Platelet rich plasma is blood plasma which is enriched with platelets. It contains cytokines and growth factors which are thought to promote bone and soft tissue healing. It is collected from whole blood, which is then centrifuged into 3 basic parts: 1. platelet rich plasma, 2. platelet poor plasma, and 3. red blood cells.
The platelets contain the growth factors, and need to release them through granules in the platelet. Thrombin and calcium chloride are needed to cause this release. What growth factors? They are thought to contain platelet derived growth factor, fibroblast growth factor, epidermal growth factor, insulin like growth factor, connective tissue growth factor, among others.
PRP has been used for a while in orthopedics, and has gotten press when used to treat sports injuries in professional athletes.
Does it work?
Ah. Here is where medicine goes awry, as marketing and media hype sometimes are ahead of the science to prove.
- There are not many scientific studies on the subject. There is basic science bench research and some pre clinical trials, but true science has controlled blinded studies in large numbers. These have not been done.
- There are differences in the quality of the PRP. This can be because the devices used to separate it out are different, and people differ in the amount of platelets they have. Some argue more platelets are not necessarily better.
- In the plastic surgery literature, there are three published studies, but all done by the same author, who is a paid consultant for the manufacturer Selphyl. This doesn’t mean PRP and PRFM don’t work; it just means we need more studies, and studies from other authors.
So what is the final word?
For this, I look to the orthopedic literature, as they have had more research and interaction with PRP. There was a 2009 review of the literature out, which said PRP is a “promising but not proven treatment for joint, tendon, muscle, and ligament injuries. ” (“Platelet rich plasma- from basic science to Clinical Applications”, Am Journal of Sports Medicine 37 (11) pages 2259-72.)
So I agree with that. Platelet rich plasma — Promising but not proven.