In recent research doctors say successful healing of large bone defects is a complicated phenomenon because the body’s natural ability often fails to effectively repair the large bone defects.
Platelet Rich Plasma Therapy (PRP) can be utilized to increase the quality and accelerate bone healing and should be be considered an attractive option for such purpose.
HOWEVER as the efficacy of PRP is dependent on various factors, the outcome of PRP therapy is variable and unpredictable in orthopedic patients. Therefore, it is still too soon to suggest PRP as the first line treatment option in complicated bone injuries such as LBDs and non-unions. However, combination of PRP with natural and synthetic biomaterials can enhance the effectiveness of PRP.1
PRP Helps Bone Growth
Three recent studies are suggesting that Platelet Rich Plasma (PRP) Therapy is effective for bone growth and Osteochondral Lesion Repair if prepared and administered correctly.
Researchers at the University of Connecticut set out to discover how different Platelet Rich Plasma Therapy (PRP) methods effected human muscle, cell and bone tissue.2 They sought to recommend a standardized platelet concentration (the optimal amount of blood platelets reintroduced into the arthritic joint).
They found that PRP helps bone, muscle, and tendon cells proliferate no matter the cell concentration level. This proliferation leads to healing of damaged tissue and curing of chronic pain and injury.
PRP Helps with Osteochondral Lesions
Recently, the American Journal of Sports Medicine published an article on the use of PRP for osteochondral lesions.3 The results were great and the researchers concluded that, “in our hands, PRGF [platelet-rich growth factors, a form of PRP] has now become the first line of nonoperative treatment in these lesions.”
This study looked specifically at osteochondral lesions of the talus bone of the ankle. 29 patients age 18-60 participated in the study and they received either Hyaluronic Acid (HA) injections or PRP injections. While both HA and PRP decreased pain scores and increased function, PRP had significantly higher scores. Given that the traditional treatments of immobilization, bracing, and NSAIDs are often unsuccessful, the researchers were encouraged by these results, especially given that surgery is the only other option once conservative treatments fail.
In a third study, doctors found that following extraction of benign giant cell tumors and resulting large defects, that a PRP gel accelerated healing and growth of bone and achieved good functional results without promoting local recurrence.4
As PRP gains popularity, it is important to remember that PRP is just one proliferant available for the regenerative injection therapy that is Prolotherapy. A skilled Prolotherapist can use numerous proliferants depending on the severity of the pain or injury. Dextrose, PRP, and stem cells from bone marrow or adipose tissue all provide regenerative therapy that is effective and safe, leading to permanent healing of chronic pain and sports injury.
1. Oryan A, Alidadi S, Moshiri A. Platelet-rich plasma for bone healing and regeneration. Expert Opin Biol Ther. 2015 Nov 11. [Pubmed]
2. Mazzocca AD, et al. The Positive effects of different Platelet-Rich Plasma methods on human muscle, bone and tendon cells. Am J Sports Med August, 2012 40.8: 1742-1749.
3. Mei-Dan O, Carmont MR, Laver L, Mann G, Maffulli N, Nyska M. Platelet-Rich Plasma or Hyaluronate in the management of osteochondral lesions of the talus. Am J Sports Med 2012 40: 534.
4. Mattiello A, Cacciapuoti C. Autologous Platelet Gel Improves Bone Reconstruction of Large Defects in Patients with Bone Giant Cell Tumors. In Vivo. 2015 09-10;29(5):533-540.