CHRONIC TENDINOPATHIES AND PLATELET-RICH PLASMA TREATMENT: HOW TO IMPROVE THE EFFICIENCY?

Introduction/Background
Platelet-rich plasma (PRP) is blood plasma with a high concentration of autologous platelets which constitute an immense reservoir of growth factors. The clinical use of PRP is widespread in various medical applications.

Material and Method
In a literature review, we take a closer look at eight parameters which may influence the quality of PRP: 1) anticoagulants used to preserve the best platelet function, 2) the speed of centrifugation used to extract the platelets, 3) the platelet concentrations obtained, 4) the impact of the concentration of red and while blood cells on PRP actions, 5) platelet activators encouraging platelet degranulation and, hence, the release of growth factors, and 6) the use or nonuse of local anesthetics when carrying out infiltration. In addition to these parameters, it may be interesting to analyze other variables such as 7) the use of ultrasound guidance during the injection with a view to determining the influence they have on potential recovery.

Results
Analysis of the 59 studies shows that a majority use ACD-A as an anticoagulant during sampling. The best results have been obtained in studies which use no platelet activator. In terms of the speed of centrifugation, analysis of all these studies appears to confirm the existence of a great number of protocols in the literature. It is difficult to draw any conclusions when these different variables are unknown (volume of initial sample, equipment used to obtain the PRP). Although it would appear inadvisable to administer a local anesthetic Finally, it appears to be advisable to carry out infiltration under ultrasound guidance.

Conclusion
Our study helped identify features of PRP recommended a platelet concentration lower than 5 times the baseline (from 3 to 4), and avoiding leukocytes and erythrocytes. We recommend leveraging this information about PRP for future studies.