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Lana JF, Macedo A, Ingrao ILG, Huber SC, Santos GS, Santana MHA. Leukocyte-rich PRP for knee osteoarthritis: Current concepts. J Clin Orthop Trauma 2019; 10:S179-S182. [PMID: 31700210 PMCID: PMC6823820 DOI: 10.1016/j.jcot.2019.01.011] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 12/12/2018] [Accepted: 01/14/2019] [Indexed: 01/15/2023] Open
Abstract
Knee osteoarthritis is a major painful and debilitating orthopaedic disease affecting a large number of adult individuals on a global scale. Over the years, this severe condition has been widely studied and while many alternatives have been utilized, platelet-rich plasma (PRP) remains one of the most popular solutions among researchers and clinicians alike. While there are different formulations and techniques involved in the preparation of PRP, produced either manually or via the use of commercial kits, the presence of leukocytes in a PRP mixture is a factor that raises concern due to their well-known pro-inflammatory activity. Although it is reasonable to worry about this, it should be taken into consideration that in order for the healing process to occur, the inflammatory phase is necessary. Leukocytes present in the inflammatory phase release both pro and anti-inflammatory molecules and, when combined with activated platelets, their potential increases. Additionally, due to the macrophage's plasticity to switch from the subtype 1 to subtype 2, it is suggested that the inclusion of the components from the buffy coat layer in a PRP mixture, classifying it as leukocyte-rich platelet-rich plasma or L-PRP, may provide benefits instead of detriments, from a standpoint of the regenerative potential of PRP.
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Affiliation(s)
- José Fábio Lana
- The Bone and Cartilage Institute, Presidente Kennedy Avenue, 1386 – 2nd floor, Room #29 – Cidade Nova I, Indaiatuba, SP, Brazil
| | - Alex Macedo
- The Bone and Cartilage Institute, Presidente Kennedy Avenue, 1386 – 2nd floor, Room #29 – Cidade Nova I, Indaiatuba, SP, Brazil
| | - Icaro Lanzoni Gallo Ingrao
- The Bone and Cartilage Institute, Presidente Kennedy Avenue, 1386 – 2nd floor, Room #29 – Cidade Nova I, Indaiatuba, SP, Brazil
| | - Stephany Cares Huber
- The University of Campinas, Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil
| | - Gabriel Silva Santos
- The Bone and Cartilage Institute, Presidente Kennedy Avenue, 1386 – 2nd floor, Room #29 – Cidade Nova I, Indaiatuba, SP, Brazil,Corresponding author. Indaiatuba, São Paulo, 13334-170, Brazil.
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