36:373–381PubMedCrossRefGoogle Scholar
  10. 10.
    Baltzer AW, Moser C, Jansen SA, Krauspe R (2009) Autologous conditioned serum (Orthokine) is an effective treatment for knee osteoarthritis. Osteoarthr Cartil 17:152–160PubMedCrossRefGoogle Scholar
  11. 11.
    Batten ML, Hansen JC, Dahners LE (1996) Influence of dosage and timing of application of platelet-derived growth factor on early healing of the rat medial collateral ligament. J Orthop Res 14:736–741PubMedCrossRefGoogle Scholar
  12. 12.
    Borzini P, Mazzucco L (2005) Tissue regeneration and in loco administration of platelet derivatives: clinical outcome, heterogeneous products, and heterogeneity of the effector mechanisms. Transfusion 45:1759–1767PubMedCrossRefGoogle Scholar
  13. 13.
    Bosch G, van Schie HT, de Groot MW, Cadby JA, van de Lest CH, Barneveld A, van Weeren PR (2010) Effects of platelet-rich plasma on the quality of repair of mechanically induced core lesions in equine superficial digital flexor tendons: a placebo-controlled experimental study. J Orthop Res 28:211–217PubMedGoogle Scholar
  14. 14.
    Buckwalter JA, Mankin HJ (1997) Articular cartilage. J Bone Joint Surg 79A:600–611Google Scholar
  15. 15.
    Buckwalter JA, Mankin HJ (1997) Articular cartilage. Part II: degeneration and osteoarthrosis, repair, regeneration, and tranplantation. J Bone Joint Surg 79A:612–632Google Scholar
  16. 16.
    Butler DL, Grood ES, Noyes FR, Olmstead ML, Hohn RB, Arnoczky SP, Siegel MG (1989) Mechanical properties of primate vascularized versus nonvascularized patellar tendon grafts. J Orthop Res 7:68–79PubMedCrossRefGoogle Scholar
  17. 17.
    Chan YS, Li Y, Foster W, Fu FH, Huard J (2005) The use of suramin, an antifibrotic agent, to improve muscle recovery after strain injury. Am J Sports Med 33:43–51PubMedCrossRefGoogle Scholar
  18. 18.
    Chen CH, Cao Y, Wu YF, Bais AJ, Gao JS, Tang JB (2008) Tendon healing in vivo: gene expression and production of multiple growth factors in early tendon healing period. J Hand Surg Am 33:1834–1842PubMedCrossRefGoogle Scholar
  19. 19.
    Chou TC, Fu E, Wu CJ, Yeh JH (2003) Chitosan enhances platelet adhesion and aggregation. Biochem Biophys Res Comm 302:480–483PubMedCrossRefGoogle Scholar
  20. 20.
    Clancy WG, Narechania RG, Rosenberg TD, Gmeiner JG, Wisnefske DD, Lange TA (1981) Anterior and posterior cruciate ligament reconstruction n rhesus monkeys. J Bone Joint Surg Am 63:1270–1284PubMedGoogle Scholar
  21. 21.
    Creaney L, Hamilton B (2008) Growth factor delivery methods in the management of sports injuries: the state of play. Br J Sports Med 42:314–320PubMedCrossRefGoogle Scholar
  22. 22.
    Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG (1997) Cartilage injuries: a review of 31, 516 knee arthroscopies. Arthroscopy 13:456–460PubMedCrossRefGoogle Scholar
  23. 23.
    Dallari D, Savarino L, Stagni C, Cenni E, Cenacchi A, Fornasari PM, Albisinni U, Rimondi E, Baldini N, Giunti A (2007) Enhanced tibial osteotomy healing with use of bone grafts supplemented with platelet gel or platelet gel and bone marrow stromal cells. J Bone Joint Surg Am 89:2413–2420PubMedCrossRefGoogle Scholar
  24. 24.
    De Moes M, Koevoet JLM, Jahr H, Verstegen MMA, Heijboer MP, Kops N, van Leeuwen JPMT, Weinans H, Verhaar JAN, van Osch GJVM (2007) Intrinsic differentiation potential of adolescent human tendon tissue: an in vitro cell differentiation study. BMC Musculoskelet Disord 8:16–27CrossRefGoogle Scholar
  25. 25.
    De Mos M, Van der Windt AE, Jahr H, Van Schie HT, Weinans H, Verhaar JA, van Osch GJ (2008) Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med 36:1171–1178PubMedCrossRefGoogle Scholar
  26. 26.
    De Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Tol JL (2010) Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 13(303):144–149CrossRefGoogle Scholar
  27. 27.
    Efthimiadou A, Asimakopoulos B, Nikolettos N, Giatromanolaki A, Sivridis E, Papachristou DN, Kontoleon E (2006) Angiogenic effect of intramuscular administration of basic and acidic fibroblast growth factor on skeletal muscles and influence of exercise on muscle angiogenesis. Br J Sports Med 40:35–39PubMedCrossRefGoogle Scholar
  28. 28.
    Efthimiadou A, Asimakopoulos B, Nikolettos N, Giatromanolaki A, Sivridis E, Lialiaris TS, Papachristou DN, Kontoleon E (2004) The angiogenetic effect of intramuscular administration of VEGF on muscle. The influence of exercise on angiogenesis. In Vivo 18:825–829PubMedGoogle Scholar
  29. 29.
    Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M (2010) Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. doi: 10.1007/s00167-010-1238-6
  30. 30.
    Filardo G, Kon E, Della Villa S, Vincentelli F, Fornasari PM, Marcacci M (2010) Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop 34:909–915PubMedCrossRefGoogle Scholar
  31. 31.
    Filardo G, Presti ML, Kon E, Marcacci M (2010) Nonoperative biological treatment approach for partial Achilles tendon lesion. Orthopedics 1(33):120–123CrossRefGoogle Scholar
  32. 32.
    Floryan K, Berghoff WJ (2004) Intraoperative use of autologous platelet rich and platelet poor plasma for orthopaedic surgery patients. AORN J 80:668–674PubMedCrossRefGoogle Scholar
  33. 33.
    Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA (2009) Platelet-rich plasma: from basic science to clinical applications. Am J Sports Med 37:2259–2272PubMedCrossRefGoogle Scholar
  34. 34.
    Frazer A, Bunning RA, Thavarajah M, Seid JM, Russell RG (1994) Studies on type II collagen and aggrecan production in human articular chondrocytes in vitro and effects of transforming growth factor-beta and interleukin-1beta. Osteoarthr Cartil 2:235–245PubMedCrossRefGoogle Scholar
  35. 35.
    Frechette JP, Martineau I, Gagnon G (2005) Platelet-rich plasmas: growth factor content and roles in wound healing. J Dent Res 84:434–439PubMedCrossRefGoogle Scholar
  36. 36.
    Frisbie DD, Kawcak CE, Werpy NM, Park RD, McIlwraith CW (2007) Clinical, biochemical, and histologic effects of intra-articular administration of autologous conditioned serum in horses with experimentally induced osteoarthritis. Am J Vet Res 68:290–296PubMedCrossRefGoogle Scholar
  37. 37.
    Gaissmaier C, Fritz J, Krackhardt T, Flesch I, Aicher WK, Ashammakhi N (2005) Effect of human platelet supernatant on proliferation and matrix synthesis of human articular chondrocytes in monolayer and three-dimensional alginate cultures. Biomaterials 26:1953–1960PubMedCrossRefGoogle Scholar
  38. 38.
    Gardner MJ, Demetrakopoulos D, Klepchick PR, Mooar PA (2006) The efficacy of autologous platelet gel in pain control and blood loss in total knee arthroplasty: an analysis of the hemoglobin, narcotic requirements and range of motion. Int Orthop 31:309–313PubMedCrossRefGoogle Scholar
  39. 39.
    Hammond JW, Hinton RY, Curl LA, Muriel JM, Lovering RM (2009) Use of autologous platelet-rich plasma to treat muscle strain injuries. Am J Sports Med 37:1135–1142PubMedCrossRefGoogle Scholar
  40. 40.
    Hildebrand K, Woo S, Smith D, Allen CR, Deie M, Taylor BJ, Schmidt CC (1998) The effect of platelet-derived growth factor-BB on healing of the rabbit medial collateral ligament. An in vivo study. Am J Sports Med 26:549–554PubMedGoogle Scholar
  41. 41.
    Husmann I, Soulet L, Gautron J, Martelly I, Barritault D (1996) Growth factors in skeletal muscle regeneration. Cytokine Growth Factor Rev 7:249–258PubMedCrossRefGoogle Scholar
  42. 42.
    Kajikawa Y, Morihara T, Sakamoto H, Matsuda K, Oshima Y, Yoshida A, Nagae M, Arai Y, Kawata M, Kubo T (2008) Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol 215:837–845PubMedCrossRefGoogle Scholar
  43. 43.
    Kasemkijwattana C, Menetrey J, Bosch P, Somogyi G, Moreland MS, Fu FH, Buranapanitkit B, Watkins SS, Huard J (2000) Use of growth factors to improve muscle healing after strain injury. Clin Orthop Relat Res 370:272–285PubMedCrossRefGoogle Scholar
  44. 44.
    Klein MB, Yalamanchi N, Pham H, Longaker MT, Chang J (2002) Flexor tendon healing in vitro: effects of TGF-beta on tendon cell collagen production. J Hand Surg Am 27:615–620PubMedCrossRefGoogle Scholar
  45. 45.
    Knighton DR, Doucette M, Fiegel VD, Ciresi K, Butler E, Austin L (1988) The use of platelet derived wound healing formula in human clinical trials. Prog Clin Biol Res 266:319–329PubMedGoogle Scholar
  46. 46.
    Kobayashi M, Itoi E, Minagawa H, Miyakoshi N, Takahashi S, Tuoheti Y, Okada K, Shimada Y (2006) Expression of growth factors in the early phase of supraspinatus tendon healing in rabbits. J Shoulder Elbow Surg 15:371–377PubMedCrossRefGoogle Scholar
  47. 47.
    Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M (2010) Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 18:472–479PubMedCrossRefGoogle Scholar
  48. 48.
    Kon E, Filardo G, Delcogliano M, Presti ML, Russo A, Bondi A, Di Martino A, Cenacchi A, Fornasari PM, Marcacci M (2009) Platelet-rich plasma: new clinical application: a pilot study for treatment of jumper’s knee. Injury 40:598–603PubMedCrossRefGoogle Scholar
  49. 49.
    Lee J, Harwood FL, Akeson WH, Amiel D (1998) Growth factor expression in healing rabbit medial collateral and anterior cruciate ligaments. Iowa Orthop J18:19–25Google Scholar
  50. 50.
    Lefaucheur JP, Gjata B, Lafont H, Sebille A (1996) Angiogenic and inflammatory responses following skeletal muscle injury are altered by immune neutralization of endogenous basic fibroblast growth factor, insulin-like growth factor-1 and transforming growth factor-beta 1. J Neuroimmunol 70:37–44PubMedCrossRefGoogle Scholar
  51. 51.
    Letson AK, Dahners L (1994) The effects of combinations of growth factors on ligament healing. Clin Orthop Relat Res 308:207–212PubMedGoogle Scholar
  52. 52.
    Lind M, Jakobsen BW, Lund B, Hansen MS, Abdallah O, Christiansen SE (2009) Anatomical reconstruction of the medial collateral ligament and posteromedial corner of the knee in patients with chronic medial collateral ligament instability. Am J Sports Med 37:1116–1122PubMedCrossRefGoogle Scholar
  53. 53.
    Lopez-Vidriero E, Goulding KA, Simon DA, Sanchez M, Johnson DH (2010) The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment. Arthroscopy 26:269–278PubMedCrossRefGoogle Scholar
  54. 54.
    Lundberg M, Messner K (1996) Long-term prognosis of isolated partial medial collateral ligament ruptures. A ten-year clinical and radiographic evaluation of a prospectively observed group of patients. Am J Sports Med 24:160–163PubMedCrossRefGoogle Scholar
  55. 55.
    Lyras DN, Kazakos K, Agrogiannis G, Verettas D, Kokka A, Kiziridis G, Chronopoulos E, Tryfonidis M (2010) Experimental study of tendon healing early phase: is IGF-1 expression influenced by platelet rich plasma gel? Orthop Traumatol Surg Res 96:381–387PubMedCrossRefGoogle Scholar
  56. 56.
    Lyras DN, Kazakos K, Verettas D, Botaitis S, Agrogiannis G, Kokka A, Pitiakoudis M, Kotzakaris A (2009) The effect of platelet-rich plasma gel in the early phase of patellar tendon healing. Arch Orthop Trauma Surg 129:1577–1582PubMedCrossRefGoogle Scholar
  57. 57.
    Lyras D, Kazakos K, Verettas D, Polychronidis A, Simopoulos C, Botaitis S, Agrogiannis G, Kokka A, Patsouris E (2010) Immunohistochemical study of angiogenesis after local administration of platelet-rich plasma in a patellar tendon defect. Int Orthop 34:143–148PubMedCrossRefGoogle Scholar
  58. 58.
    Lyras DN, Kazakos K, Verettas D, Polychronidis A, Tryfonidis M, Botaitis S, Agrogiannis G, Simopoulos C, Kokka A, Patsouris (2009) The influence of platelet-rich plasma on angiogenesis during the early phase of tendon healing. Foot Ankle Int 30:1101–1106PubMedCrossRefGoogle Scholar
  59. 59.
    Maniscalco P, Gambera D, Lunati A, Vox G, Fossombroni V, Beretta R, Crainz E (2008) The “Cascade” membrane: a new PRP device for tendon ruptures. Description and case report on rotator cuff tendon. Acta Biomed 79:223–226PubMedGoogle Scholar
  60. 60.
    Martin JA, Buckwalter JA (2000) The role of chondrocyte-matrix interactions in maintaining and repairing articular cartilage. Biorheology 37:129–140PubMedGoogle Scholar
  61. 61.
    Marx R (2001) Platelet rich plasma (PRP): what is PRP and what is not PRP? Implant Dent 10:225–228PubMedGoogle Scholar
  62. 62.
    Marx RE (2004) Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surgery 62:489–496CrossRefGoogle Scholar
  63. 63.
    Menetrey J, Kasemkijwattana C, Day CS, Bosch P, Vogt M, Fu FH, Moreland MS, Huard J (2000) Growth factors improve muscle healing in vivo. J Bone Joint Surg Br 82:131–137PubMedCrossRefGoogle Scholar
  64. 64.
    Mishra A, Pavelko T (2006) Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sport Med 34:1774–1778CrossRefGoogle Scholar
  65. 65.
    Mishra A, Woodall J Jr, Vieira A (2009) Treatment of tendon and muscle using platelet-rich plasma. Clin Sports Med 28:113–125PubMedCrossRefGoogle Scholar
  66. 66.
    Molloy T, Wang Y, Murrell G (2003) The roles of growth factors in tendon and ligament healing. Sports Med 33:381–394PubMedCrossRefGoogle Scholar
  67. 67.
    Murray MM, Palmer M, Abreu E, Spindler KP, Zurakowski D, Fleming BC (2009) Platelet-rich plasma alone is not sufficient to enhance suture repair of the ACL in skeletally immature animals: an in vivo study. J Orthop Res 27:639–645PubMedCrossRefGoogle Scholar
  68. 68.
    Murray MM, Spindler KP, Abreu E, Muller JA, Nedder A, Kelly M, Frino J, Zurakowski D, Valenza M, Snyder BD, Connolly SA (2007) Collagen-platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament. J Orthop Res 25:81–91PubMedCrossRefGoogle Scholar
  69. 69.
    Murray MM, Spindler KP, Ballard P, Welch TP, Zurakowski D, Nanney LB (2007) Enhanced histologic repair in a central wound in the anterior cruciate ligament with a collagen-platelet-rich plasma scaffold. J Orthop Res 25:1007–1017PubMedCrossRefGoogle Scholar
  70. 70.
    Murray MM, Spindler KP, Devin C, Snyder BS, Muller J, Takahashi M, Ballard P, Nanney LB, Zurakowski D (2006) Use of a collagen-platelet rich plasma scaffold to stimulate healing of a central defect in the canine ACL. J Orthop Res 24:820–830PubMedCrossRefGoogle Scholar
  71. 71.
    Nagumo A, Yasuda K, Numazaki H, Azuma H, Tanabe Y, Kikuchi S, Harata S, Tohyama H (2005) Effects of separate application of three growth factors (TGF-beta1, EGF, and PDGF-BB) on mechanical properties of the in situ frozen-thawed anterior cruciate ligament. Clin Biomech 20:283–290CrossRefGoogle Scholar
  72. 72.
    O’Keefe RJ, Crabb ID, Puzas JE, Rosier RN (1994) Effects of transforming growth factor-beta 1 and fibroblast growth factor on DNA synthesis in growth plate chondrocytes are enhanced by insulin-like growth factor-I. J Orthop Res 12:299–310PubMedCrossRefGoogle Scholar
  73. 73.
    Orrego M, Larrain C, Rosales J, Valenzuela L, Matas J, Durruty J, Sudy H, Mardones R (2008) Effects of platelet concentrate and a bone plug on the healing of hamstring tendons in a bone tunnel. Arthroscopy 24:1373–1380PubMedCrossRefGoogle Scholar
  74. 74.
    Parkkari J, Pasanen K, Mattila VM, Kannus P, Rimpelä A (2008) The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up. Br J Sports Med 42:422–426PubMedCrossRefGoogle Scholar
  75. 75.
    Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T (2010) Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 38:255–262PubMedCrossRefGoogle Scholar
  76. 76.
    Peers KH, Lysens RJ (2005) Patellar tendinopathy in athletes: current diagnostic and therapeutic recommendations. Sports Med 35:71–87PubMedCrossRefGoogle Scholar
  77. 77.
    Prisk V, Huard J (2003) Muscle injuries and repair: the role of prostaglandins and inflammation. Histol Histopathol 18:1243–1256PubMedGoogle Scholar
  78. 78.
    Pujol JP, Chadjichristos C, Legendre F, Bauge C, Beauchef G, Andriamanalijaona R, Galera P, Boumediene K (2008) Interleukin-1 and transforming growth factor-beta 1 as crucial factors in osteoarthritic cartilage metabolism. Connect Tissue Res 49:293–297PubMedCrossRefGoogle Scholar
  79. 79.
    Radice F, Yánez R, Gutiérrez V, Rosales J, Pinedo M, Coda S (2010) Comparison of magnetic resonance imaging findings in anterior cruciate ligament grafts with and without autologous platelet-derived growth factors. Arthroscopy 26:50–57PubMedCrossRefGoogle Scholar
  80. 80.
    Randelli P, Arrigoni P, Cabitza P, Volpi P, Maffulli N (2008) Autologous platelet rich plasma for arthroscopic rotator cuff repair. A pilot study. Disabil Rehabil 30:1584–1589PubMedCrossRefGoogle Scholar
  81. 81.
    Sakai T, Yasuda K, Tohyama H, Azuma H, Nagumo A, Majima T, Frank CB (2002) Effects of combined administration of transforming growth factor-beta1 and epidermal growth factor on properties of the in situfrozen anterior cruciate ligament in rabbits. J Orthop Res 20:1345–1351PubMedCrossRefGoogle Scholar
  82. 82.
    Sampson S, Gerhardt M, Mandelbaum B (2008) Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med 1:165–174PubMedCrossRefGoogle Scholar
  83. 83.
    Sánchez M, Anitua E, Azofra J, Aguirre JJ, Andia I (2008) Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol 26:910–913PubMedGoogle Scholar
  84. 84.
    Sánchez M, Anitua E, Azofra J, Andía I, Padilla S, Mujika I (2007) Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports 35:245–251CrossRefGoogle Scholar
  85. 85.
    Sánchez M, Azofra J, Anitua E, Andía I, Padilla S, Santisteban J, Mujika I (2003) Plasma rich in growth factors to treat an articular cartilage avulsion: a case report. Med Sci Sports Exerc 35:1648–1652PubMedCrossRefGoogle Scholar
  86. 86.
    Sanchez AR, Sheridan PJ, Kupp LI (2003) Is platelet-rich plasma the perfect enhancement factor? A current review. Int J Oral Maxillofac Implants 18:93–103PubMedGoogle Scholar
  87. 87.
    Schmidt MB, Chen EH, Lynch SE (2006) A review of the effects of insulin-like growth factor and platelet derived growth factor on in vivo cartilage healing and repair. Osteoarthr Cartil 14:403–412PubMedCrossRefGoogle Scholar
  88. 88.
    Schnabel LV, Mohammed HO, Miller BJ, McDermott WG, Jacobson MS, Santangelo KS, Fortier LA (2007) Platelet rich plasma (PRP) enhances anabolic gene expression patterns in flexor digitorum superficialis tendons. J Orthop Res 25:230–240PubMedCrossRefGoogle Scholar
  89. 89.
    Senet P, Bon FX, Benbunan M, Bussel A, Traineau R, Calvo F, Dubertret L, Dosquet C (2003) Randomized trial and local biological effect of autologous platelets used as adjuvant therapy for chronic venous leg ulcers. J Vasc Surg 38:1342–1348PubMedCrossRefGoogle Scholar
  90. 90.
    Shen W, Li Y, Zhu J, Schwendener R, Huard J (2008) Interaction between macrophages, TGF-beta1, and the COX-2 pathway during the inflammatory phase of skeletal muscle healing after injury. J Cell Physiol 214:405–412PubMedCrossRefGoogle Scholar
  91. 91.
    Silva A, Sampaio R (2009) Anatomic ACL reconstruction: does the platelet-rich plasma accelerate tendon healing? Knee Surg Sports Traumatol Arthrosc 17:676–682PubMedCrossRefGoogle Scholar
  92. 92.
    Spindler KP, Dawson JM, Stahlman GC, Davidson JM, Nanney LB (2002) Collagen expression and biomechanical response to human recombinant transforming growth factor beta (rhTGF-beta2) in the healing rabbit MCL. J Orthop Res 20:318–324PubMedCrossRefGoogle Scholar
  93. 93.
    Spindler KP, Murray MM, Detwiler KB, Tarter JT, Dawson JM, Nanney LB, Davidson JM (2003) The biomechanical response to doses of TGF-beta 2 in the healing rabbit medial collateral ligament. J Orthop Res 21:245–249PubMedCrossRefGoogle Scholar
  94. 94.
    Stellos K, Kopf S, Paul A, Marquardt JU, Gawaz M, Huard J, Langer HF (2010) Platelets in regeneration. Semin Thromb Hemost 36:175–184PubMedCrossRefGoogle Scholar
  95. 95.
    Virchenko O, Aspenberg P (2006) How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks? Interplay between early regeneration and mechanical stimulation. Acta Orthop Scand 77:806–812CrossRefGoogle Scholar
  96. 96.
    Weibrich G, Hansen T, Kleis W, Buch R, Hitzler WE (2004) Effect of platelet concentration in platelet-rich plasma on peri-implant bone regeneration. Bone 34:665–671PubMedCrossRefGoogle Scholar
  97. 97.
    Widuchowski W, Widuchowski J, Trzaska T (2007) Articular cartilage defects: study of 25, 124 knee arthroscopies. Knee 14:177–182PubMedCrossRefGoogle Scholar
  98. 98.
    Woo SL, Smith DW, Hildebrand KA, Zeminski JA, Johnson LA (1998) Engineering the healing of the rabbit medial collateral ligament. Med Biol Eng Comput 36:359–364PubMedCrossRefGoogle Scholar
  99. 99.
    Wright-Carpenter T, Opolon P, Appell HJ, Meijer H, Wehling P, Mir LM (2004) Treatment of muscle injuries by local administration of autologous conditioned serum: animal experiments using a muscle contusion model. Int J Sports Med 25:582–587PubMedCrossRefGoogle Scholar
  100. 100.
    Yasuda K, Tomita F, Yamazaki S, Minami A, Tohyama H (2004) The effect of growth factors on biomechanical properties of the bone-patellar tendon-bone graft after anterior cruciate ligament reconstruction; a canine model study. Am J Sports Med 32:870–880PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Elizaveta Kon
    • 1
    Email author
  • Giuseppe Filardo
    • 1
  • Alessandro Di Martino
    • 1
  • Maurilio Marcacci
    • 1
  1. 1.Biomechanics Laboratory—III ClinicRizzoli Orthopaedic InstituteBolognaItaly

Personalised recommendations